When Heartburn Leads to Heartache:
Heartburn is epidemic, and you may not even know you have it.
Maybe your problems began with a runny nose or a persistent cough – a wearisome feeling of a lump in your throat with repeated throat clearing. You didn’t think it was a cold or the “flu” coming on because it just didn’t have the ordinary sniffles, sneezing, congestion or productive cough. But it kept up for several weeks, and now your voice was getting hoarse.
You googled your symptoms and thought it might be your thyroid or an allergy, but then it went away, only to return a week later with vengeance–keeping you awake until the wee hours of the morning. It finally got to the point where you began to cough so much that you were wheezing, and you thought you might even have asthma.
At breakfast after one particular restless night you got really scared when a piece of your favorite bagel got stuck in your throat. You went and saw your primary doctor who ran another round of labs, all normal, but you got even more frustrated when she prescribed an antidepressant. Or perhaps one evening when you couldn’t sleep, you went, as millions do, to the local emergency room. In the brief time available to examine you and listen to your complicated story, your ER doc proposed a series of choices–maybe antibiotics for a possible infection, or antihistamines in case this was an allergic reaction, or maybe an inhaler or even a nebulizer to give you some relief.
Someone with experience and insight into this clinical picture might suggest that all this suffering could be related to reflux – not the kind of back-flow of stomach juices that produces the familiar pains of heartburn, but another variety – a type of reflux in which caustic substances from the stomach get up into the throat, voice box, and even the lungs. Depending on this last examiner’s frame of reference concerning reflux, he or she might tell you that you could be suffering from a particular disease. Unfortunately, the list of names to describe basically the same disorder is long:
- reflux laryngitis,
- extraesophageal reflux (EER),
- laryngeal reflux,
- gastropharyngeal reflux,
- esophagopharyngeal reflux,
- posterior laryngitis,
- laryngo-pharyngitis ,
- gastroesophageal reflux disease (GERD),
- gastroesophago-pharyngeal reflux (GEPR),
- atypical reflux,
- atypical GERD,
- GERD-related laryngitis,
- supra-esophageal reflux,
- ENT reflux,
- the laryngeal form of gastroesophageal reflux disease (LF GERD),
- nasopharyngeal reflux (NPR) – or
- probably more often than not, Laryngopharyngeal Reflux, otherwise known as LPR or silent reflux.
It is not just indigestion, gastritis, or GERD, but what you may have is “silent reflux” or LPR Laryngopharyngeal reflux. LPR is a condition that most often occurs in a person who has gastroesophageal reflux disease (GERD). Stomach content (mainly bile and pepsin) travels up the esophagus (swallowing tube). When that content gets to the throat, it is called laryngopharyngeal reflux (LPR). The following are common symptoms of “silent reflux”:
You often cough or clear your throat after eating a meal,
You wake up in the middle of the night coughing or short of breath,
You wake up in the morning with a hoarse or sore throat,
You often experience a lump in your throat,
You have difficulty swallowing, and
You are plagued with post-nasal drip.
And, you may experience ALL THESE SYMPTOMS without indigestion. If you are over forty, there’s a 50-50 chance you already have it. It is estimated that 100 million Americans have reflux, many unaware, and many incorrectly diagnosed. Why?
Silent reflux is not just about overeating, insufficient stomach acid (hypochlorhydria), obesity, or a malfunctioning lower esophageal sphincter (LES) muscle, but probably due to many years of eating the SAD (Standard American Diet). In fact the term “acid reflux” is often misleading–since it is the digestive enzyme pepsin, not your stomach acid, that causes most of the heartburn–silent and/or painful.
Symptoms can extend along a broad range, from excessive throat mucus, neck pain, bad breath, heavy postnasal drip, voice changes, or even dental decay. Even little children may have LPR and can exhibit feeding difficulties, earaches, or have difficulty sleeping. As a result of this variability many people with LPR may be erroneously diagnosed and treated for problems displaying similar symptoms such as allergies, asthma, or sinus infections.
