American Reflux: It's On The Rise

Acid reflux is becoming a huge global issue. It’s been on the rise for decades, and it’s worse than ever before, particularly in the US. It’s estimated that over 20% to 30% of Americans suffer from acid reflux  at least once weekly, according to the National Digestive Disease Information Clearinghouse. Hospitalization from acid reflux and GERD also increased in 2015 to 3,141,965 people.  GERD diagnoses for infants continue to rise, increasing 42% for infants and 84% for children ages 2-17 in 2015, according to the Healthcare Cost and Utilization Project.

Anyone can develop the more serious form of reflux called GERD.  It occurs in young and old and among different races.  Most of the hospital discharges of GERD were women according to Healthcare and Utilization Project. 

Reflux is caused by acid splashing back up into the esophagus, usually after a meal. It can be caused by a number of things, but generally it’s seen in people who have a weakened lower esophageal sphincter. When the LES is weak it isn’t able to close properly, which allows stomach acid to splash back up into the esophagus and results in reflux. The symptoms of reflux are heartburn, sour taste in the mouth and throat, vomiting, chronic cough, and breathing difficulty, so you can see why people don’t exactly love it.

Doctors are still not sure exactly what causes the lower esophageal sphincter to weaken, or why rates of reflux are so high in the United States. In some people it may be genetic, and in many cases there are a number of other lifestyle factors that may contribute. Overeating, being overweight, pregnancy, wearing tight clothing, and smoking are just a few. They’ve got a few more suspicions about what might be contributing to the rise of reflux in the US.

Causes and Factors That Increase the Risk of Reflux and GERD

Many doctors believe excessive weight is a big contributor to reflux.  There is a rise in overweight children and adults in the US. Excessive weight puts pressure on the stomach and often puts on fat around the organs in the body.  When you eat fat this slows down the digestive process, leaving more food to cause reflux.

Another culprit? Food. We have a large selection of food in the supermarkets and restaurants in the United States, and many of these foods increase stomach acid, which causes reflux.  Beverages like coffee, tea, and soda have large amounts of caffeine that is acidic. Coffee and other caffeinated beverages also interfere with the natural ability of the esophagus to move food into the stomach, backing things up and potentially causing heartburn or reflux. Fatty food also slow down the passage of food from the stomach into the intestines.  In fact, you will find reflux to be worse after large meals.

In addition to food, other American lifestyle habits can cause reflux. Smoking often leads to belching and swallowing air that worsens the symptoms of reflux and GERD. Too much alcohol (yes, there is such a thing!) produces excessive stomach acid and affects how the esophagus functions.  Pregnancy, with all those crazy hormonal changes, drastically increases the symptoms of GERD.

So What Can We Do?

Dr. Kevin McGrath, an Associate Professor of Medicine at the University of Pittsburgh Medical Center, says that part of the problem might be that some people have sensitive nerve ending and they feel the acid more than others. He believes stress is another factor.  He thinks taking anti-depressants to relieve anxiety and to desensitize the nerve fibers may help alleviate reflux and GERD.

Dr. McGrath tells patients to eat several small meals a day.  Meals should be low-fat, because fat slows down the digestion of food. Dr. Ronnie Fass, a member on the Advisory Board for the International Foundation for Gastrointestinal Disorders, says many people believe heartburn is part of the eating experience, which is frankly just incorrect. It’s not normal to experience heartburn after you eat. Heartburn is a sign that something is very wrong with your digestive process, and can be an indicator of GERD.

Overeating, obesity, and a poor diet are some of the main causes of GERD in the United States. Many of the processed foods we eat contain citric acid and ascorbic acid used to preserve food. When we eat these foods, we expose our body to more acid. Look at labels and cut down on canned and processed food with these two ingredients.

Lifestyle changes and diet can help with reflux symptoms.  When symptoms persist, seeing a doctor for GERD will help find a solution. There are many medications that help with GERD and treatments that are effective in ending the symptoms.

Written by: Joan Russell

5 Tips For Preventing Heartburn

Heartburn is a sour acidic taste in the mouth and throat and a burning sensation in the chest.  It occurs after eating any meal during the day or lying down to rest or sleep. It is unpleasant and disruptive to men and women when working or attending to daily activities. The symptoms often last several minutes to a few hours.

The good news is that heart burn is manageable with lifestyle changes and over the counter medications suggested by your doctor.  Heartburn typically happens when food goes down a tube called the esophagus after you eat. When the muscle in the esophagus is weak it does not close properly, which causes stomach acid to splash back up (AKA acid reflux). Heartburn is the way that you feel that acid reflux occurring, and if you’ve had it before then you’ll know that it’s incredibly uncomfortable.

