Treatments
For occasional relief of heartburn (once or twice a month), nothing beats antacids, which neutralise the stomach acid that has splashed up into your oesophagus. They're also cheap, effective and remarkably fast acting. You're undoubtedly familiar with brands that have become household words: Alka-Seltzer, Mylanta and a host of others--along with their generic equivalents. If you're taking any prescription medications, check with your doctor or pharmacist before trying an antacid because it can block the absorption of certain drugs.
>SOME DOCTORS TREAT HEARTBURN conservatively at first, especially in milder cases. They start with antacids, progress to H2 blockers like Zantac and then finally to prescription drugs. Other experts, however, are bucking this trend and moving directly to prescription proton pump inhibitors (drugs that slow your stomach's production of acid) even for milder cases of GORD. Their reasoning is that these drugs are more effective, and need to be taken only once a day.
Lifestyle changes
Doctors have found that lifestyle changes alone can reduce or eliminate GORD symptoms in about half of those who live with them. So once you get the pain and burning under control, set your sights on changing the habits that may have caused the problem in the first place. Some things you can do include:
HIATUS Hernia
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If you were to check for a hernia, you'd probably look around your abdomen for the telltale bulge. But one type of hernia isn't so easy to spot--and some doctors think it may be a major reason you develop gastro-oesophageal reflux disease (GORD).
A hiatus hernia happens when a portion of your stomach protrudes through an opening in your diaphragm (the muscular wall separting your chest from your abdomen). Its origin isn't always known--it may be something you were born with or perhaps the result of a trauma such as a car accident. What ever its cause, doctors surmise that it may weaken the sphincter that leads into your stomach and cause acid to back up into your throat, leaving you with heartburn. One interesting fact: many people with hiatus hernia have no heartburn, and most people with heartburn do not have hiatus hernia.
The surprsing thing is how common it is: more than 40 percent of people have a hiatus hernia, though few are aware of it. If you seem to be suffering from moderate to severe heartburn, make sure your doctor checks you for this type of hernia. In the worst cases, a surgeon can operate to reduce its size.
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gastric juices. The nicotine in cigarettes also relaxes the lower oesophageal sphincter, which makes it even easier for acid to backflow.
There are multitudes of treatment options for those with heartburn or GORD. The right choice for you will depend on how often you experience symptoms and how seriously your oesophagus has been damaged. Therapies range from simple diet 'don'ts' and over-the-counter antacids and H2 blockers to prescription drugs that control oesophageal movement or turn off the production of stomach acid. In severe cases, surgery may be needed to get the lower oesophageal sphincter to behave itself once and for all.
MedicationsFor occasional relief of heartburn (once or twice a month), nothing beats antacids, which neutralise the stomach acid that has splashed up into your oesophagus. They're also cheap, effective and remarkably fast acting. You're undoubtedly familiar with brands that have become household words: Alka-Seltzer, Mylanta and a host of others--along with their generic equivalents. If you're taking any prescription medications, check with your doctor or pharmacist before trying an antacid because it can block the absorption of certain drugs.
>SOME DOCTORS TREAT HEARTBURN conservatively at first, especially in milder cases. They start with antacids, progress to H2 blockers like Zantac and then finally to prescription drugs. Other experts, however, are bucking this trend and moving directly to prescription proton pump inhibitors (drugs that slow your stomach's production of acid) even for milder cases of GORD. Their reasoning is that these drugs are more effective, and need to be taken only once a day.
WHAT-AND HOW-YOU EAT MATTER'S
If you never ate, you'd never have heartburn. But that's not possible or sensible, so the best option is to work out how food affects you. And it's worth the effort: one study found that an altered diet led to improvement in almost half of people with the other lifestyle changes mentioned here, your chances of beating GORD are excellent.
Try the following:
- Give up large meals. When you overeat, the extra food pushes, back up into your oesophagus. So instead of three large daily meals, switch to four to six smaller ones, but be sure to three hours before bedtime.
