The heartburn thread: Who suffers from it?

[guest username]

Let me clarify a few things, as there are multiple causes of heartburn. Some of the things mentioned here are correct, while others are not.

Doctors are full of shit on this one. The problem is NOT excess stomach acid, the problem is the food is not moving THROUGH the digestive tract as it should and it's sitting in our stomach longer than our stomach was designed to hold it for. Eating food that doesn't agree with us damages the microvilli in our gut, which dramatically slows the peristaltic action that moves the food through the digestive tract.[/I]

I disagree about us being full of shit regarding heartburn. You are partially correct. People who are allergic to certain foods will produce more stomach acid and therefore have heartburn. However, this isn't the only cause (more on that later).

The stomach is lined by histaminergic receptors that stimulate acid production. If you eat something that you are allergic to, then it will stimulate acid production. Heartburn comes not from the amount of acid produced, but the inability of the lower esophageal sphincter to control it. It refluxes, thereby causing symptoms. Taking an anti-histamine, specifically an H2 blocker, reduces these symptoms. Examples of H2 blockers are ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet), etc.

As musclemom correctly pointed out, anti-acids will only cover up what is wrong. Keeping a food diary is a good idea. I am allergic to pineapple, and if I absolutely must eat pineapple (for some reason, I seem to crave it sometimes), then I premedicate myself with 150 mg of ranitidine.

So the problem is not with food moving slowly through the digestive system, but instead is a problem with an allergic reaction stimulating histamine production (through mast cells), which in turn stimulate acid production by stimulating the histamine receptors. This excess acid overwhelms the ability of the lower esophageal sphincter to prevent it from refluxing into the esophagus.

i had the persistent cough at night while laying down too

The three most common causes of cough:

1. Postnasal drip
2. Cough-variant asthma
3. GERD

People who have a chronic cough without evidence of serious disease often get relief from PPI's.

Maintaining a proper PH balance with the foods you eat will help as well.

Actually the pH of your food has very little to do with acid relufx. Your stomach acid has an extremely low pH (very acidic). There are very few things that can change that level.

I'm gonna try Tums after I eat a large meal and anything that causes heartburn which is just about everything.

I would recommend against Tums. Calcium is one of the stimulants for acid production. Although you will get some instantaneous relief with Tums, it will actually make your heartburn worse by stimulating more acid to be produced.

For immediate relief of heartburn, the recommendation is to drink several glasses of water (dilutional effect), take an anti-histaminergic (i.e., ranitidine, famotidine), and avoid lying down for 30-60 minutes. It usually takes about 30 minutes for an anti-histaminergic to start working.

For prolonged treatment, a proton-pump inhibitor works best. They take 2-3 days to start working, and you may find that you only need to take one every other day. You can buy omeprazole (Prilosec) over the counter.

Finally, if you continue to have heartburn, you should be tested for Helicobactr pylori. Sometimes ulcers can present as heartburn. If you have H pylori, then you'll need antibiotics to treat it (a complicated medicine regimen actually).

I am assuming your self-diagnosis of heartburn is correct. Many patients who have cardiac ischemia complain of "burning" in their chest. So if you have risk factors (family history, high blood pressure, high cholesterol, or other things), then I would make sure it's not your heart.

My own Cliff's notes version:

1. Not all heartburn is caused by food allergies.
2. GERD is often caused by inability of the lower esophageal sphincter to control regurgitation of acid.
3. PPI's are not for immediate treatment of heartburn; it's for prophylaxis and continued treatment.
4. GERD is associated with development of Barrett's esophagus, a precursor to cancer.
5. Treatment with PPI's may not prevent development of Barrett's (it's thought to be from reflux of bile acids as well).
6. Surgery is sometimes necessary in severe cases of GERD (a Nissen procedure).

 

[bigmann245]

my wife gets it real bad. we need to start owning stock in Pepsid-AC Complete. she goes through a bottle every week, sometimes sooner.

 

[guest username]

my wife gets it real bad. we need to start owning stock in Pepsid-AC Complete. she goes through a bottle every week, sometimes sooner.

If you get it more than 2-3 times/week, you should be taking a PPI for prophylaxis unless you can identify the cause of the heartburn.

 

[bigmann245]

If you get it more than 2-3 times/week, you should be taking a PPI for prophylaxis unless you can identify the cause of the heartburn.

shes stubborn and wont go to the doc.

 

[musclemom]

I disagree about us being full of shit regarding heartburn. You are partially correct. People who are allergic to certain foods will produce more stomach acid and therefore have heartburn. However, this isn't the only cause (more on that later)..

Of course you're going to disagree with me, you're a conventionally trained physician. Staying within the paradigms of conventional thought is rewarded in your profession.

Look, I have NO argument with docs when it comes to trauma. But when it comes to "curing" illness, they're clueless. Sorry.

A NORMAL human body does NOT "NEED" proton pump inhibitors any more than it "NEEDS" aspirin (or tylenol or Advil or Relpax ...)

What physicians DON'T understand about the body would fill more volumes than what you DO understand, short and sweet. While I respect your calling, and your training, the inability to think outside delineated parameters makes it impossible to have a logical conversation with a physician. PERIOD.

Until ALL doctors begin testing for gluten intolerance as FIRST LINE for patients complaining of heartburn in combination with either IBS/slow/low bowel motility and/or headaches/migraines and/or acne, acne rosacea, I have NO hope for Western Medicine NONE, much less being able to even have a reasonable conversation with a western/conventionally trained/indoctrinated physician.

 

[biteme]

MM - I agree wholeheartedly with everything you said. I have long been suffering w/reflux and all the complications thereof since I was old enough to remember. Yup, I grew up literally thinking that Rolaids were candy.

