This Week In The HSI Forum Heartburn, acid reflux, gastro esophageal reflux disease (GERD) - call it whatever you like, it still adds up to discomfort (at the very least), and in chronic cases can develop a condition called "Barrett's esophagus,' which also happens to be the title of a thread on the HSI Forum this week. When stomach acids are regurgitated up into the esophagus with some consistency, the lining of the esophagus becomes irritated. Barrett's esophagus is an advanced stage of the irritation, and is a precursor of esophageal cancer. No wonder then that an HSI member named Pat is concerned enough to post this comment and request: "I have been diagnosed with Barrett's Esophagus. My gastro doc says it was only 1cms. now and we will just do an endo. once a year to keep an eye on it. I'm assuming he knows what he's talking about. Could any of you post some thoughts on this?" It appears that Pat's doctor is erring on the side of caution, because three members (Rainie, Cody and KB) respond to say that their doctors have all advised an endoscopic examination once every two years to monitor their Barrett's. Rainie adds, "I personally think it should be every 12 months, a lot can happen in 2 yrs so sounds like your Dr. is more vigilant than most. 1 cm. also sounds good. The main thing is to protect your esophagus. Remember no alcohol or smoking. Go easy or eliminate any foods that irritate the esophagus." All of that is good advice - most likely echoed by many doctors. But along with this good advice, quite a few doctors also reach for the prescription pad. KB states that he's using Nexium "indefinitely," and Cody says, "I take Prevacid twice a day. Thinking of changing to Nexium. Any suggestions?" Glad you asked, Cody. In the e-Alert "Fire Down Below" (12/23/02), HSI Panelist Allan Spreen, M.D., explained how using antacids and other acid blockers begins a vicious cycle: When the acid is neutralized, "… the body, in its wisdom, saves the energy required to protect the esophagus from the stomach's (normally) more acid environment, and weakens the GE sphincter. This allows any remaining acid to sometimes slip past and irritate the esophagus. So, you take an antacid and you feel better, because you lessen even more what little acid remains that has been irritating your already sensitive esophagus. "The above association reinforces that you need more antacid next time, since it helps in the short term. So look what's happening - the short term 'fix' assures that the problem will continue (and even worsen)." The alternative? Dr. Spreen recommends an acidophilus supplement (which kills the pain "almost immediately" while protecting the esophagus without killing stomach acids), and a digestive enzyme supplement. The enzymes actually increase the stomach acid. And if that sounds like a bad thing, Dr. Spreen says, "Remember, it isn't acid that's the problem (you need it desperately for digestion); it's acid reaching the esophagus. Proper digestion allows for higher concentration of acid while tightening the gastro-esophageal junction and protecting the esophagus." If you suffer from chronic heartburn, this thread provides a reminder of how important it is to seek treatment before it turns into something more serious. Other topics on the HSI Forum this week include: - Antibiotics
- Weight loss
- Shingles, older people
- Soy protein
- Lung problems
- Vitamin C chewable
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