|
|
|


| back to main |
|
Heartburn and Reflux
Esophagitis The combined market
for the prescription forms of Pepcid, Tagamet, and Zantac is more than two and
a half billion dollars. The revenue for the over-the-counter forms of these
drugs which are lower dosages of the prescription formulas, must also be
impressive considering the advertising dollars being spent by the
manufacturers. Obviously, heartburn and reflux esophagitis are common ailments
although these drugs are also prescribed in the treatment of stomach and
duodenal ulcers. Histamine stimulates stomach cells to produce acid. Pepcid,
Tagamet, and Zantac belong to a class of medications called H2-blockers that
inhibit the action of histamine on the stomach cells thereby reducing stomach
acid production. Tagamet should not be used by persons taking Coumadin
(warfarin) or Dilantin (phenytoin). Major side effects include confusion,
hallucinations, enlargement of the breasts and impotence. Nursing mothers
should not use Pepcid. Major side effects include agitation, anemia, confusion,
depression, easy bruising or bleeding, hallucinations, hair loss, irregular
heartbeat, rash, visual changes, and yellowing of the eyes or skin.
Normally,
the lower esophageal sphincter, a band of muscle around the lower esophagus,
acts as a valve to prevent the contents of the stomach from flowing back into
the esophagus. When the esophageal sphincter is not working properly, the
resulting back flow is called gastroesophageal reflux. The burning sensation
heartburn is the result of stomach acid coming in contact with
the lining of the esophagus. If a person experiences chronic reflux,
inflammation and/or ulceration of the esophagus may result a condition
called reflux esophagitis. The condition can be very painful and may even cause
chest pain which mimics the symptoms of a heart attack. Over an extended period
of time, scarring and narrowing of the esophagus from esophagitis may lead to
difficulty in swallowing, chronic cough, hoarseness, sore throat, and
asthma.
Approximately half of the patients with severe
reflux have problems with delayed gastric emptying. If the stomach remains
full, it produces excessive amounts of acid which in turn worsens the reflux
symptoms. Many other people experience heartburn during the night. These people
should eat a light supper early in the evening which is low in fat and easy to
digest. If the stomach is empty, reflux will not occur. In severe cases, Reglan
(metoclopramide) or Propulsid (cisapride) may be prescribed. These drugs help
the stomach to digest food more rapidly and strengthen the lower esophageal
sphincter, but common side effects include headache, diarrhea and adomininal
pain.
Diet and lifestyle changes should be your first
course of action before seeking a prescription drug. Eat smaller meals more
often, avoiding foods you know cause you distress. Carbonated beverages,
coffee, alcoholic beverages, chocolate, onions, fatty foods, and peppermint
should be avoided because they have been found to weaken the lower esophageal
sphincter. Smoking increases acid production and weakens the lower esophageal
sphincter. If heartburn awakens you during the night, sleeping on a foam wedge
may help.
The goal is to heal your esophagus, but you have
to be patient because it may take several months, but you should notice steady
improvement if you work diligently at modifying your diet and lifestyle to
control the problem. Many people have reported that Pure Green Power, taken
prior to meals, has greatly reduced the number and severity of their heartburn
attacks. |
|
|