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Acid Reflux: Heartburn

Posted by on in Acid Reflux: Heartburn
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Heartburn is best described as a burning sensation in the bottom of the chest and ribcage that can expand into the middle of the chest area toward the throat.

When the esophagus is irritated, one can experience a burning sensation in the chest, commonly referred to as heartburn. The term “heartburn” doesn’t mean an actual heart condition. It simply refers to the fact that the pain resulting from acid injury to the esophagus emanates from an area where the heart sits anatomically. This condition is referred to as GastroEsophageal Reflux Disease (GERD). Regurgitation, the other typical symptom of GERD, is the sensation of food coming back up into your chest and throat after you've already swallowed it.

Some important points about Heartburn reflux or GERD:

1. Acid reflux affects approximately 60 million Americans. Classically, acid reflux disease was thought to be a disease affecting white males over 50. However, that no longer holds true. Acid reflux affects every race, gender and adult age group.

2. There are two types of acid reflux disease: “Heartburn reflux,” in which the main complaint is heartburn, and “Throatburn reflux,” in which the main complaints are chronic cough, frequent throat-clearing, hoarseness and/or a lump-like sensation in your throat. Throatburn reflux is acid reflux without any heartburn complaints. The medical term for heartburn reflux is GERD (gastro-esophageal reflux disease) and the medical term for Throatburn reflux is LPR (LaryngoPharyngeal reflux)

3. Acid reflux can lead to more serious problems. Left untreated, or insufficiently treated, acid reflux disease can lead to severe inflammation in the esophagus, stomach, lungs, vocal cords, and throat. In some cases, untreated or insufficiently treated acid reflux can even progress to esophageal cancer – the fastest growing cancer in America and Europe since the mid 1970s.

4. You should avoid certain foods if you have either form of acid reflux disease, because they either loosen the muscle between the stomach and the esophagus or are directly acidic themselves.  The 6 most commonly consumed foods that disable the protective muscular barrier between the esophagus and stomach are caffeine, chocolate, alcohol, mint, onion, and garlic. The 4 most commonly consumed foods that are frankly acidic are sugary soda, tomato, vinegar and citrus. Also, there are a few very healthy foods such as honey, blackberries, strawberries, raspberries, and blueberries which are very acidic too.

5. Healthy acidic foods such as honey and berries can have their acidity neutralized by buffering them with more alkaline (less acidic) foods. For example, berries become safer for people with acid reflux if you add unsweetened almond milk to the berries then blend them all together to create a smoothie.

6. A low acid, high-fiber diet that contains a balance of all three macronutrients (proteins, fats, carbs), such as that found in the Acid Watcher® Diet, reduces inflammation from acid reflux and helps with sustainable weight loss as well.

7. Acid reflux can be diagnosed without having to sedate the patient. In other words, we now have the ability to examine the esophagus for damage from acid reflux with the patient wide awake. This technique, which I helped pioneer in the late 1990’s in the United States, is called TNE (TransNasal Esophagoscopy).

The traditional way to examine the esophagus had been to place a large camera in the mouth and guide it past the throat into the esophagus. Because the camera went through to the back of the mouth, where the powerful gag reflex is located,  we needed to give patients intravenous sedation to negate the effects of the gag reflex. With TNE, an ultra-thin camera the size and softness of a cooked piece of spaghetti, is placed via the nose into the throat area, then into the esophagus. By going through the nose, the doctor bypasses the back of the mouth, so the gag reflex isn't stimulated.

Because you don’t have to worry about the gag reflex with TNE, patients don’t need intravenous sedation (also known as conscious sedation or “twilight” anesthesia). Because the patient is awake, the procedure is much safer, there’s also no need for expensive monitoring, and the patient can go back to work or to play right after the procedure.

TNE is less expensive and more convenient than traditional sedated upper endoscopy and numerous studies have shown that TNE is as safe as traditional sedation upper endoscopy, as well-tolerated by the patient, and as good at detecting potentially precancerous tissue. Most people have never heard of TNE, but in the past 10 years, more doctors are using this technique and residency training programs are teaching it.

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