Heartburn and Acid Reflux Relief Blog

If you had any doubts about whether eating early helps reducing nighttime heartburn look at this link with scientific article from Centre Hospitalier Universitaire Vaudois, Gastroentérologie, Lausanne, Switzerland.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1434162

It pretty clearly proves that if you go to bed at 11pm and have later dinner at 9pm your pH will be 1.39. If you have early dinner at 6pm than your pH will be 1.69 or 20% lower.

Please note that the higher the pH the lower the acidity. Thus pH of 1 is very acid while pH of 5 is very alcaline.

Conclusion: moving your dinner 3 hours early will reduce your nighttime heartburn 20%… Of course your mileage may vary but trend is quite obvious.

Moving dinner even earlier won’t help much since you’ll get hungry by the time you need to get to sleep.

Good news for those with Barret’s esophagus.

Nebraska Medical Center, offers the BARRX Medical HALO ablation technology, which removes the diseased layer of cells from the esophagus and offers treatment of the disease before it has the chance to progress to cancer.

For more details look at http://app1.unmc.edu/publicaffairs/todaysite/sitefiles/today_full.cfm?match=5503

This looks like a very good progress in prevention of esophageal cancer. Hopefully this procedure will prove to be successfull long term.

Here is a simple strategy on how to manage nighttime heartburn which occured every day for quite some time.

Option 1: Use PPIs - if it works you’re done. Most people stay with this option until it stops working (I have no idea why - but I heard from lots of people that PPIs stop for them working after several years)

Option 2: Use plan below to get rid of constant nighttime heartburn.

1) Find all food triggers for your heartburn and remove them from your diet. This included but is not limited to alcholol, chocolate, caffeine, acidic food (if you have doubts about any food acidity just exclude it - you can also use acidity database on this site). It is better to exclude all foods that you have doubts in rather than suffer nighttime heartburn.

2) Make your last meal very simple and plain. I use steamed rice with butter in this case. Simple meal will make your stomach produce only tiny amount of acid before the night and reduce irritation.

3) Last meal should be at least 3 hours before going to sleep.

4) Make sure you’re not hungry through the day and especially before going to sleep. This doesn’t mean you need to eat right before going to bed. It means that you have to eat through the day to get all the calories you need. Since your last meal is going to be simple you will need to consume more food during the day. Just eat some snacks to compensate loss of calories.

5) As a bonus you should get anti heartburn propup pillow. It will help you a lot in your efforts.

Plan above works like a clock to me. It just takes willpower to stick to it.

Good luck!

1) Immediate pain: starts right after consumption of acidic food. It is caused by acidic substances from food irritating esophagus.

2) After meal pain: starts after heavy meal when there is too much food in the stomach and stomach acid refluxes back to the esophagus.

3) Alcohol/spicy or bitter food related delayed pain: starts several hours after alcohol/spicy food consumption. My guess is that alcohol causes some kind of delayed action when stomach starts actively producing acid several hours after consumption.

4) Chocolate/caffeine consumption heartburn pain. Starts when you consume some chocolate or caffeine late in the evening and lay down later. Heartburn happens because chocolate and caffeine relax the valve between stomach and esophagus and let acid get into esophagus.

After series of experiments I discovered that fresh onion and garlic are guaranteed heartburn/stomach pain triggers for me. Even though both of them are not acidic in nature they contain very bitter substances which irritate my stomach and cause hell lot of pain. This pain is different from the usual heartburn caused by acid but it hurts as bad.
The only form of onion and garlic I can consume without any irritation is well cooked: fried or steamed. It is good that I can consume at least cooked onions since they add flavor to the food but cooking destroys many vitamins in onion thus making it less nutritious. But I haven’t discovered any way to make raw onions or garlic harmless for my stomach.
PS: Don’t believe to anyone who tells you that garlic or onion could help you against stomach diseases. They’re completely wrong.

Correction: actually it looks like onions don’t loose many vitamins and minerals during cooking. Please see tables below.

If you ask people who take PPIs about its safety the answer you most probably will hear: it is totally safe.

Well it looks like it is safe unless you combine it with Plavix. Recent research study found that in patients who suffered heart attack and were prescribed PPIs (in case of study it was Prilosec) together with blood thinner Plavix risk of repeat heart attack doubled in comparison with patients who were prescribed just Plavix. So Plavix+Prilosec equal to double risk of getting repeat heart attack.

