How could North Americans have so many ill stomachs? Why does treatment cost so many billions? And why are so many taking the wrong medication?
According to the Canadian Institute for Health Information, 10 years ago one in eight Canadians over 65 years of age was taking PPIs (proton pump inhibitors), the strongest medicine available to stop gastric acid secretion. Now, the number is one in five. A report from Johns Hopkins University says that every year 113 million Americans take these pills.
But how many people need PPIs and what are the dangers of long-term use? In 2009 the U.S. Food and Drug Administration (FDA) warned that those taking PPIs along with Plavix, hindered the ability of Plavix to prevent clotting.
Another report in the Archives of Internal Medicine found that men who took PPIs and Plavix following coronary attack were 64% more likely to have a second heart attack.
This same journal also reported that PPIs increased the risk of fractures in postmenopausal women, as well as lung and intestinal infections in hospital patients. It's the old story of treating one problem and ending up with another.
Patients suffering from serious gastrointestinal problems do need PPIs to totally stop acid production in the stomach. In fact, in this case, it can be life-saving.
But not everyone has a critical gastric problem. The great majority have heartburn, a burning sensation in the chest often associated with belching and bloating. Nearly everyone suffers from garden-variety heartburn at some time in their lives, usually after overindulgence. The problem is that too many people use PPIs such as Nexium, Prevacid and Prilosec to treat heartburn. It's like using an elephant gun to shoot a mouse.
So what should medical consumers who do develop heartburn do? Remember that many cases of simple heartburn go away when a faulty diet is corrected. Tincture of time is a great healer.
In addition, those who are overweight should start to shed pounds. This decreases pressure on the stomach to push gastric juices into the esophagus (food tube).
Remember, our muscles need an occasional rest. The stomach needs a holiday even more from heavy meals, considering how these can abuse it. You can do this by eating smaller, less challenging meals. In fact, fasting for a day now and then would benefit a lot of people.
Keep a diary of food you eat for at least two weeks to see if there are any foods that cause heartburn. Most health food authorities agree that it's prudent to stay away from fatty, spicy and acidic foods. So limit or eliminate orange and grapefruit juice, french fries, raw onions, garlic, chicken nuggets, buffalo wings, hot spices, liquor, wine, coffee, tea and high fat brownies, to name a few. Adding milk to the diet also helps to soothe the stomach.
Stop smoking. The chemicals in cigarette smoke relax muscles in the lower end of the esophagus, allowing gastric juices to enter. Avoid lying down or bending for three hours after a meal, which decreases the chance of irritating juices entering the esophagus. It also helps if you get rid of tight-fitting clothes and waistbands.
If you still have heartburn, antacid drugs such as Mylanta, Maalox, Rolaids or Tums may help. These drugs reduce the amount of stomach acid. But if there's no speedy relief, it's time to see the doctor. It's never a good idea to take any medication for a prolonged period of time without seeking medical attention.
Your doctor may be right to treat stomach acid production by prescribing PPI drugs. But he may also suggest a gastroscopy to examine the stomach and esophagus. Chronic heartburn can lead to malignant changes in the lower end of the esophagus.
It may be difficult during a severe attack of heartburn to know whether it's been overindulgence or a heart attack. Dial 911 if there's any doubt.
It's shocking that North Americans have to spend billions of dollars every year on stomach medication. Obviously millions are doing something wrong, and it's usually stomach abuse. So don't blame the stomach. It's the brain that's the problem.