Indigestion drugs can cause the symptoms they are designed to treat
Posted on 17 July 2009
Published July 17, 2009 . Filed under: Healthy Eating, Nutrients and Supplements
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I don’t know whether there is any scientific evidence to support this but someone recommended honey for indigestion many years ago and it has always worked for me. A small spoonful mixed with saliva in the mouth and slowly swallowed.
July 17, 2009 @ 7:14 pm
There are two forms of reflux – gastro-oesophageal reflux and laryngo pharyngeal reflux. As a Voice Therapist (Speech and Language Therapist) a lot of my patients have been put on PPIs because reflux is thought to be contributory to dysphonia. Often they do seem to help, however I always try to encourage them to reduce reflux,which is seen in the throat at laryngoscopy as redness around the arytenoid cartilages, in more conservative ways. Pineapple juice helps digestion and refraining from several foods – tomatoes, chocolate and citrus foods also helps, as well as not eating too late at night.
July 17, 2009 @ 7:43 pm
I was diagnosed with a minor hiatus hernia and prescribed PPIs. I didn’t take them but what I did do was Alexander technique. It has helped hugely with lots of things (see BMJ article re. back pain), and it helped me with reflux (probably by improving my tendency to postural slump, especially over the computer keyboard; thereby giving everything in that area more room to manoeuvre and perhaps taking pressure off the valve between the oesophagus and the stomach). Also, if I do get an attack, I take aloe vera juice, a good-quality one. All that you say about eating late etc. is valid too. Thanks!
July 17, 2009 @ 8:14 pm
One of the great advantages of low carb diets is that it eliminates almost all indigestion.
July 17, 2009 @ 8:31 pm
Jake
That’s certainly been my experience in practice, and here are some of the reasons why:
1. A common (but under-recognised) cause of dyspepsia is food sensitivity, especially wheat.
2. On a low carb diet, foods tend to be ‘better combined’ (protein and veg without starch).
3. People tend to eat less anyway (because they’re usually naturally less hungry).
July 17, 2009 @ 8:40 pm
In my experience wheat is the culprit in many cases of any digestive problem. A pharmacist friend told me that antacids were only meant to be used for short periods.
July 17, 2009 @ 10:05 pm
Anybody ever hear of using hydrochloric acid? I’ve read that (and even found a digestive enzyme that contains it), but haven’t tried it yet.
July 17, 2009 @ 11:56 pm
Nancy
I sometimes use hydrochloric acid in practice. But you need to be reasonably certain that the stomach lining (mucusa) is in good condition before you try it, or it can burn. I usually recommend DGL for a while then a trial of hydrochloric acid. It’s a real boon for those who undersecrete stomach acid.
July 18, 2009 @ 12:11 am
I have used unfiltered raw apple cider vinegar. I just started out with a little in a small amount of water and got to the point I sipped it straight. No more indegestion.
July 18, 2009 @ 1:27 am
I am 55 and have had problems with reflux, esophageal strictures (at least 6 times I’ve been dialated), hiatal hernia, low esophageal pressure with corkscrew spasms for over 30 years. At times I get food and liquids getting “stuck” in my esophagus (confirmed by XRay testing with a barium tablet), and horrendous hiccups.
I’ve been on all the meds on the market, most recently taking Nexium twice a day in order to control symptoms. Recently, due to a job lay-off and loss of insurance, I’ve been unable to afford my meds (over $400/month) so I’ve weaned myself off. I’ve also gone back on low carb, eating no grains and a 50-70% fat diet. For the most part I’ve done very well….taking Tums when needed, but only a few times a week.
In the past low carb has had little effect, but I think maybe getting off the meds in conjunction with low carb is what I needed. I eat everything docs tell you not to! I love spicy foods and, as noted, a very high fat diet.
The last time I took a Nexium was over 4 weeks ago, and that was because of having 2 alcoholic drinks!
I DO have damage confirmed by XRay and direct visualization, but really hope that I’ve finally found a solution!
The other thing I highly recommend is having a warm drink on hand when eating! Cold can cause the esophagus to spasm, and warm liquids help relax it and also help the food go down easier.