I've been poked, prodded, tested out the wazoo, have taken every pill/potion even had surgery in a desperate attempt to gain relief.

And yup, you guessed it. The drugs I took were in such high doses that when they finally alleviated my reflux sypmtoms they caused other sides so severe that they were worse than the initial symptoms. I won't even go there about how the surgery has PERMANENTLY screwed me up.

My symptoms are now so advanced and severe that I do recognize it will lead to my demise sooner than later.

I was at my sickest at the height of my competitive bbing career. Very small, super clean meals - very low bf - very active - no drinking or smoking or any drugs. The docs all shook their heads and merely called me an enigma. On the outside I was the picture of unbelievable health yet I had the insides of a 65 y/o alcoholic, sedentary, obese male smoker.

I have suffered with SEVERE diahrea since the surgery a few years back which has gotten so bad that it nearly killed me. I am ALWAYS in pain. Food gets stuck on the way down. Matter of fact, it is not pretty because I can't always predict when it will get "ugly".

If there were a food or foods that I could eliminate or something supplement/medicine I could take to make it go away or if there was some sort of lifestyle change that I could make, I would do it gladly.

I'm very sorry about that and I hope you find a cure some day.

 

[Smurfy]

Of course you're going to disagree with me, you're a conventionally trained physician. Staying within the paradigms of conventional thought is rewarded in your profession.

Look, I have NO argument with docs when it comes to trauma. But when it comes to "curing" illness, they're clueless. Sorry.

A NORMAL human body does NOT "NEED" proton pump inhibitors any more than it "NEEDS" aspirin (or tylenol or Advil or Relpax ...)

What physicians DON'T understand about the body would fill more volumes than what you DO understand, short and sweet. While I respect your calling, and your training, the inability to think outside delineated parameters makes it impossible to have a logical conversation with a physician. PERIOD.

Until ALL doctors begin testing for gluten intolerance as FIRST LINE for patients complaining of heartburn in combination with either IBS/slow/low bowel motility and/or headaches/migraines and/or acne, acne rosacea, I have NO hope for Western Medicine NONE, much less being able to even have a reasonable conversation with a western/conventionally trained/indoctrinated physician.

so if you had a sick child you wouldnt take them to a physician?

 

[musclemom]

If you get it more than 2-3 times/week, you should be taking a PPI for prophylaxis unless you can identify the cause of the heartburn.

DON'T YOU GET IT, THERE IS A CAUSE, A CAUSE!!!

She is NOT digesting her food properly, WHY? WTF is wrong with assessing her diet FIRST?!?

Don't you wonder why we're getting cancer? Don't you wonder? Do you think it's normal for the body to let cells run amok? NO? WTF is suppressing the immune system? 70% of the frigging immune system is produced in OUR INTESTINES! If the intestines are being damaged by exposure to toxins (foods we are intolerant -- as opposed to truly allergic to) doesn't it stand to reason that the immune function starts breaking down.

The human body is not discrete parts, operating individually and autonomously, it's ALL integrated, it ALL works together! If you're eating things that your body perceives as dangerous you're setting up an inflammatory condition. Covering up those symptoms with some "prophylactic" medication does NOT remove the inflammatory process, it just changes it's location. You continue to expose your body to the inflammatory agent over days, weeks, months and you create a progressively degenerated state. Over time you damage your body

Headache and heartburn are our bodies ways of telling us SOMETHING IS FRIGGING WRONG! How can doctors be so fucking STUPID!?! Our bodies are NOT stupid, the people living in them may be, but our BODIES are not inherently STUPID. Our bodies desire homeostasis, but as long as doctors tell people that headaches are some bad thing that needs medicine and heartburn is some other bad thing that needs yet MORE medicine people are never going to learn, and neither will conventional medicine.

 

[biteme]

If you get it more than 2-3 times/week, you should be taking a PPI for prophylaxis unless you can identify the cause of the heartburn.

What if you get it intermittently throughout the day. My symptoms do not last long, certainly not all day. Usually after I burp, I can feel the burn for a minute or so, but it never lasts long. I'm just thinking I should medicate because the burn could do some damage long term even though it doesn't last long??

 

[biteme]

DON'T YOU GET IT, THERE IS A CAUSE, A CAUSE!!!

She is NOT digesting her food properly, WHY? WTF is wrong with assessing her diet FIRST?!?

Don't you wonder why we're getting cancer? Don't you wonder? Do you think it's normal for the body to let cells run amok? NO? WTF is suppressing the immune system? 70% of the frigging immune system is produced in OUR INTESTINES! If the intestines are being damaged by exposure to toxins (foods we are intolerant -- as opposed to truly allergic to) doesn't it stand to reason that the immune function starts breaking down.

The human body is not discrete parts, operating individually and autonomously, it's ALL integrated, it ALL works together! If you're eating things that your body perceives as dangerous you're setting up an inflammatory condition. Covering up those symptoms with some "prophylactic" medication does NOT remove the inflammatory process, it just changes it's location. You continue to expose your body to the inflammatory agent over days, weeks, months and you create a progressively degenerated state. Over time you damage your body

Headache and heartburn are our bodies ways of telling us SOMETHING IS FRIGGING WRONG! How can doctors be so fucking STUPID!?! Our bodies are NOT stupid, the people living in them may be, but our BODIES are not inherently STUPID. Our bodies desire homeostasis, but as long as doctors tell people that headaches are some bad thing that needs medicine and heartburn is some other bad thing that needs yet MORE medicine people are never going to learn, and neither will conventional medicine.

I never get headaches. Just intermittent heartburn throughout the day that doesn't last long with each episode. Tomatoes can cause it and tomatoes are a healthy food.