Alan Gaby, MD had a great line the progression of poor health in America. He said it was a sequence, “Big Mac, Zantac, Prozac”. In other words, you eat junk, you develop digestive problems (reflux) and eventually, through the lack of necessary cofactors and nutrients, the nervous system is affected, creating depression.
GERD is an acronym for gastroesophageal reflux disease. And, according to Dr. Gaby’s model, your patient with reflux may have some issues with diet and lifestyle. Obesity has been linked to GERD, the recent rise in the obesity epidemic may have led to an increase in GERD hospitalizations. In fact, a recent Healthcare Cost and Utilization Project Statistical Brief shows that the obesity epidemic has had a profound effect on hospitalizations. Between 1996 and 2004, the number of hospitalizations with obesity diagnoses increased by 112% while all other hospitalizations increased by only 13%.
All patients do not have the same symptoms, but they may have some or even all of the following:
- Heartburn (the most common symptom; a rising, burning sensation in the chest
- Sour or bitter taste from regurgitation of stomach contents
- Difficult or painful swallowing
- Chronic sore throat
- Waterbrash (sudden excess flow of saliva)
- Bad Breath
GERD can also lead to inflammation of the gums and erosion of tooth enamel. The drugs that are taken for GERD are designed to limit hydrochloric acid production. This is problematic because hydrochloric acid is needed to suppress bacteria (which can cause gastritis). As pointed out in the article on the front page, the medication may be linked to osteoporosis and hip fracture. Suppressing acid production can interfere with the absorption of important nutrients, especially minerals and amino acids.
Americans spend around $10 billion per year treating GERD. Up to 60% of the population at some time during the year, and 20% to 30% weekly, experience symptoms of GERD. More serious complications may emerge, such as the precancerous condition known as Barrett’s esophagus, as well as esophageal adenocarcinoma.
The most common treatment is to use drugs that suppress acid production. The problem with medication is that ALL of them have side-effects. Certain medications for reflux may increase your chance of getting osteoporosis. Use of the drugs has been linked to hip fracture in people over 50, according to research appearing in the Journal of the American Medical Association (2006;296:2947-2953). What is most shocking is what University of Michigan researchers found—A study performed on mice done by researchers from the University of Michigan Medical School at the Howard Hughes Medical Institute showed that acid suppressing medications (proton pump inhibitors, like Prilosec and Prevacid) actually contribute to bacterial overgrowth, and may actually aggravate the condition that they are designed to treat.
SEEMS COUNTERINTUITIVE, BUT SOMETIMES HYDROCHLORIC ACID IS NEEDED.
Many people who have acid reflux actually are not producing enough stomach acid. This is controversial, traditional medicine does not recognize underproduction of HCl as a health problem. Many times, however, giving HCl helps the pylorus to relax, facilitates stomach emptying and keeps the contents out of the esophagus.
Patients who need HCl often have symptoms: Fingernails break easily; gas or bloating immediately after a meal; distaste for meat; vitamin supplements cause nausea; coated tongue (there are other causes of this); itchy anus (there are other causes of this).
There are a number of health issues that have been linked to underproduction of hydrochloric acid—at least in the natural health community. These include:
- Depression (Neurotransmitters are made from amino acids—HCl is necessary to break protein down into amino acids.)
- Arthritis (Protein is incompletely broken down, so the body steals from the joints to fill its need.)
- A variety of digestive problems, including irritable bowel, constipation, diarrhea and Candidiasis
Patients should not take hydrochloric acid supplements on your own. They need to discuss it with a health professional.
CAN A GOOD FOOD BE BAD FOR YOU?
Sometimes hidden food sensitivities can be the cause of reflux symptoms. Usually the food is one that is eaten every day. Seldom does the patient associate this food with the symptom, but very often giving up the food produces relief. There are different ways to find and deal with food sensitivities. Sometimes lab tests are performed, sometimes muscle tests are used and sometimes just a trial avoidance of the suspected food works.