- Chew slowly an thoroughly. Doing so makes it easier for your body to speed the food through your digestive system, giving it less time in your stomach.
- Avoid high-kilojoule, fatty foods. Research shows high level of dietary fat increase a sensitivity to heartburn.
- Steer clear of common triggers. These include mint, coffee, alcohol, citrus fruit, tomatoes, chocolate, spicy foods and carbonated drinks.
Alginic acid (Gavison and other brands) is a unique antacid specifically designed for heartburn. This drug works by mixing with your saliva and gastric juices to form a foam, which floats to the top of your stomach and up into your oesophagus. While other antacids move forwards into your small intestine, Gaviscon's backwards foam can neutralise oesophageal acid within minutes.
If you're experencing heartburn throughout the day, the next step is histamine (H2) blockers, which reduce acid production. These drugs include cimetidine (Tagamet), famotidine (Pepcidine), nizatidine (Tazac) and ranitidine (Zantac). Although they take longer to kick in than antacids--up to 90 minutes--H2 blockers make up for it by lasting for about 12 hours. Many people need two doses a day, and usually it's best to take one of them at bedtime, when heart-burn symptoms are the most intense. You can also use H2 blockers in combination with antacids, getting immediate relief from one while waiting for the longer-term effects of the other. Prescription-strength H2 blockers are also available.
If the over-the-counter drugs aren't working, your doctor may suggest a proton pump inhibitor (also called an acid pump inhibitor), such as omeprazole (Losec) or pantoprazole (Somac). This type of drug works by inhibiting the mechanism, or 'pump', your stomach uses to excrete acid and has been shown to improve symptoms in up to 80 percent of those with GORD. Finally, if none of these drugs help, you may need a prescription prokinetic agent, such as metoclopramide (Maxolon). It strenghtens your struggling sphincter and helps to move food through your stomach more quickly.
>What exactly is Barrett's oesophagus?
This condition, named after British Surgeon Norman Barrett, is a complication of GORD that appears only in a small number of people. It occurs when the cells lining the oesophagus are over-exposed to gastric juices, become permanently damaged and enter a precancerous state. Some people with Barrett's oesophagus cancer. For that reason, it's a good idea to have an endoscopy if you've had heartburn for more than a few years.
A doctor will slip a thin, lighted tube down your throat to check for any signs of cancer. One study from the University of California at San Francisco found that oesophageal cancer caught early by endoscopy led to much higher survival rates over five years.
Doctors have found that lifestyle changes alone can reduce or eliminate GORD symptoms in about half of those who live with them. So once you get the pain and burning under control, set your sights on changing the habits that may have caused the problem in the first place. Some things you can do include:
HIATUS Hernia
------------------------------------------------------------------------------------------------------------------------------
If you were to check for a hernia, you'd probably look around your abdomen for the telltale bulge. But one type of hernia isn't so easy to spot--and some doctors think it may be a major reason you develop gastro-oesophageal reflux disease (GORD).
A hiatus hernia happens when a portion of your stomach protrudes through an opening in your diaphragm (the muscular wall separting your chest from your abdomen). Its origin isn't always known--it may be something you were born with or perhaps the result of a trauma such as a car accident. What ever its cause, doctors surmise that it may weaken the sphincter that leads into your stomach and cause acid to back up into your throat, leaving you with heartburn. One interesting fact: many people with hiatus hernia have no heartburn, and most people with heartburn do not have hiatus hernia.
The surprsing thing is how common it is: more than 40 percent of people have a hiatus hernia, though few are aware of it. If you seem to be suffering from moderate to severe heartburn, make sure your doctor checks you for this type of hernia. In the worst cases, a surgeon can operate to reduce its size.
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gastric juices. The nicotine in cigarettes also relaxes the lower oesophageal sphincter, which makes it even easier for acid to backflow.
- Shed the extra kilos. Studies have shown time and again that GORD accompanies girth. A pot belly often pushes upwards against the stomach and forces acid into the oesophagus.
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