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Why Your Heartburn Drugs May Not Work


As we head into a holiday season full of heavy, rich meals, here's unwelcome news: Not only is heartburn increasing, but also those highly popular acid-blocking drugs don't seem to work for a large number of us.

A recent study in the journal Gut found that during the past two decades there was a 47 percent increase in the number of people who suffered weekly bouts of heartburn, or gastroesophageal reflux disease (GERD), the condition that most often causes that burning sensation in our chests, NBC News reports.

Other data show that about 44 percent of Americans have heartburn at least once a month, and 7 percent have it daily, according to the International Foundation for Functional Gastrointestinal Disorders.

But the particularly bad news is that those strong, acid-reducing medicines called proton pump inhibitors (PPIs) don't seem to work for up to half of GERD patients, reports the Wall Street Journal.

With these patients there doesn't seem to be the acid erosion of the esophagus that gastroenterologists typically see in cases of stubborn heartburn. Why? The doctors aren't sure. So far, all they can do is come up with a silly acronym - NERD, for nonerosive reflux disease - and offer theories.

Gastrointestinal experts now estimate that 50 to 70 percent of GERD patients actually have NERD, according to the newspaper. Doctors suspect it may be because the culprit is bile - a digestive juice in the intestines produced by the liver - and not stomach acid that's the cause of this new condition. If it's bile, then pills to lower stomach acid won't have much effect. Or maybe it's because some people have a supersensitive esophagus that reacts to even reduced stomach acid.

And then there's the old bugaboo stress that could be causing it. The Wall Street Journal reports that a 2004 study of 60 patients conducted at the University of California, Los Angeles, found that those with severe, sustained stress in the previous six months were more likely to have heartburn symptoms during the next four months.

David Clarke, M.D., a gastroenterologist near Portland, Ore., told the newspaper that his patients with heartburn that didn't get better on PPIs, or show signs of acid reflux, had severe stress in their lives. Once the stress was recognized and reduced, their heartburn symptoms improved.

Until there's more research, doctors can recommend only lifestyle changes to deal with this kind of heartburn: lose weight, avoid wearing tight clothes that restrict the waist, eat smaller meals that don't overload the stomach, choose lower-fat foods (fat slows down the stomach from emptying), quit smoking and don't lie down within three hours of eating.

And, of course, avoid stressful holiday gatherings whenever possible.

In other health news:

Testosterone gel plus Viagra doesn't help ED. Reuters reports that using a testosterone gel in addition to Viagra doesn't make the little blue pill work any better, according to a new study. A study of 140 men ages 40 through 70 found that adding the gel doesn't provide increased sexual benefits to those with erectile dysfunction.

Panel recommends that everyone get HIV test. There's a new push to make testing for the AIDS virus as common as cholesterol checks, the Associated Press reports. An independent panel proposed Monday that all Americans ages 15 through 64 - not just people considered at high risk for the virus - should get an HIV test at least once.

Photo:  Nick Daly/Image Source/Corbis









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