The struggles I hear about involving acid reflux, GERD, heartburn and hiatal hernia come up frequently. These types of digestive problems are quite common. Medications that are recommended or prescribed are meant to try and decrease acid production or neutralize stomach acid. Some people report night sweats which can also be associated with acid reflux. Along with medications, it's also recommended that those who suffer from any of these gut maladies to avoid large meals, eat slower, avoid coffee and alcohol, reduce their weight, not laying down right after meals (or bending over). These are all in attempts to address the symptoms basically. In some cases, surgery may be recommended to resolve a hiatal hernia.
For most sufferers, prescription drugs and over the counter meds are their only real choice for living with the symptoms other than watching their diets very closely. With these drugs and medications, come some pretty troublesome possible side effects -both short term and long term. If you would like to read some interesting thoughts on the subject of PPI's (proton pump inhibitors like Prilosec, Prevacid and Nexium) just go to www.mercola.com and enter Prilosec in the search engine and you'll see a number of articles by Dr. Mercola who is of the opinion that these drugs actually can cause acid-related problems and a dependency on these drugs.
Dr. Andrew Weil recommends a few things that could help with the typical symptoms of Hiatal Hernia on his web site: http://www.drweil.com/drw/u/id/QAA293383 He says in reply to a question about suggestions for relief of symptoms:
“For relief, I recommend deglycyrrhizinated licorice (DGL), which can soothe the lining of the esophagus and stomach. Chew two tablets slowly before each meal or between meals, or take one-half teaspoon of the powder before meals. Let it slowly trickle down your throat. You can continue to use DGL as long as you have symptoms. Here are some other lifestyle changes that can help:
· Reduce or eliminate alcohol consumption. If you do take an occasional drink, be sure to eat something first.
- If you smoke, stop - tobacco can irritate the digestive system.
- Avoid coffee and decaffeinated coffee. Caffeine can aggravate symptoms. Substitute chamomile tea, which is soothing.
- Experiment with foods to see which ones trigger your symptoms and avoid any that do.
- Don't eat within two to three hours of bedtime, and don't lie down after meals.
- Eat frequent small meals rather than three large ones.
- Elevate the head of your bed by six to eight inches (to prevent stomach acid from refluxing while you're lying down).
- You should also try to avoid drugs that can make reflux worse by decreasing the pressure of the lower esophageal sphincter. These drugs include calcium channel blockers, nitrates, sedatives, and theophylline. Peppermint can have the same undesirable effect.
Conventional doctors probably will prescribe acid-suppressive drugs. I recommend using them only short-term or not at all, as they have significant side effects, are not intended for long-term use, treat the problem superficially, and cause rebound increase in acid production when you stop taking them.” Andrew Weil, M.D.
Here are a few concerns and warnings coming from the FDA over the last few years in regards to PPI’s:
Don’t take Prilosec with Plavix:
The FDA added a warning regarding Prilosec (one PPI which is used to prevent/reduce stomach acid) can actually reduce the effectiveness of Plavix if these two are being taken at the same time. Plavix is a anti-clogging drug taken by those who are at risk for heart attacks/stroke.[1]
Depletion of magnesium
HEARTBURN DRUGS DEPLETE MAGNESIUM
“The FDA has warned that prescription drugs for heartburn or acid reflux can cause serious side effects because they deplete the body’s stores of magnesium. Such drugs-including Nexium, Prilosec, Prevacid and others-work by blocking production of acid in the stomach. If you use one of these drugs regularly, it’s a good idea to take magnesium supplements and have a doctor check your magnesium levels.
Symptoms of magnesium depletion include racing heartbeat, palpitations, muscle spasms, tremors, or convulsions, but low magnesium levels don’t always produce these effects. Children might experience abnormal heart rates and fatigue, upset stomach, dizziness and lightheadedness. An FDA review of adverse event reports and scientific literature found that magnesium shortages occurred most often when the drugs were taken for more than a year. In 75 percent of cases, magnesium supplements provided relief, but in others, patients had to stop taking the drugs.[2]
The FDA issued this warning March 2, 2011 so this warning might be unknown to some. There are a few podcasts available on the FDA web site here: http://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm246866.htm[3]
Risk of increased fractures
The FDA also notes in a press release in May 2010 that studies suggest an increased risk of fractures for those who have been taking the drugs for more than a year.[4] Additionally, in the FDA’s advice to consumers on the same topic, they remind people of the following: “Be aware that the over-the-counter PPIs should only be used as directed for 14 days for the treatment of frequent heartburn. If your heartburn continues, talk to your health care professional. No more than three 14-day treatment courses should be used in one year.”[5]
I wonder if people who are taking PPI's are really reading the label or if their doctors are reminding them of this 3 treatment per year recommendation?
[2] Better nutrition, Aug 2011, volume 73, no. 8, p. 10
[3] http://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm246866.htm, accessed 11/7/11
[5] http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm213240.htm, accessed 11/7/11
