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Heartburn or GERD

Most adults have experienced occasional burning pain or pressure in the middle of their chest. It’s rarely a heart attack even though it seems to be in that area.
Two recent newsletters have different takes on treating heartburn or the chronic condition called GERD (gastro-esophageal reflux disease)
The November 2011 issue of Johns Hopkins Newsletter “Health After Fifty” tells of a European study comparing proton pump inhibitors such as Nexium, Prilosec or Prevacid with surgery that repairs the junction of the stomach and esophagus. Both prevented acid regurgitation for five years, but 18% of both groups had upper abdominal pain and some still had occasional heartburn. 57% of the surgery group and 40% of those on pills had flatulence and 40% and 28% had bloating. Proton inhibitors have been considered benign, but they can increase the risk of breaking hip, spine and wrist bones in persons over fifty.
Dr. Sydney Wolfe editor of Public Citizen’s “Worst Pills, Best Pills News” says that this and other side-effects of proton pump inhibitors (PPIs) can be life-threatening. If an elderly woman with osteoporosis breaks a hip it might be fatal. Decreased .stomach acid can allow harmful bacteria to get to the small intestine and cause infections. PPIs can lower magnesium and also decrease the effectiveness of several medications. PPIs can cause dependence because if you quit taking them your stomach produces even more acid. Dr. Wolfe says most people should first change daily routines and take anti-acids for relief as needed. PPIs should be the last resort.
I say that preventing these symptoms is best but then use the mildest method available to treat a temporary excess of stomach acid. You wouldn’t kill a mouse with a canon so resist the doctor’s suggestion that you need a proton pump inhibitor to prevent your stomach from making acid. Realize that drinking black coffee or hard liquor without food can cause your stomach to make acid. The main use of stomach acid is to break down proteins. If you have eaten too big a steak, it’s only natural for your stomach to make more acid and do a lot more churning that might cause some acid to be forced past the junction of your esophagus. You need that acid for proper digestion. Take an anti-acid for relief but be good to your stomach and be more moderate in the future.

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