Acid Reflux Treatment – A Bitter Pill To Swallow
By Dr. Melissa P. Broyles
Gastroesophageal Reflux Disease, or GERD, affects greater than 50 percent of the US population.
The symptoms of GERD can be heartburn, bad taste in mouth, burping or coughing. Most commonly GERD is due to diet and obesity. Other causes are a hiatal hernia, gastroparesis (the slow movement of food through the stomach), a defective lower esophageal sphincter (the ring of muscle between the esophagus and stomach) or a weakening in the diaphragm.
Lifestyle modification, including weight loss, avoiding spicy foods, caffeine and alcohol, and not eating three hours before bedtime can be a very effective treatment for GERD. However, if further treatment is needed, one must consider the risks versus the benefits of medication.
The most common pharmaceuticals prescribed or bought over the counter are a class of medications called Proton Pump Inhibitors (PPIs). While these medications certainly relieve GERD symptoms and can aid in the healing of inflammation of the esophagus and stomach, they have the potential for serious complications. Prolonged use of PPIs can cause malabsorption of several critical nutrients (i.e. calcium, magnesium, zinc, vitamin B12 and iron). A lack of calcium and magnesium can lead to osteoporosis; deficiencies in B12 and iron can cause anemia; and zinc deficiency can cause hair loss. By decreasing stomach acid, bacteria can enter into the lungs and gastrointestinal tract. For this reason, PPIs can increase one’s risk for community acquired pneumonia and bacterial overgrowth in the stomach and small intestine. If that is not enough, a new observational study showed that patients on PPIs for 1-2 years had a threefold higher risk of kidney failure than those who used the drugs for a month or less. (Journal of the American Society of Nephrology, 4/14/16)
Another reason PPIs may be a bitter pill to swallow is their “rebound effect.” Blocking stomach acid production causes stomach cells to secrete a hormone called gastrin. This hormone signals the body that more acid is needed. When the PPI is stopped, the elevated gastrin level causes a rebound increase in acid secretion. This makes it very difficult for a person to get off of the medication. Therefore, it is imperative to talk to your doctor about a weaning schedule to prevent this phenomenon.
If dietary changes and weight loss do not alleviate a person’s acid reflux, one may consider alternative treatments, such as aloe vera, slippery elm, or DGL (deglycyrrhizinated licorice). However, it is important to consult with an integrative practitioner for proper dosing and scheduling of these treatments.
For more information visit www.drmelissapbroyles.com or call 610-459-3773
I have been a patient of Dr. Broyles for over a year now, and have found her to be a kind and concerned professional. I have been having trouble with my weight since I was a child. Over the years I have gained and lost more weight than I could count. I am 67 and heavier then I has ever been in my whole life. It didn’t seem to matter what I did to lose weight I still keep getting heavier. In February of 2013 Dr. Broyles ask me if I was really serious about losing weight; I told her if I don’t do something I was fearful of death. At that time she began to work with me on a weight management and proper eating program. I have lost 25 pounds since I’ve started eating properly.
I feel much better and stronger. The swelling in my legs is all but gone. I was getting varicose veins around the ankles and starting up my legs. They are disappearing. Blood pressure is down. Sugar is down. Cholesterol is down. My clothes fit better and I feel better. I am happy… ~ Bob V.
I was tired of being treated for each symptom and not as a whole person. I thought that the few issues I have could be interconnected, like my migraines and hormonal issues such as night sweats. I wanted to see an Integrative physician who would address all of my problems. I have been seeing Dr. Broyles for four months and can honestly say that I have not felt this well in a long time. I am now off of my blood pressure medication, I am on vitamin supplements, and we are addressing my hormonal imbalance. Dr. Broyles listens to all of my concerns and tries both conventional and alternative solutions. She is very patient and spends a lot of time both listening and explaining what could be wrong, and how to address the issues. Her office is warm and relaxing, and is conducive to healing. I am very happy that we have started this relationship. ~ Maria M.