WHY DOES MY GUT HURT SO MUCH?
reflux: If any particular foods or types of food do this to you,
Dyspepsia is a term that literally means “hurting stomach.”
they are your
“trigger” foods. Your triggers may be different
It is used when discussing the pain
of acid reflux. Dyspepsia is
from these. I have listed these because
they are common
actually a term that literally means “hurting stomach.” We doc-
tors sometimes use that word as the patient’s diagnosis until
• Tomato-based foods,
(spaghetti sauce, chili,
Among teenagers and young adults in today’s American
culture, the underlying problem if quite often acid reflux
• Citrus fruits
known as GERD or gastroesophageal reflux disease.
• Any drinks with caffeine
• Soda pop.
(If it fizzes, then it contains carbonic
WHAT IS HAPPENING THAT CAUSES THIS PAIN?
acid, and that’s a trigger for many people)
Gastroesophageal reflux disease, or GERD, occurs when
the bottom muscle of the esophagus (the lower esophageal
• Fatty and fried foods
sphincter or LES) does not close properly and stomach con-
• Garlic and onions
tents leak back, or reflux
, into the esophagus.
• Mint flavorings
The LES is a ring of muscle at the bottom of the esopha-
• Spicy foods
gus that acts like a valve between the esophagus and stom-
ach. The esophagus carries food from the mouth to the
The list above is not only a list of the most common
trigger foods, it is also written in order of frequency. Tomato-
When stomach acid comes back up and touches the
product containing foods are the number 1 trigger when we
lining of the esophagus, it causes a burning sensation in the
chest or throat called “heartburn.” (As you may guess, this pain
has nothing to do with the heart at all. That name came about
HOW CAN I FIX MY ACID REFLUX?
because it may feel like the heart is burning since the pain is
Avoid food 2 to 3 hours before bed is often quite helpful.
Reflux occurs most easily when a person is lying down.
The fluid may even be tasted in the back of the mouth—
Avoiding the foods in the list above may be all that is nec-
it has a vomit-like taste. Occasional heartburn is common
essary. Sometimes simply reducing the amount of such foods
and that does not necessarily mean one has GERD. But if
“heartburn” is happening say, more than twice a week it is
Reducing the amount that you eat will often be helpful.
more likely that it should be considered GERD, and it should
Sometimes reflux is triggered not so much by what you eat,
be treated properly because it can eventually lead to more
If you do all of these things, and you still experience
Excess acid in the stomach (more acid than is needed to
reflux, then medication will probably be necessary. Sometimes
digest food) can also cause pain in the stomach itself. One
medication alone will do the job. Most often, you need to do a
way to look at this is that when the stomach makes too much
combination of avoiding certain foods and taking medications
acid, after it is finished digesting the food, the excess acid
to allow the stomach lining to heal adequately. Sometimes you
starts to “digest” the stomach lining. It’s not a pretty picture,
can then begin to eat the” problematic” foods again— but in
but that is essentially what is happening— and that is also
quantities. Sometimes . . . But not always.
MEDICATIONS THAT HELP
A TWENTY-FIRST CENTURY PROBLEM
What medicines might help me? In days past, all we had
Teenagers and young adults can definitely
can have GERD.
to use were antacids, such as Alka-Seltzer, Maalox, Mylanta,
Certain types of foods cause the stomach to produce more
Pepto-Bismol, Rolaids, Tums, and the like. These neutralize
acid than necessary. These may be the very foods you like the
acid that has already formed. By the time you are hurting, you
already have produced too much acid and the excess acid is
The additional acid begins to irritate the stomach caus-
ing pain wherever the irritation exists (dyspepsia), and the
Today we have better medications. The first I usually
excess acid can back up into the esophagus and produce pain
recommend or prescribe are called H2 blockers. These include
such medications as Zantac (ranitidine), Pepcid, or Axid. For
more than half of my patients, these work well.
Sometimes we need to go to the next step and use
I have seen a huge increase in GERD in my medical prac-
“proton-pump inhibitors.” Proton pump inhibitors include
tice over the past two decades. That is due largely, I believe,
omeprazole (Prilosec), lansoprazole (Prevacid), pantopra-
to life style and dietary changes in our culture. We eat far
zole (Protonix), rabeprazole (Aciphex), and esomeprazole
more fast food than we used to. We eat many more “acid-
(Nexium), which are all available by prescription. Sometimes a
triggering” foods than we used to. And we eat much larger
portion sizes than any generation in the past. (Super size,
Changing diet, reducing portion sizes and using one or more
of this medications will “fix” reflux for most people. I will be happy
Trigger foods are foods that cause dyspepsia or acid
to continue to work with you until the problem is overcome.
Programmes and principles in treatment of multidrug-resistanttuberculosis Joia S Mukherjee, Michael L Rich, Adrienne R Socci, J Keith Joseph, Felix Alcántara Virú, Sonya S Shin, Jennifer J Furin, Mercedes C Becerra, Donna J Barry, Jim Yong Kim, Jaime Bayona, Paul Farmer, Mary C Smith Fawzi, Kwonjune J Seung Multidrug-resistant tuberculosis (MDR-TB) presents an increasing threat to global tub
Leben mit dem Todesurteil Mein Brustkrebs und seine Lungenmetastasen Ein Jahr ist es her, dass ich von den Ärzten der Bonner Robert-Janker-Krebsklinik vonmeinen fünf Lungenmetastasen erfuhr. “Ist dies ein Todesurteil?” fragte ich siefassungslos. Sie nickten betreten: “Metastasierender Brustkrebs ist nicht heilbar, nurnoch palliativ zu behandeln.” Vor allem, wenn sich die Krebszell