Heart burn

[undressa]

Sorry I sent u an email b4 I say this part of the thread
My boyfriend has heart burn, mostly at nite and it wakes him up. He is young (28) and just moved to this state so I am finding him a doc as soon as we get back from vaca. It has been going about year, and causes him great pain. Any sugestions?
V

[Dr Steve]

Sorry I sent u an email b4 I say this part of the thread
My boyfriend has heart burn, mostly at nite and it wakes him up. He is young (28) and just moved to this state so I am finding him a doc as soon as we get back from vaca. It has been going about year, and causes him great pain. Any sugestions?
V

hmmm...I haven't gotten an email from you yet. where did you send it? PM me and we'll figure it out.

On to your question:

"Heartburn" is also called "pyrosis" by doctors and is usually caused by stomach acid doing things it isn't supposed to do.

The stomach itself is (generally) protected from digestive juices by a layer of mucus and other substances...this keeps the stomach from being digested by itself. However, stomach acid CAN attack the stomach in some circumstances, and if it gets into the esophagus, it can cause symptoms and problems as well.

The "valve" that is supposed to keep stomach acid out of the esophagus is called the lower esophageal sphincter. The LES is not a perfectly functioning device, however, and in a lot of people it's just too loose to do the job, allowing acid to reflux into the esophagus, causing heartburn and changes to the esophagus on a cellular level. This is the famous Gastro-Esophageal Reflux Disease (GERD).

http://www.gerdcare.org/images/gerd-reflux.jpg

At other times, a part of the stomach protection breaks down and the stomach begins to attack itself, making a small ulcer or even a perforation of the stomach (rarely). This is the famous PEPTIC ULCER DISEASE (PUD). This can cause burning pain that is described as "heartburn" as well.

http://images.medicinenet.com/images/illustrations/peptic_ulcer.jpg

In the short-term, it's perfectly fine to try to treat heartburn on your own at home, with the understanding that you need to see a health care provider sooner rather than later. If your heartburn is described as "crushing" pain at the sternum that comes on with exercise and radiates down the left arm, go to the ER immediately; that ain't "heartburn", it may be "acute coronary syndrome" and needs to be evaluated urgently.

Ok, that said, the most common thing your BF probably has is GERD. These are the things he can do until he sees a doctor (which he should definitely do):


put a brick under the legs at the head of the bed to raise the bed a few inches. this will keep gastric juices in the stomach when sleeping. a few degrees is all that's necessary
avoid TUMS, use MYLANTA or MAALOX instead. Calcium carbonate actually makes your stomach produce more acid over time. Mylanta doesn't.
Buy an "acid reducer" over the counter. Prilosec is most likely to be effective. You need to take it daily, though, until he gets a doctor's appointment



hopefully, this will help until you can get him seen.


your pal,



steve

[biozombie]

Hey Dr. Steve, any thoughts on diluted Apple Cider Vinegar to reduce heartburn? It seems to work for me, depending on what horrible food I ate earlier. I used to use the old baking soda in water and now I know why my heartburn is worse now than it used to be.

Thanks!

[Dr Steve]

Hey Dr. Steve, any thoughts on diluted Apple Cider Vinegar to reduce heartburn? It seems to work for me, depending on what horrible food I ate earlier. I used to use the old baking soda in water and now I know why my heartburn is worse now than it used to be.

Thanks!

A very interesting question, and one I run across from time to time.

The weird thing is that vinegar is acetic acid, and adding acid to a stomach that already has too much acid seems counterintuitive. Most in the know feel that this came from homeopathy which proclaims that things that cause similar symptoms to the one you're treating will cure those symptoms. For example, something that causes fever is somehow good for treating fever. The other thing that homeopathic medicine likes to do is take those substances and dilute them so they are no longer harmful. Doing this somehow "imprints" the action onto the water, but there is no toxic substance left. The dilute acetic acid method fits this model reasonably well and therefore the theory that this "treatment" originally sprung from homeopathy sounds on the surface to be valid.

Now, if you feel this works for you, assuming there are no contraindications to taking it in small amounts, it's probably not going to hurt you. However, if you have chronic heartburn, this really needs to be evaluated by a gastroenterologist. They may want to do a 'scope on you at some point to make sure that it really is just garden-variety heartburn and not something else.

I did a search of the medical literature on vinegar and heartburn and couldn't find a single study to support its use. If you have some studies, or run across any, let me know!


your friend,



Steve