15, 2003 -- Anyone who’s watched TV lately can’t miss the many
commercials for heartburn medication. It’s a growing market because more
Americans are suffering from heartburn-related conditions. Still, pills
may not be the answer for everyone, and they’re not the best place to
Twenty-five percent to 30 percent of Americans suffer from frequent
heartburn. Heartburn is caused by stomach acid that backs up into the
esophagus--the tube that carries food from the mouth to the stomach.
between the stomach and the esophagus -- the lower esophageal sphincter
(LES) -- plays a major role. When working properly, the LES opens to
allow food into the stomach. In some people the LES becomes weak or
doesn't always close properly, allowing stomach acid to flow back up.
This can lead to varying degrees of heartburn and, in some cases,
gastroesophageal reflux disease (GERD).
there more cases of GERD than ever before? “We eat too fast, we eat too
much, and we eat the wrong things,” says Dr. David Peura, associate
chief of UVa’s Division of Gastroenterology and part of U.Va.’s
Digestive Health Center of Excellence. “We eat high-fat foods that
delay stomach emptying. We inhale our food rather than eat it, and we
often eat large meals at night. All of these things can provoke reflux.”
CANCER AND OTHER RISKS?
reflux of stomach acid can damage the lining of the esophagus, which
isn’t protected against the acid as the stomach is. It also may lead to
hoarseness, chronic cough, asthma, tooth decay and esophagitis--an
inflammation of the esophagus. The chest pain that accompanies heartburn
can feel similar to the most common sign of a heart attack.
GERD can cause serious damage, doctors are beginning to realize that the
threat of it leading to cancer is not as great as they had thought. “We
recognize that while that is a possibility, it’s far more the exception
than the rule,” says Peura.
factors may weaken the LES or increase the amount of acid in the
stomach. These include:
down or bending over after eating.
prevent heartburn, done eat “red light” foods (see photo), manage your
weight and don’t eat anything for three hours before bed time.
with mild or occasional episodes of heartburn can usually treat it with
over-the-counter antacids such as Tums or Mylanta. These medications
quickly neutralize stomach acids but work only for short periods of
severe heartburn, H2 blockers such as Tagamet, Pepcid, Axid and Zantac,
which don’t need prescriptions, reduce the amount of acid the stomach
produces and provide relief for up to 12 hours. Larger doses may require
are using either type of acid reducers regularly for more than two
weeks, you should see a doctor because you may need different treatment.
Food and Drug Administration (FDA) recently approved one popular drug
that suppresses production of stomach acid, Prilosec, for sale without a
prescription. That means it should be less expensive than other similar
prescription medications. However, Dr. Peura stresses that Prilosec
should not be taken for more than two weeks without a doctor’s