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WHY DOES MY GUT HURT SO MUCH?
reflux: If any particular foods or types of food do this to you, Dyspepsia is a term that literally means “hurting stomach.” they are your “trigger” foods. Your triggers may be different It is used when discussing the pain of acid reflux. Dyspepsia is from these. I have listed these because they are common trig- actually a term that literally means “hurting stomach.” We doc- tors sometimes use that word as the patient’s diagnosis until • Tomato-based foods, (spaghetti sauce, chili,
Among teenagers and young adults in today’s American culture, the underlying problem if quite often acid reflux, also
• Citrus fruits
known as GERD or gastroesophageal reflux disease.
• Any drinks with caffeine
• Soda pop. (If it fizzes, then it contains carbonic
WHAT IS HAPPENING THAT CAUSES THIS PAIN?
acid, and that’s a trigger for many people) Gastroesophageal reflux disease, or GERD, occurs when • Chocolate
the bottom muscle of the esophagus (the lower esophageal • Fatty and fried foods
sphincter or LES) does not close properly and stomach con- • Garlic and onions
tents leak back, or reflux, into the esophagus. • Mint flavorings
The LES is a ring of muscle at the bottom of the esopha- • Spicy foods
gus that acts like a valve between the esophagus and stom- ach. The esophagus carries food from the mouth to the The list above is not only a list of the most common trigger foods, it is also written in order of frequency. Tomato- When stomach acid comes back up and touches the product containing foods are the number 1 trigger when we lining of the esophagus, it causes a burning sensation in the chest or throat called “heartburn.” (As you may guess, this pain has nothing to do with the heart at all. That name came about HOW CAN I FIX MY ACID REFLUX?
because it may feel like the heart is burning since the pain is Avoid food 2 to 3 hours before bed is often quite helpful. Reflux occurs most easily when a person is lying down. The fluid may even be tasted in the back of the mouth— Avoiding the foods in the list above may be all that is nec- it has a vomit-like taste. Occasional heartburn is common essary. Sometimes simply reducing the amount of such foods and that does not necessarily mean one has GERD. But if “heartburn” is happening say, more than twice a week it is Reducing the amount that you eat will often be helpful. more likely that it should be considered GERD, and it should Sometimes reflux is triggered not so much by what you eat, be treated properly because it can eventually lead to more If you do all of these things, and you still experience Excess acid in the stomach (more acid than is needed to reflux, then medication will probably be necessary. Sometimes digest food) can also cause pain in the stomach itself. One medication alone will do the job. Most often, you need to do a way to look at this is that when the stomach makes too much combination of avoiding certain foods and taking medications acid, after it is finished digesting the food, the excess acid to allow the stomach lining to heal adequately. Sometimes you starts to “digest” the stomach lining. It’s not a pretty picture, can then begin to eat the” problematic” foods again— but in but that is essentially what is happening— and that is also reasonable quantities. Sometimes . . . But not always.
MEDICATIONS THAT HELP
A TWENTY-FIRST CENTURY PROBLEM
What medicines might help me? In days past, all we had Teenagers and young adults can definitely can have GERD. to use were antacids, such as Alka-Seltzer, Maalox, Mylanta, Certain types of foods cause the stomach to produce more Pepto-Bismol, Rolaids, Tums, and the like. These neutralize acid than necessary. These may be the very foods you like the acid that has already formed. By the time you are hurting, you already have produced too much acid and the excess acid is The additional acid begins to irritate the stomach caus- ing pain wherever the irritation exists (dyspepsia), and the Today we have better medications. The first I usually excess acid can back up into the esophagus and produce pain recommend or prescribe are called H2 blockers. These include such medications as Zantac (ranitidine), Pepcid, or Axid. For more than half of my patients, these work well. TRIGGER FOODS
Sometimes we need to go to the next step and use I have seen a huge increase in GERD in my medical prac- “proton-pump inhibitors.” Proton pump inhibitors include tice over the past two decades. That is due largely, I believe, omeprazole (Prilosec), lansoprazole (Prevacid), pantopra- to life style and dietary changes in our culture. We eat far zole (Protonix), rabeprazole (Aciphex), and esomeprazole more fast food than we used to. We eat many more “acid- (Nexium), which are all available by prescription. Sometimes a triggering” foods than we used to. And we eat much larger portion sizes than any generation in the past. (Super size, Changing diet, reducing portion sizes and using one or more of this medications will “fix” reflux for most people. I will be happy Trigger foods are foods that cause dyspepsia or acid to continue to work with you until the problem is overcome.
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