I find that heart burn is
one of the most common complaints in primary
care. Prior to coming into the office may
patients have tried over-the-counter-products to
relieve the symptoms. Often these products
are not effective because they are not
addressing the real cause of the problem.
First let me give you a
little background on what causes heart burn.
The stomach contains acid which helps digest the
food. The tissue lining the stomach is
resistant to the effects of the acid. The
tissue that lines the esophagus is not designed
to withstand the effects of acid.
Therefore when the food travels down the
esophagus it passes thru a tight muscle ring
(not unlike the anus) that opens up to allow the
food to drop into the stomach but then closes
off to prevent the acid from the stomach from
damaging the tissues of the esophagus.
There are several
conditions that cause the acid from the stomach
to travel into the esophagus, damage the tissue
lining the esophagus and cause the pain referred
to as heart burn. If the muscle the
separates the stomach from the esophagus is not
tight, it will leak and allow the acid to pass
upward (particularly when lying flat). In
addition if you have trouble digesting your food
due to a lack of digestive enzymes (which
happens as we age) the pressure in the
stomach can build up to the point that the acid
is forces up thru the muscle closing off the
esophagus.
The most common way heart
burn is treated is by reducing the acid in the
stomach thru antacids, histamine blockers (ie
Zantac and Pepcid) or by block the cell pumps
that secrete the acid into the stomach (ie
Prilosec). However by decreasing the acid
we are merely masking the problem and not
solving the problem. In addition by
decrease the acid we slow digestion and this may
worsen the problem.
May doctors feel that the
best way to solve the problem of heartburn is by
aiding digestion by supplementing with digestive
enzymes. The goal is to increase the
efficiency of the digestive process, reduce the
pressure build-up in the stomach and reduce the
reflux of acid into the esophagus.
I am currently research
effective solutions to the problem of heart burn
and hope to be able to make some recommendations
in the near future. Please check back or
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