Causes of Heartburn

Certain foods, medications and health conditions can be the cause of heartburn. Citrus fruits, tomatoes, hot peppers, spicy food, fatty food, onions, and candy are usually the biggest culprits. Beverages that are carbonated, acidic drinks and alcohol can also contribute to heartburn, as well as certain medications like aspirin, pain killers, sedatives and some high blood pressure medications. If you smoke, are overweight or pregnant, you may be at risk for chronic heartburn.  

Tips For Preventing Heartburn

For patients who are struggling with occasional heartburn, in many cases medication isn’t necessary. A lot of doctors recommend trying  heartburn home remedies as a solution for your heartburn woes before an over the counter antacid. In addition to trying these home remedies, it’s important to remember that most cases of heartburn can be solved by simply making some small lifestyle changes. Here are five things that you can do to help prevent heartburn:

1. Plan meals carefully and eat foods that prevent heartburn.

Oatmeal is a good breakfast cereal or snack any time of day because it absorbs the acidity of other foods.  Salads are full of vitamins and minerals, which is great, but if you’re opting for a salad then be sure to avoid acidic vegetables like onion and tomato and only add one tablespoon of dressing. As far as fruits go, bananas are a great option for people with heartburn because their ph. level of 5.6 is great for acid reflux. Most melons are also good for minimizing acid reflux. Good sources of protein for heartburn are chicken, turkey, fish, and seafood. Eat green vegetables with meals as a side dish.  Be sure to plan smaller meals or have less on your plate during meal times, and try not to eat meals too late at night.

2. Make an effort to drop those extra pounds.

People with excessive weight are often more likely to suffer from heartburn, so do the best you can to maintain a healthy body weight and shed those excess pounds! This means eating lean protein, vegetables, fruits, whole grains, low-fat dairy products, and healthy oils, and probably putting in some time at the gym. Exercise daily for about 30 minutes walking, doing housework, yard work, biking, swimming, running, or working out  at the gym. Choose an exercise that you like so you will stick to it. If you’re going to head out for your exercise, make sure to wait 2 hours to exercise after eating a meal.

3. Write down what you eat and when you get heartburn.

Keeping a heartburn journal is actually incredibly helpful, especially for people who may be suffering from chronic heartburn and will need to seek medical advice. Journaling helps keep track of when and why you’re experience your heartburn, and it can help doctors determine what may be triggering your attacks. After a few weeks you should be able to see what foods cause your heartburn.  Write these foods down and avoid eating them in your meals and snacks.

4. Try over the counter medications for heartburn that have been used and tested.

In some cases, simple lifestyle changes aren’t enough to keep you from experiencing heartburn. In those situations, your doctor may recommend that you try an over the counter medication to easy your symptoms. Drugs like antacids work and have been on the market for years.  Some of these drugs are Alka Seltzer,  Maalox, Di-Gel, and Rolaids.

5. Stay away from the no-nos.

After a meal avoid drinking coffee or tea, smoking a cigarette or drinking alcohol.  All these items can negatively affect the sphincter muscle in the esophagus and lead to more frequent bouts of acid reflux, and therefore heartburn.

Chronic Heartburn

Chronic heartburn is heartburn that you get more than twice a week, and it could be a sign that something is wrong. If you’re experiencing frequent heartburn on a regular basis, you should see a doctor to determine whether there might be something more serious causing it. Often after testing, chronic heartburn can be treated with prescription drugs and some lifestyle changes.

Heartburn sucks, but it’s also something that will most likely affect you at some point in your life. The good news is that both heartburn and chronic heartburn are manageable by making some lifestyle changes and taking medications. You don’t have to suffer from heartburn, there are many solutions to the problem that works successfully.

Written by: Joan Russell

Meet A Secret Bacteria Terrorist: H. pylori

There are a lot of bacteria out there, and some of them aren't that great, but there are a few that are just downright nasty. When it comes to acid reflux and GERD, there's one bacteria in particular that's the worst of the bunch!

Meet H. pylori. It’s a bacteria and the real (fancy) name is “Helicobacter pylori.” It grows in the digestive tract and has a tendency to attack the stomach lining. H. pylori infections are usually harmless however the reason you may want to be familiar with it, or are already, is because the infection rears its ugly head in the form of heartburn, GERD (Gastroesophageal reflux disease), and acid reflux disease.