July 18, 2009 @ 5:54 am
This didn’t surprise me at all because I long ago saw evidence that reflux and ‘indigestion’ were caused by low stomach acid (often described as candida-related), which apparently has some effect on the opening of the valves in the stomach (I cannot now remember the detail, but think it was about the failure of the lower valve to open)…Would need to research this again…
July 18, 2009 @ 6:57 am
Lactose intolerance is often the cause of acid reflux and, like wheat intolerance, is easily overlooked. Avoiding all dairy products for a few days can result in dramatic improvement in symptoms, which can also include bouts of diarrhoea, blocked sinuses, phlegm, eczema, rashes and spots.
If there are other digestive issues (such as IBS, bloating, constipation or diarrhoea), it’s worth considering the possibility of dairy and wheat intolerance occurring together, which is not at all uncommon. People tend to cut out one food group, and if some symptoms remain, they assume that wasn’t it.
Food intolerance testing takes the guesswork out of it.
July 18, 2009 @ 9:09 am
Am glad to see at the end of your article you mention chewing, size of meal, and timing of eating. I’ve seen these things mentioned in a small number of articles and books, but are mostly ignored. Surely they are a very important aspect of what we are asking our digestive system to do, and I feel not enough chewing / too large meals / bad time of eating are a big factor in many peoples digestive problems.
Why are these issues not more commonly discussed, and better education / emphasis undertaken?
July 18, 2009 @ 11:39 am
Dr Briffa, I agree wholeheartedly with your thinking and reasoning on indigestion and acid reflux, but, could you please take it a stage further and outline some of the reasons why some people experience low stomach acid in the first place. I have always understood that a Helicobacter Pylori infection or parasites can compromise the production of stomach acid. Also, a deficiency of zinc, magnesium and B6. Are you able to expand on this, and perhaps give other reasons for low stomach acid?
July 18, 2009 @ 1:11 pm
(pardon my english i am dutch)
In addition to your useful suggestions:
do not eat when tired or stressed out or in a hurry, take at least 15 minutes to unwind, if possible lay down and stroke your stomach
enjoy your meal in a relaxed atmosphere (no tv news or papers or discussions)
do not eat while walking or driving or working on your computer
pay attention to the first signs of being satisfied so you do not overload your system :”listen” to your stomach
What helped me off indigestion ( from keeping these rules), was : no grains and no legumes
July 18, 2009 @ 2:31 pm
Thank you (as always) for your valuable contribution Dr. Briffa. As a Low carb eater, I can attest to the comments earlier about the lack of indigestion or heartburn when carbs are severely restricted. This should be the standard conservative treatment for this condition. I was recently out of town at a conference and found that the only food available was carb-laden treats. By day three I was in the sundry store buying a roll of antacids!
I suspect there may be a fermentation factor. Another pleasant side-effect of my low-carb diet is the near complete lack of embarrassing flatulence. I can only assume it is a by-product of fermenting sugars in the diet, which explains the utter lack of that problem. That might also explain a complete lack of underarm odor – I rarely need deodorant when I exclude carbs from my diet. Forgive me if I’m getting too graphic!
The point is this – Taubes may have only covered the tip of the iceberg in his excellent tome. If any of you haven’t read “Good Calories, Bad Calories” (the American title) by Gary Taubes, I cannot recommend it more highly. The western diet is severly biased toward high-carbohydrate foods, perhaps this really does explain nearly every common ailment we encounter…
July 20, 2009 @ 2:30 am
Steve
Completely agree on the fermentation thing. And I enthusiastically recommend Gary Taube’s book (entitled The Diet Delusion in the UK).
July 20, 2009 @ 8:28 am
Interesting – but disappointing!
I’ve had symptoms of “acid reflux” for years and sadly they are one of the only things that hasn’t improved on a low carb diet.
I started off on Gaviscon, then was prescribed Omeprazole. It took about three weeks to start to have an effect, then my GP halved the dose. Only the half dose tabs weren’t available so I went without for a couple of weeks, after which they did no good.
A different GP prescribed Famotidine (an H2 blocker rather than a PPI) which worked immediately and effectively.
After moving, the famotidine was replaced by ranitidine which simply didn’t work, after a couple of weeks the symptoms returned and I had to jump through hoops to be represcribed famotidine (local formulary doesn’t include it). Stopping the famotidine, like this changeover, causes the symptoms to return but 2 – 3 weeks later.