The pharynx, larynx, trachea, esophagus and the stomach are also influenced by the vagus nerve, one of the twelve major nerves that originate in the brain and extend out into the body. I mention the vagus because it figures in some theories about how LPR causes so many problems. So what happens in the vagus does not necessarily stay in the vagus.
Reflux can be acid or non-acid, a liquid, or a mix of liquid and gas. Reflux reaching up into the pharynx has been shown to be predominately a gas and/ or fine droplets known as an aerosol. Whatever the physical form of the refluxate, it can be composed of varying concentrations of acid, bile, pepsin, enzymes from the pancreas, and even partially digested food, all of which are potentially harmful.
In summary, first, determine whether you’re eating the SAD (Standard American Diet). Second, find out if gastric juices are coming into your esophagus (lungs, sinuses, etc.) as a result of a malfunctioning lower esophageal sphincter (LES) muscle. Third, have you been misdiagnosed with asthma, sinusitis, or allergies, when in fact you have reflux as a result of SIBO (Small Intestinal Bowel Overgrowth)? Remember, that the real villain is the digestive enzyme pepsin, not gastric acid, and therefore taking antacids won’t do a thing except mask your symptoms. At present, there is no “anti-pepsin” medication, so the disease that is literally eating away at your throat, voice, lungs and sinuses, keeps munching away–silently or painfully.
Through our analysis, and your feedback, we can determine whether your heartburn (silent or painful) is as a result of having insufficient stomach acid, SIBO, a malfunctioning LES, or an acidic diet in order to implement the correct treatment modality for your reflux.
If you have low stomach acid, you probably have SIBO.
Here’s a simple question: before you were diagnosed with GERD or heartburn from “too much stomach acid,” did your doctor perform a stomach acid function test? You’d remember if you had this test done.
Interestingly, the Heidelberg test is ALMOST NEVER PERFORMED before excess stomach acid is diagnosed, hence the incorrect diagnosis!
Up until the 1950’s, hydrochloric acid (HCl) supplements were widely prescribed and used for digestive issues. Physicians simply considered replacement of digestive acid to be like replacement of thyroid hormone for a failing thyroid.
Then some very poorly designed and misinterpreted “research” was used to convince physicians that HCl and pepsin replacement therapy is unnecessary. Besides, HCL is a natural substance and difficult to patent. Instead, drug companies focused on patentable drugs to treat “excess stomach acid,” and the highly profitable prescription and OTC acid blocking drug industry was born–to the tune of more than $15+ billion a year–Nexium alone $6 Billion.
Our bodies need 60 or so essential nutrients. “Essential” means that the body MUST have these nutrients or disease will eventually ensue. In addition, these nutrients must be obtained from our diet because the body cannot manufacture them.
Most of these essential nutrients require stomach acid for their assimilation. When stomach acid production declines, as it does with age, nutrient deficiencies begin.
Calcium, magnesium, iron, copper, chromium, selenium, manganese, cobalt, vitamin B-12 and other micro-trace elements requires vigorous stomach acid in order to be properly assimilated. Interestingly, hip replacement surgery and bone fractures are much higher in people who routinely use antacids and acid-blocking drugs.
Why does this matter? Because the chronic use of antacids and acid-blocking drugs (PPIs) for indigestion has dangerous side-effects—even their limited use. A 2009 study concluded that of 59 healthy adults with no history of acid reflux symptoms who took Nexium for 8 weeks and then stopped, forty-four percent developed reflux symptoms during weeks 9-12 compared to 15% in the placebo group. The author of the study, Christina Reimer of the Department of Medical Gastroenterology, Copenhagen, Denmark, concluded, “I think our findings challenge the very liberal prescribing of these drugs and this study should lead to careful consideration about possible changes in prescribing habits.” This phenomenon is called “acid rebound”, and has put renewed emphasis on “weaning” people from PPIs rather than a sudden withdrawal. For example, one might start by cutting the usual dose in half, and two weeks later, cut in half again, and continue
Silent or Painful Heartburn occurs when stomach content
(primarily pepsin & bile) flows back into the esophagus.