If you’ve got this type of bacteria, you may not even show signs or symptoms of having it. Many people get H. pylori during childhood, but adults can get it too. The germs live in the body for years before symptoms start, but most people who have it will never get ulcers. Just because you have an H. pylori infection doesn’t mean you’ll develop symptoms of heartburn, GERD, and acid reflux disease. You won’t necessarily develop gastritis, cancer or an ulcer either. It does put you at a significantly higher risk, though.

H. pylori attacks your stomach lining, which usually protects you from the acid your body uses to digest food. You can get H. pylori from food, water, or utensils and it’s more common in countries or communities that lack clean water or sufficient sewage systems. You can also pick up the bacteria through contact with the saliva or other body fluids of infected people.

It’s believed that the H. pylori infection plays a substantial role in the pathogenesis of other digestive disorders, like “silent reflux.” Silent reflux, Laryngopharyngeal reflux, or LPR, is a medical condition that results from the backflow of stomach contents, including stomach acid and digestive enzymes, into the airway. It incorporates acid reflux into all parts of the airway, including the trachea, nose, sinuses, voice box, throat, bronchi and lungs. 

Those afflicted with LPR may have a chronic cough, become hoarse, always have to clear their throat, have a feeling that something is stuck in the back of the throat, or have trouble swallowing. LPR can also exacerbate existing asthma and sleep-breathing disorders such as obstructive sleep apnea. These types of symptoms may be mistakenly attributed to an allergy, sinus issue or pulmonary disease, especially given that a majority of patients do not experience obvious heartburn or indigestion. Because of this, LPR is commonly referred to as silent reflux. 

There are some natural ways to attack H. pylori, beginning with limiting or removing these from your diet:

1)    Sugars. One of the biggest culprits is agave nectar, which many regard as a “healthy sugar”. Remember, bacteria eat all forms of sugar. Even fructose can lead to an increase in bacterial overgrowth.

2)    Prebiotics. Many times a prebiotic can help intestinal health. However sometimes they just provides more food for unwanted bacteria.

3)    Fiber and carbohydrates. A certain percentage of fiber and carbohydrates that we consume escape absorption, which means they may also become food for unwanted bacteria.

So here’s the lowdown: if you have heartburn, ulcers, gastritis acid reflux, GERD, or other GI symptoms and you test positive for H. pylori, the wiser move would be to treat it. The most common reason being is that is has been shown to suppress stomach acid, which you need to fix to finally get rid of the symptoms of heartburn once and for all.

Written by: Cindy Stephens

Diagnosing and Dealing With Infant Reflux

Many infants experience acid reflux due to a weak sphincter muscle in the esophagus. It does not close properly and acid comes back up to the feeding tube.  Infants spit up, burp, refuse to eat, and are hard to feed.  This subsides after 12 to 18 months.  When symptoms continue and worsen GERD disease may be the problem. This is a frightening reality for parents and caregivers of infants and toddlers to face.  

A very low percentage of infants and toddlers develop GERD. Acid reflux is caused by an under developed digestive system and produces symptoms similar to GERD. When a toddler has symptoms after 12 to 18 months a doctor should be consulted.  What are infant GERD symptoms? You should look for symptoms like forceful spitting up or vomiting often after eating, failure to gain weight, arching or straining the body during feeding, coughing, frequent infections, gagging, choking, or disturbed sleep.

Reflux and GERD Disease

Most babies and infants outgrow reflux after one year’s old.  Less than 5% of infants have symptoms longer.  When reflux is diagnosed in infant and toddlers it is manageable with life style changes and diet. They use several tests to determine the acid reflux. The tests are the barium swallow and upper GI series, ph probe, upper Gi endoscopy and gastric emptying study.

Often simple changes will help you change reflux in infants and toddlers. You should elevate the head of the baby or child. Hold the baby 30 minutes upright after a feeding. Thicken bottle feeding with cereal if your doctor recommends this.  Feed your baby more often and smaller amounts of food. Try solid food if it is suggested by your physician.

Treatment for GERD in infants may involve feeding changes, medications, and sometimes surgery. They will only prescribe medications when you have tried other methods and it has not helped. Often they prescribe H2 beta blockers to reduce acid in the stomach.  Proton pump inhibitors are prescribed to reduce the amount of acid in your infant’s stomach and help heal the esphogusal lining. 

Sometimes small infants are fed through the nose, mouth or stomach using an intragastric tube. Only in severe cases will surgery be used in infants and toddlers.

Many young infants and toddlers have symptoms of reflux that do not require treatment. When symptoms continue past 12 to 18 months it might be GERD disease. The good news is there is treatment for reflux and GERD that works effectively for infants and toddlers. 

Written by: Joan Russell