September 26, 2011

What a problem in our country! Statistically, 50% of us suffer a bout of reflux/heartburn at least once a year. Many people suffer daily. The symptoms often present at night when laying down or after certain types of meals. The pain that you feel is caused by the acid in your stomach burning the esophagus after reflux occurs.

Traditional treatments involve blocking or suppressing the stomach's acid production. Historically, we thought that this was a good idea. Remember the commercials for antacids - take your blah blah blah medicine and eat your chicken wings. No worries. Fast forward to 2011 and that reality is flipped on its head. Studies are now showing that the acid blockade over the long term makes you feel better but also causes increased issues with digestion, allergy risk, infection risk and possibly the risk of cancer.

Our bodies produce acid for a reason. Removing it is messing with nature. Stomach acid activates protein digesting enzymes, kills foreign microbes and is necessary to absorb vitamin B12. Before we start long term acid suppression with drugs let us find the true issue by taking a good history and treat the real problem - whatever it may be. Short term acid suppressing drug use is reasonable while we find the root cause of the reflux.

Children in the first year of life with reflux rarely benefit from these drugs. Most pediatricians knew this, but it took a strong meta-analysis to analyze the data and prove it to us. Once again, the band aid approach has problems

What can we do to alleviate the symptoms? In most people the biggest culprits are poor nutrition, lack of exercise, and stress. Go figure.

The obvious answer is to reverse all three. Easier said than done! A new approach would entail working on all fronts simultaneously.

1) Increase exercise at any level with a goal to increase the amount weekly.

2) Diet - pursue an anti inflammatory diet to reduce irritation to the GI tract.

3) Add herbal remedies like DGL licorice and Turmeric to heal the stomach lining and reduce inflammation. See your physician for dosing,

4) Adding ginger to your diet will increase gastric emptying and reduce the food left to reflux.

5) Avoid eating 2 hours before bedtime.

6) Avoid tobacco and excessive alcohol intake.

7) Eat smaller/more frequent meals.

8) AVOID THESE FOODS - Saturated fat foods ( animal products), chocolate, caffeine - coffee/soda, red wine, citrus juice and tomato based foods. As always just avoid processed food!

9) Eat food with chili and turmeric - these herbs naturally mildly reduce stomach acid.

See the excellent link on GERD

In children less than a year old, I am looking for a food intolerance or anatomic defect for persistent symptoms. Do not settle for, "it is normal", if they are fussy when they "spit up". Dairy protein intolerance is a major cause of reflux and colic.

More on this common issue in the future.