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- $Unique_ID{BRK00181}
- $Pretitle{}
- $Title{How Do You Manage Heartburn Caused By Stomach Acid?}
- $Subject{heartburn GER reflux esophagus irritation Digestive System Stomach
- Acid Gastroesophageal carcinoma backflow gastric food foods Sedatives sedative
- Antiacids antacid H2 receptor antagonist antagonists Carafate}
- $Volume{I-10}
- $Log{}
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- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
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- How Do You Manage Heartburn Caused By Stomach Acid?
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- QUESTION: How do you manage heartburn caused by stomach acid?
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- ANSWER: Gastroesophageal reflux (GER), or heartburn, was once considered to
- be common and relatively nonthreatening, but it is now recognized as having
- serious effects on the lives of many patients and has been associated with
- carcinoma and other risky conditions. For this reason, diagnosis and
- management are of supreme importance, and this is no longer a problem to take
- lightly. Careful diagnostic workup is a must to be sure that it is, indeed, a
- condition caused by the backflow of acid into the esophagus. For the purposes
- of this answer, I am going to assume you are sure of your diagnosis.
- Basically, there are three therapeutic approaches for treating the
- condition--lifestyle modification, drug therapy, and surgical intervention.
- The initial approach should involve simple lifestyle changes alone, since they
- pose no risk for the patient, and since long clinical observation has
- determined they are beneficial practices for the general population on the
- whole.
- To begin with, patients suffering from heartburn should eat small,
- frequent meals and avoid the large evening meal which is so common in our
- country. GER disease has been associated with delayed gastric emptying and
- smaller meals can make gastric emptying more efficient.
- Food selection is another important factor in managing chronic heartburn.
- Certain foods such as animal fat and chocolate decrease the pressure in the
- lower esophageal sphincter which can produce heartburn. Therefore, patients
- should steer clear from foods high in fat, and eat foods high in protein which
- actually increase sphincter pressure.
- Patients should also be advised not to lie down immediately after eating
- since there seems to be a correlation between heartburn and body position and
- gravity. Raising the head of the bed from six to eight inches is advisable as
- well.
- Other lifestyle practices that effect heartburn involve certain
- over-the-counter drugs and medications. Sedatives and the deep sleep they
- produce cause a decrease in the swallowing reflex and should therefore be
- avoided. Other medications, such as calcium channel blockers used by cardiac
- patients, can cause heartburn as well.
- When symptoms persist after weeks of lifestyle modification, drug therapy
- may be necessary. Antiacids and H2 receptor antagonists are most frequently
- prescribed, producing results within the first week. Antacids have limited
- powers and are not valuable for prolonged therapy. However, they are
- recommended as a first drug approach. H2 receptor antagonists can offer
- considerable relief, with the longer-acting agents proving more effective than
- the shorter-acting ones. In aggravated cases, these drugs should be taken for
- a minimum of twelve weeks. Carafate, another drug compound, mixed in water
- and taken before meals and at bedtime, can be helpful as well. Ideally,
- therapy is most effective when antacids, H2 receptor blockers, and carafate
- are taken together.
- If none of the above treatments work, surgery may be the last resort.
- However, mild or intermittent symptoms should not warrant surgical
- intervention. Such treatment is required in only a small number of patients,
- and only when all other therapy fails.
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- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
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