Since this works on histamine receptors rather than blocking the acid formation per se I wonder if the cause might be autonomic neuropathy – other symptoms of both peripheral and autonomic neuropathy resolved on controlling my blood glucose but this one like a couple of others still hasn’t.
At one stage it got worse and I found sucking a Rennie after eating helpful, also sodium bicarbonate but used for long this seemed to produce leg cramps.
Currently I’m trialling magnesium citrate although my electrolytes appear to be within limits (magnesium shortage appears to be associated with diabetes) and it’s really too soon to tell if it’s helping but I think it may be – not enough to discontinue the famotidine though.
In a newsgroup there’s a surgeon who usually recommends surgery for the condition. However there’s also someone who, having gone through the usual meds, jacking up his bed at an angle etc. found relief from betaine HCL, ie. increasing the acid level.
So like a lot of things my impression is that it may be several orders of magnitude more complex than the drug company rep tells you . . .
July 21, 2009 @ 12:18 am
Dr Briffa,
Interesting article, and thank you. I saw a ENT specialist today after experiencing some weeks of discomfort in my throat, like there was something stuck there. He did a fibreoptic endoscopic examination through my nose and diagnosed me as having larygophangyral reflux. The symptoms I have read about pretty much match what I have been experiencing recently.
He prescribed me Somac 40mg before bed time. After reading your article and those of others, I am not particularly keen on taking this drug.
I have not had any heartburn experiences since I eliminated wheat from my diet about 6 months go, but I find that I burp – a lot. I wonder if this contributes to my symptoms? What natural remedies are there to stop/minimise the burping, or even alternatives to the Somac?
Any advice from yourself or readers would be greatly appreciated.
David
July 22, 2009 @ 3:08 pm
I take a low dose of Nexium to control reflux; without it, I run the risk of doing more harm to my eosphagus. I’ve had two dilations done because of scar tissue and I don’t want more acid doing further damage. The danger of cancer of the esophagus isn’t something I feel I can ignore and I’ve been warned that acid refluxing into the esophagus can cause this.
I should maybe add that I had no pain nor indigestion with my reflux, my only symptom was food occasionally getting stuck. I had an acid taste sometimes in my throat, but that was all. If I’d known the acid was doing so much damage, forming scar tissue until my esophagus was too narrow to allow food to pass easily, then I’d have wanted something to stop the acid. And with Nexium that’s what I’ve got.
I only take one 20 mg tablet every other day and that does the trick. No taste of acid in my throat and no more swallowing problem. I eat a varied vegetarian diet but don’t avoid carbs; I have no indigestion or stomach problems, no bowel problems either. I haven’t noticed any side effects from Nexium, except perhaps my hair isn’t quite as thick as previously, but I put that down to age as much as to Nexium. I’m happy to continue with this drug and wonder if maybe some people take too high a dose; the 20 mg every other day works perfectly for me.
Good luck to everyone here in their endeavours to improve their digestive health. I agree that what we eat and how we eat it is important, but sometimes medication – in moderation – is the safest way to go.
July 26, 2009 @ 1:08 am
I have MS and in 05, a relapse weakened the stoma and acid reflux was making me cough.
A scan confirmed that my esophagus was inflamed and whilst it wasn’t affecting my voice too much, the risk of continual inflammation and the awful cough, indicated more medication.
I did start on Lansoprazole, but decided to try Omeprazole which seems to work just as well.
It looks as though I’m stuck with it, despite following a low-carb, gluten-free diet.
As Isobel wrote above, sometimes there’s no choice.
There are times when this type of medication is the best option -despite the risks.
I also take LDN. Now, there’s a good topic for discussion…..(Low Dose Naltrexone) AND I take Beta-interferon.
xx
July 27, 2009 @ 2:52 am
I have gastritis caused most likely by bile reflux. (I have had my gall bladder out). My gastro Dr put me on Nexium first and then Prilosec and now I am on Ranitidine. I have all kinds of digestive problems which (I think) are because of the proton pump inhibitors. If I go off the meds I have super pain. Have you had to deal with this and if so what is the solution? (I am 69 years old)
October 9, 2009 @ 11:36 pm