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One of the most common ailments is heartburn, or gastroesophageal reflux disease (GERD).  The most common symptom is a burning sensation in the area of the heart that can radiate towards the throat, neck, or back.

In order to be properly diagnosed with GERD, the person must have symptoms causing complications that adversely affect his well being.  The medical world also defines “frequent” heartburn as occurring on two or more days per week.

Experts estimate that 40% of adults have monthly heartburn, 7% to 30% have weekly heartburn, 8% to 26% have heartburn two to three times a week, and 7% to 10% have daily heartburn.

The small, round muscle located where the esophagus meets the stomach is called the lower esophageal sphincter (LES).  The LES opens to allow food to pass, then is supposed to remain closed while food is in the stomach.  Sometimes, the LES does not close off completely and acid will reflux back into the esophagus, causing the burning sensation and pain.

A few medical conditions are known to increase the chances of having GERD.  These include pregnancy, obesity, slowed stomach emptying, and hiatal hernia.  During the day, gravity can help keep the acid down but once the person lays down at night, the stomach acid can leak upward it the LES does not close properly.

The first step in avoiding GERD is to avoid foods that cause the problem.  The common GERD causing foods are coffee, alcohol, chocolate, citrus, carbonated beverages, fatty foods, and spicy foods.  Some lifestyle changes include; losing weight, avoiding alcohol and tobacco, raising the head of the bed, eating small meals, eating the last meal at least four hours before bedtime, and remaining upright for at least two hours after eating.

Going the medicine route, there are a couple choices for you:

To just treat symptoms as they occur, an over the counter antacid can be a good choice.  If the symptoms persist for more than two weeks, contact your doctor.  Products like Maalox, Mylanta, Rolaids, or Tums contain calcium carbonate that will neutralize the acid shortly after taking it.  Calcium carbonate works quickly but does not last very long.  On the down side, calcium can stimulate the stomach to produce more acid after a short period of time.

H2 antagonists like Pepcid, Zantac, Axid, or Tagamet have a slower onset of action but work for a longer period of time.  They all have about the same effectiveness and can be good to use before a meal.  These should also not be used for more than two weeks without seeing your doctor and are not to be used while pregnant or breastfeeding.  Tagamet has several drug interactions that you should be made aware of by your pharmacist.

The final over the counter remedy is the proton pump inhibitors.  The two available are Prilosec OTC and Prevacid 24HR.  These are the slowest acting but last the longest.  They shouldn’t be used by anyone under 18 years of age or women who are pregnant or breastfeeding.  Prilosec and Prevacid are only recommended for people who have frequent heartburn and neither should be take for more than 14 consecutive days.

If you would like some other options to treat your heartburn, here are some suggestions:

Sodium bicarbonate tablets are very cheap and you can buy them at just about any pharmacy.  They work almost instantly to knock down the stomach acid.  Another trick is dissolve a teaspoonful of plain old baking soda in water and drink that down.  Both these suggestions, as well as the medication route, neutralize stomach acid so you cannot properly digest food.  The acid is there for a reason, you need it.

Many people, believe it or not, do not make enough stomach acid.  These symptoms present themselves very similarly to heartburn.  This can be quickly solved by taking a spoonful of lemon juice or vinegar.  Those can be tough so I recommend a small glass of pickle juice.  It takes a couple minutes to get a result, but if you find relief, you know the problem is low stomach acid.

To fix this problem, you first need to take Probiotics to get the beneficial bacteria back into your gut.  Next, try some digestive enzymes with meals and some Betaine (hydrochloric acid) after meals.  Just taking medication could decrease your ability to digest your food leading to deficiencies in certain vitamins and minerals.

I have a theory as to why many people get heartburn as they get older.  Have you noticed that children rarely have acid reflux?  That’s because the LES is still strong.  As we age, we have a tendency to overeat and stuff our stomachs with food.  Doing this over and over and over, weakens the LES so it cannot hold the acid down as well as it used to.  You have to control how much food you put into your stomach.  It is overeating that is causing the LES to weaken and for the acid to come back up.  Also, when you have low acid, your stomach is trying to pump out more acid even after the food has left the stomach.

It’s up to you whether you want to chose the medication route or a more natural way to get rid of this problem.  Also, when you go the medication route, there are not only side effects that you have to consider, but when you decrease acid in your stomach, it changes the pH of your stomach and therefore alters the absorption of everything you eat, including all your vitamins and minerals in the foods.  Long term use could theoretically cause multiple vitamin and mineral deficiencies.

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