Popping Pills for Heartburn?
Try Diet and Exercise Instead
Whether its blood pressure, Type 2 diabetes, high cholesterol or gastric reflux, my experience has been that most people would rather just take a pill than actually change their diet and exercise regularly. Yet every medication has side effects, some of which can be worse than the disease itself. Drugs considered safe when they were first marketed can turn out to have severe side-effects that only become apparent after millions of people take them for a long enough time.
Such is the case with a popular class of drugs known as proton pump inhibitors or PPIs, now used by more than 6 million Canadians. They go by names such as omeprazole, pantoprazole, Nexium, Pantoloc, Prilosec and many more. These are all used to treat an increasingly common ailment: acid reflux, which many people refer to as heartburn or indigestion.
These medications are now linked to a growing number of complications, ranging in seriousness from nutrient deficiencies, joint pain and infections to bone fractures, heart attacks and even dementia. While not every person who takes these drugs may suffer any of these conditions, consumers plagued by acid reflux would be wise to consider an alternative approach, namely diet and lifestyle changes that can minimize symptoms and even heal damage already done.
Acid reflux is more than just as nuisance. It involves the backward flow of stomach acid into the tissues above it. It results when the lower esophageal sphincter, a ring of muscle between the esophagus and the stomach, fails to close tightly enough to prevent the contents of the stomach from moving up instead of down. Sometimes, the upper sphincter, between the esophagus and the throat, malfunctions as well.
Acid reflux is a serious disorder that can and must be treated to prevent symptoms and stave off potentially life-threatening consequences. Known medically and commercially as GERD, the acronym for gastroesophageal reflux disease, repeated bathing of the soft tissues of the esophagus with corrosive stomach acid can seriously damage them and even cause esophageal cancer, which is often fatal.
Contrary to what many believe, heartburn is but one of the many symptoms of GERD, and failure to recognize the others when heartburn is not among them can result in harmful untreated reflux. In addition to indigestion, GERD can cause a persistent dry cough, sore throat, frequent throat clearing hoarseness, burping or hiccups, bloating, difficulty swallowing and a sensation of a lump in the throat.
If you find yourself faced with some of those symptoms and no known reason for them and your doctor fails to think of GERD, then you might suggest it yourself. An examination of the esophagus may be the only way to find out if someone without obvious heartburn has acid reflux but doesn’t know it.
One characteristic often associated with acid reflux—being overweight, especially with abdominal obesity—largely explains why the condition has become so common in North America. Somebody with a body mass index in the overweight range is almost twice as likely to have GERD as a person of normal weight. Losing weight is one of the best ways to find relief without having to rely on medication.
Quitting smoking, limiting alcohol and avoiding carbonated drinks are also important protective measures. Smoking and alcohol can loosen tension of the upper esophageal sphincter and cause symptoms of reflux such as hoarseness, postnasal drip and shortness of breath by irritating the mouth, larynx and trachea.
Eating big meals, lying down before a meal is digested and exercising too soon after eating can also trigger symptoms. Reflux sufferers are often advised to eat five or six small meals a day rather than two big ones, and to avoid eating within three hours of bedtime. For further protection, the head of the bed can be raised 15 centimeters or more.
But, while certain foods, such as raw onions, garlic, citrus juices, coffee and chocolate are likely to cause reflux in most people with the condition, it is important to know that we are all different and trial and error is the best way to determine the food and drinks that trigger your reflux. I usually recommend keeping a food diary for a week or two, recording everything you eat and the timing of the symptoms in order to identify your trigger foods.
A food does not have to be obviously acidic to be troublesome. High-fat foods are problematic for many people because they take a long time to digest. Also many commercially produced foods and drinks are treated with acid-containing substances to enhance flavour and shelf life. There is a 28 day “healing” diet” which consists almost entirely of natural, unprocessed foods, especially lean-protein foods such as white meat poultry, fish, egg whites and low-fat dairy, beans (combined with whole grains) and non-acidic vegetables and fruits.
High-fibre foods are very helpful, second only to eliminating acidic foods. Fiber enhances digestion, reducing pressure on the lower esophageal sphincter and can aid in weight loss and maintenance, among other benefits such as reducing inflammation. Try to eat a pound of vegetables each day, half of which are cooked and the other half eaten raw, as well as half a pound of raw fruit. Good sources include broccoli, carrots, beets, green leafy vegetables, apples, berries, bananas, avocados and pears. Include almonds, walnuts, lentils, chickpeas and lima beans.
In the health food store you can buy broad spectrum digestive enzymes to treat your GERD. Normally your saliva and stomach acid start the digestive process but this only accounts for ten per cent of digestion. Once your stomach empties, your enzymes in the upper and lower intestines break down the rest of the food. Plant enzymes taken before a meal can start the process early in the stomach so it receives a signal that much less acid is needed in the initial phase of digestion. This does the same job as proton pump inhibitors, only naturally.
If nothing else works, then then you may need a proton pump inhibitor but take it in the lowest dose possible and for a very short period of time. Almost 80 per cent of people are taking these powerful meds incorrectly. They should be taken 30 to 60 minutes before eating breakfast or dinner (or both), but not used as an “antidote” to consuming acidic foods.
If you have gastric reflux, the stress of the Christmas season can only make it worse. Try and control your diet and do as much as you can to avoid symptoms so you can enjoy the holiday spirit.