It would be nice to get some study to figure out if Plavix+Prilosec are doubling chances of first heart attack. If it is then it should be taken very seriously and every patient prescribed with PPIs should know what risk they may be taking.

Anyway looks like there are some hidden sides in PPIs. It doesn’t mean that we should stop taking them when heartburn is really bad but be careful and if you can find alternatives it maybe time to consider them.
Here you can find more details on this study http://www.healthfinder.gov/News/newsstory.aspx?docid=624675.

From time to time I browse news to search for new promising treatment options for heartburn. Today I found quite an interesting one called LINX.

This procedure is only at the very beginning of its trials but an idea sounds very smart and also significantly less invasive than everything else available at the moment (in my opinion).

The idea of the procedure is to place a bracelet with magnetic beads at the very bottom of your esophagus. The magnetic force of the bracelet will help your esophagus to close and won’t let acid back into your stomach.

I like this idea a lot because instead of trying to anatomically change esophagus by putting scars or staples on it LINX adds some force to your esophagus without doing anything bad to it.

Another positive side of LINX is that if magnetic bracelet doesn’t work due to some reasons you can remove it and completely reverse the procedure! None of other anti-reflux procedures give you that.

The one possibly negative side is that to insert the bracelet a minimally invasive surgical technique, called laparoscopy is required. At the same time this surgery technique is one of the safest available and lots of surgeries are performed using it nowadays since laparoscopy considerably minimizes infection risks and hospital stay.
I really hope that trials would go successfully and we’ll see high success ratios for this procedure.

If you’re interested in this procedure here is LINX official page http://www.toraxmedical.com/patients/linx.php. On this page they also have a link to a site where you can find information on how to participate in LINX trials.

Sabrosa means tasty in spanish and it would be especially tasty for heartburn sufferers since it is produced in a way to be easy on heartburn.

So how Duane Thompson, the inventor of this product, did it? Even though his salsa contains some tomatoes they are thoroughly cooked and pureed to keep acidity low. Another ingredient which is great for taste and good for you stomach is roasted green and red peppers.

So if you’re keen to try some salsa and keep your stomach safe - try some of Sabrosa salsa. You can find it in selected Sam’s warehouse locations or directly in Sabrosa foods online store.

Here is some information on DGL studies from Astrid Pujari, M.D.”In terms of relevant studies, the two that I know of were published in the late 1960s and early 1970s. They were small, and didn’t meet the ideal criteria we now use for research studies. These scientists didn’t study heartburn specifically, but found that DGL helped to accelerate healing in people with ulcers.

While the data on DGL for heartburn is fairly skimpy, licorice has been safely eaten as a food, in reasonable amounts, for hundreds of years. Without the glycyrrhizin, the risk is even lower. Given that, it may be worth a try — as long as your doctor agrees.”

This is very close to my experience. DGL is claimed to be a proven heartburn remedy by many web sites but there is very little ground for that.

For more information read entire article in Seattle Times.

According to recent review released by the Food and Drug Administration patients who suffer from heartburn are not at increased risk for heart problems as a result of taking Prilosec or Nexium. The FDA and its Canadian counterpart began reviewing the drugs, used by tens of millions of people, in May.

The drug’s manufacturer, AstraZeneca PLC, provided them with an early analysis of two small studies that suggested the possibility of a risk.

The agency said its review of that study as well as 14 others indicated no increased risk for patients.

“FDA recommends that health care providers continue to prescribe, and patients continue to use these products as prescribed,” the agency said.
Well it is a great news for us - heartburn sufferers. We can take our Protonixes, Prilosecs and Nexiums without worrying about consequences too much :).

I hope they will do more research regarding all other concerns related to long term PPI treatment like malnutrition, potential lung diseases, etc. For example:

Abstract:
Reduced serum vitamin B12 (cobalamin) levels have been documented occasionally during long-term treatment with a proton pump inhibitor (PPI) in selected groups of patients. This has largely been confined to patients being treated for Zollinger-Ellison syndrome who have sustained drug-induced achlorhydria, which does not ordinarily occur during treatment with a PPI. An appreciation of normal cobalamin metabolism and the pharmacological action of the PPIs adequately explain the mechanism for this reduction. PPIs do not promote the development of pernicious anemia.