Posted by on May 3, 2011 - 10:11am

Most of us get heartburn from time to time. It may come as a burning sensation in the chest, or a bitter taste in the back of the throat. Heartburn is one word people use to describe reflux. It happens when stomach contents come back upwards. Reflux is sometimes painless: You may have trouble swallowing or get a dry cough, perhaps some wheezing.

Occasional reflux episodes are normal. Like millions of Americans, you can manage reflux by avoiding foods that don’t agree with you—things that are fatty, spicy or acidic—or by eating smaller meals. If reflux occurs less than once a week, you can usually cope by making lifestyle changes or using over-the-counter medications.

“We all have a little reflux when we burp or belch,” says Dr. John Pandolfino of Northwestern University. But of the 20 million or more Americans with reflux, about 5% have significant episodes 2 or 3 times per day. When severe events occur this often, it’s not ordinary reflux. It may be gastroesophageal reflux disease (GERD). You may need prescription medications to control it.

Surprisingly, there is very little data addressing sex differences in GERD--and perhaps this is one condition where sex differences only play a small role.  In the few studies that do exist, it appears that the overall incidence of heartburn, regurgitation, non-cardiac chest pain, and wheezing was the same in both sexes though there may be a higher intensity and frequency of symptoms in women but the clinical significance is not clear.   Heartburn is more prevalent during pregnancy and increases in each trimester but that  is believed to be due to anatomic changes such as the pressure of the expanding uterus or, possibility, something to do with progesterone level during pregnancy. It usually goes away after pregnancy.   Obesity and body mass index seems to increase the risk of GERD.

GERD should be taken seriously. Stomach (gastric) contents contain acid needed to digest food. In reflux, these contents wash upward into the esophagus, a slender tube connecting the mouth and the stomach. Because the lining of the esophagus isn’t meant to touch gastric acid, the acid can irritate the lining of the esophagus and lead to bleeding and scarring. In adults, GERD can raise the risk of cancer of the esophagus. And if you have asthma, GERD can make it worse.

As for babies, reflux is common in healthy infants. Most babies outgrow reflux by 13 months, but if they don’t, they too may have GERD.   GERD can harm a child’s ability to feed and grow. It can also increase the risk for inhaling stomach contents into the lungs which could be life-threatening.

People of any age can have GERD. Available medications, whether over-the-counter or prescription, can make the acid in the esophagus less intense. But medications don’t prevent GERD. Surgery can be an option if symptoms are severe and medicine and lifestyle changes don’t seem to help.  The problem isn’t that the stomach makes too much acid. In GERD, the special set of muscles between the esophagus and the stomach is weakened.  Scientists are beginning to look at how nerves receive and send messages to these muscles.

If you have reflux twice or more per week, talk to your health care provider. It’s best to start treatment early to prevent GERD from leading to more serious health problems.

How To Steer Clear of Reflux

Maintain a healthy weight.
Eat smaller meals.
Avoid triggering foods, including alcohol.
Don’t lie down for 3 hours after a meal.
Raise the head of your bed 6 to 8 inches by putting wood blocks under the bedposts.
For an infant, try burping frequently during feeding. Keep the infant upright for 30 minutes after feeding.
If you have reflux twice or more per week, see your health care provider.

Posted by on June 4, 2010 - 3:02pm

A recent publication from the National Osteoporosis Foundation reported that many women with postmenopausal osteoporosis underestimate their risk for fractures.  This is particularly alarming when it is coupled with new information released from the Food and Drug Administration (FDA) that found potential increased risk of fracture of the hip, wrist and spine if you take certain drugs for heartburn, acid reflux, or ulcers.

The drugs under study belong to a class of medications called proton pump inhibitors (PPIs), which work by reducing the amount of acid in the stomach.   They are available as prescriptions and as over-the-counter medications.  These drugs treat conditions like gastroesophageal reflux disease (GERD),  heartburn and ulcers of the stomach and small intestines.

Prescription PPIs include:    Nexium, Dexilant, Prilosec, Zegerid, Prevacid, Protonix, Aciphex and Vimovo. The over-the-counter PPIs are:   Prilosec OTC and Zegerid OTC (omeprazole), and Prevacid 24R (lansoprazole).

According to the FDA, consumers should:

  • NOT stop taking your PPI unless told to by your health professionals.  They are an effective treatment for many GI disorders.
  • Be aware that an increased risk of fractures of the hip, wrist, and spine have been reported in some studies with the greatest increased risk for these fractures among those who receive high doses of these medications or use them for a year or longer.
  • Read labels and follow instructions carefully and talk to your health provider if you have questions.
  • Be aware that the over-the-counter PPIs should only be used as directed for 14 days for the treatment of frequent heartburn.   If your heartburn persists, talk to your health professional.   No more than three 14-day treatment courses should be used per year.
  • Report any side effects from the use of PPIs to the FDA MedWatch Adverse Reporting Program.

To read the full FDA article click here.  Osteoporosis affects 8 million women and 2 million men in the U.S.