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Do you have acid reflux or the more serious form called gastroesophageal reflux disease? (GERD) This is one of the most prevalent digestive conditions treated by gastroenterologists and primary care physicians. Typical symptoms include heartburn, regurgitation, and throat pain, while less common symptoms might include coughing, chest pain, and wheezing. The prevalence of GERD varies greatly between continents; in North America, the prevalence is highest and is estimated to affect as many as 28% of adults.
With GERD, there is a backwash of stomach acid into the esophagus, and in more extreme cases, into the mouth. This irregularity happens due to the lower esophageal sphincter (LES) not working properly. Usually when someone swallows, the LES relaxes and allows food and liquid to flow into the stomach. The LES subsequently tightens again to keep the stomach content in the stomach. When the LES relaxes too much or weakens, it does not prevent stomach acid from moving up into the esophagus.
The most common risk factor for GERD is being overweight as it creates pressure on the LES. Other increasing factors include:
The most commonly prescribed medications for GERD are proton pump inhibitors (PPIs). PPIs currently available with prescription in the USA are: dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex).
These drugs reduce stomach acid secretion. They can be successful in reducing GERD yet they are not recommended for long term use. The most common side effects are headache, diarrhea, nausea, and vomiting.
And there is more concern, a study by the U.S. Department of Veterans Affairs, which found PPI use was linked to deaths, in particular from cardiovascular disease, chronic kidney disease, and upper gastrointestinal cancer. That study was performed in a large cohort that included over 157,000 PPI users and nearly 57,000 users of H2 blockers-- which is a different type of stomach acid suppressor. Among the lead researchers of that study was Ziyad Al-Aly, MD, assistant professor of medicine at the Washington University School of Medicine in St. Louis. He stated his worries that "Given the millions of people who take PPIs on a regular basis, this equates to countless excess deaths every year." In addition, because many people take PPI drugs long-term, he warned: "Taking PPIs over many months or years is not safe, and now we have a clearer idea of the health conditions linked to long-term PPI use."
Your body is made to use stomach acid to break down food and help in the absorption of particular nutrients. Also, hydrochloric acid triggered the protein digestive enzyme pepsin. The reduction of hydrochloric acid makes a person prone to bad protein digestion, imbalance in gut flora, and nutrient deficiencies.
PPIs can cause the following nutrients to be deficient:
In addition, PPIs increase the likelihood of these diseases:
Eighty-five of the patients were treated with PPIs, while 88 other patients followed a Mediterranean-style diet (restricting animal products more than normal) and also drank alkaline water. Also, both groups avoided foods known to usually trigger acid reflux like coffee, tea, soda, greasy and fatty foods, chocolate, spicy foods, and alcohol. Remarkably, the researchers found that of those that made the diet adjustments, 62.6 percent showed a clinically meaningful improvement, while of those taking PPIs, 54.1 percent showed a clinically meaningful improvement. The decrease in reflex symptom index also was significantly better in the diet group (39.8%) than in the PPI group (27.2%). The benefit of the Mediterranean Diet with GERD might be connected to its effect on the LES given that dietary intake impacts LES pressure.