- Esophagitis: When stomach/gastric content backs up into the esophagus, it irritates the lining and causes inflammation. Over time, the inflammation can affect the vocal chords and lead to a change in voice.
- Strictures: Stomach content can damage the lining of the esophagus, resulting in scar tissue (called strictures) that can narrow the esophagus and make swallowing difficult.
- Pneumonia and lung scarring: Stomach content may also enter your lungs, causing coughing and possibly infection (pneumonia). It can also lead to scarring, which can cause breathing difficulties.
- Barrett’s Esophagus: Over time pepsin can permanently damage cells in your esophagus, which can lead to esophageal cancer.
- Esophageal cancer: It is the fastest growing cancer in the U.S.
WHAT CAN YOU DO?
THE STOMACH ACID SELF TEST
First self test–do the following:
- Buy some Betaine HCL with pepsin,
- Eat a high protein meal of at least 6 ounces of meat,
- In the middle of meal take 1 Betaine HCL pill,
- Finish your meal as normal and pay attention to your body.
There are really only 2 outcomes from this test.
- The first is that you won’t notice anything, as you go about your normal life after the meal nothing will change. This means it is very likely you have low stomach acid levels.
- If as you go about your normal life and start to feel stomach distress characterized as heaviness, burning, or hotness – then these are signs that you don’t have low acid levels.
If you do get some burning, don’t worry it will pass in about an hour. You can also mix up a ½ teaspoon of baking soda and drink it to help stop the discomfort. After getting 2 positive tests, it is time to start supplementing with Betaine HCL to get your stomach acid levels where they need to be for good digestion. To determine your proper dosage do the following.
The 2nd Three-Day-Self-Test:
- On the first day, take one 650 mg of betaine HCl tablet or capsule form with breakfast. If no discomfort occurs, you can proceed to step two.
- On the second day, repeat step one, but this time taking two capsules instead of one. If there is any discomfort with two capsules, then the long-term dose is one capsule with each meal. If there is no discomfort, proceed to step three.
- On the third day, step one is repeated, this time with three capsules instead of one. If there is any discomfort with three capsules, then the long-term dose is two capsules with each meal. If there is no discomfort, then the dose is three capsules with each meal.
- And so and so on–until the correct dose is determined, that amount is usually taken at the beginning of each meal.
WARNING: You should not take hydrochloric acid capsules or tablets IF YOU HAVE AN ULCER or also taking anything that might irritate the stomach lining. For example, hydrochloric acid should not be taken with aspirin, indomethacin, Bufferin, Anacin, butazolidine, cortisone, or Midol. Hydrochloric acid capsules or tablets should not be chewed, because the acid may damage teeth.
- Do not eat for 3 hours before bedtime. Wait at least 3 hours after eating before laying down.
- AVOID acidic foods such as citrus fruits and juices.
- Do not consume carbonated beverages, sugar, tobacco, onions (raw), fried foods and all processed foods.
- Maintain an exercise program that includes walking, biking, or low impact aerobics. Avoid running and weight lifting as they put pressure on the stomach. DO NOT EXERCISE AFTER EATING.
- Elevate the head of your bed 6 to 8 inches.
- DO NOT IGNORE GERD SYMPTOMS. THIS CONDITION CAN CAUSE SERIOUS HEALTH PROBLEMS.
- The early symptoms of angina and heart attack sometimes mimic those of GERD. If symptoms persist, and pain travels down your left arm, accompanied by a feeling of dizziness, weakness, or shortness of breath, seek emergency medical help at once.
- 57% of heart burn sufferers have hiatal hernias.
- If you take antacids more than 2 times a week consult with a knowledgeable physician…. click here to read more….