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Too much reflux medicine carries a risk

April 10, 2012

Or you could drink Evamor Alkaline Artesian Water. Evamor has been scientifically proven to help with acid indigestion.

CREDIT: COURIER-JOURNAL.COM
by Drs. Kay Judge and Maxine Barish-Wreden

Gastrointestinal reflux disease, better known as “GERD,” is a growing health care concern in the United States, as well as Europe, Asia, and South America.

Data from the 2007 National Health and Wellness Survey suggest that 23 percent of all people in the United States and Europe report intermittent GERD symptoms, and of those, 39 percent have symptoms at least two days per week.

Acid-reducing medicines like Aciphex and Nexium (aka PPIs, or proton pump inhibitors) are among the most heavily prescribed drugs in the U.S. We spend gargantuan amounts of money on these drugs, both the prescription versions as well as the over-the-counter variety. In 2010, more than $6 billion was spent on Nexium alone, second only to Lipitor, for which we spent $7.2 billion (data from the Institute for Healthcare Informatics).

These drugs may be useful to help quench the gastric fires that we stoke with our fast food diets, but used chronically, they can be troublesome.

We need stomach acid to absorb many of our nutrients, so chronic suppression of stomach acid can lead to depletion of a number of important minerals and vitamins, including calcium, magnesium, iron, zinc, sodium, beta-carotene, vitamin B1, vitamin B12, folate, vitamin C and possibly vitamin D. Acid in the stomach also helps protect us from bacterial infections.

Although short-term use is likely safe, taking these drugs routinely for more than a year raises the risk of osteoporosis, hip fracture, cardiac rhythm disturbances, pneumonia, kidney disease, bacterial overgrowth of the stomach and small intestine, and infectious colitis of the large intestine.

In February, the FDA issued a warning stating that use of PPI meds can increase the risk of Clostridium difficile colitis, a potentially life-threatening form of infectious diarrhea.

Another problem with these medications is that once you start them, they often are difficult to stop — tossing those pills often leads to rebound acid reflux, making you want to reach for the pill bottle again.

OK, that’s the bad news. But here’s the good news: there are a number of alternative remedies that can help with stomach acid in the first place, and also help you to get off these meds if you are having a hard time stopping them:

• DGL is a form of herbal licorice that is effective for heartburn and excess stomach acid; it also can help you to wean off PPIs. When taken at the same time as aspirin and other anti-inflammatory meds, it can significantly reduce damage to the stomach lining.

For heartburn or if trying to wean off acid meds, chew 600-800 mg 20 minutes before meals for 6-8 weeks, then try to reduce the dose to 300-400 mg as needed.

• Many other herbs can help to soothe the gut, including peppermint, chamomile, caraway, milk thistle and lemon balm. They can be used as teas or as herbal supplements.

A product from Germany called Iberogast contains a mixture of these herbs, and has been found to be very effective for both GERD and irritable bowel syndrome.

• Turmeric is a powerful anti-inflammatory medicine that also may help reduce GERD symptoms; the active ingredients in turmeric are known as curcumins.

One study using 162 mg of curcumin twice daily for 4 weeks showed that patients experienced significant relief from dyspepsia and irritable bowel symptoms. Improvement was noted after patients had been on the curcumin for one week.

• Ginger can also reduce GERD symptoms by helping move food out of the stomach and into the intestines; try drinking ginger tea 3 times daily, or take dried ginger in capsule form, about 500 mg twice daily.

• A recent study in China showed that acupuncture was effective at reducing reflux and alleviating symptoms in patients with GERD. The benefit was similar to a group of patients who received Prilosec 20 mg twice daily.

• Chewing gum for one hour after a meal has been shown to reduce acid reflux.

• Stress makes acid reflux worse by reducing the movement of food out of the stomach; deep-breathing exercises, hypnosis and meditation can all help to reduce symptoms from GERD.

Of course, don’t forget about lifestyle changes to help prevent a fiery gut in the first place.

Being overweight increases your risk of reflux. Spicy/fatty foods, heavy meals, and alcohol also can increase symptoms, while a high-fiber diet tends to prevent symptoms.

Finally, if you are being treated with PPIs and you would like to try and wean off them, don’t stop any prescription medications without first speaking with your physician.

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