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A New Drug To Treat Heartburn

A New Drug To Treat Heartburn

 By Dr. Gifford Jones

Nietzsche, the German philosopher wrote in 1886 that “The belly is the main reason why man does not mistake himself for a god.” The gnawing, burning pain that accompanies heartburn, the most common symptom of dyspepsia or digestive disease always reminds us we’re very human. Now, a new medication will provide speedier relief for this ungodly distress.

Heartburn is a huge problem. In Canada more than seven million people suffer from symptoms of digestive disease. It’s the fourth most common reason to visit a physician and accounts for seven percent of all family doctor visits.

The symptoms of digestive disease include, epigastric abdominal pain, bloating, heartburn, acid regurgitation, nausea, belching, and fullness before completing a meal.

Putting a finger on the cause of digestive disease or acid™related disorders is not always easy. Most cases are believed to be due to excess acid in the stomach. Others, the result of a condition called GERD (gastroesophageal reflux disease).

Before a meal, the lower esophageal sphincter (LES), a tight ring of muscle separating the stomach from the esophagus (food™pipe) usually remains closed.

Following a meal acid-related problems occur when the LES either doesn’t close or it opens at the wrong time. This allows acid contents of the stomach to splash up into the esophagus causing inflammation of its lining.

In other cases it’s poor motility of the stomach that causes epigastric discomfort. Less often it’s due to a peptic ulcer and on rare occasions, malignancy.

A recent survey shows that 85 percent of people believe faulty lifestyle and poor diet cause heartburn. There’s little doubt that questionable habits can exacerbate symptoms.

But Dr. Richard Hunt, vice-president of the Canadian Digestive Disease Foundation, says, “In truth, most individuals experience symptoms through no fault of their own.”

The treatment of heartburn, GERD and peptic ulcers has changed as much as the old Model-T Ford. For instance, not too many years ago, partial removal of the stomach was performed for peptic ulcers.

In 1972 a new era was ushered in when “H2 receptor antagonists” became available. These drugs decreased the amount of acid produced by the one billion cells that line the stomach.

The next major advance was the discovery of PPI’s (proton pump inhibitors) which cause even greater suppression of gastric acid. These drugs such as Losec, Prevacid, Pantoloc and others have helped millions of people. Losec alone has been used by more than 500 million people suffering from acid-related upper abdominal pain.

Dr David Armstrong, a gastroenterologist at McMaster University, Hamilton, says that “a new PPI, “Nexium” is a refinement of Losec and the only one that has proven to be clinically superior to it.”

Nexium is indicated for the treatment of conditions where a reduction of gastric acid secretion is required. For acute conditions the recommended dose is 20 to 40 milligrams a day for four to eight weeks. A dose of 40 mg once daily provides maximum gastric acid suppression.

Dr. Nigel Flook, Assistant Clinical Professor at the University of Alberta, reports that “Patients are normally completely relieved of their symptoms in five days compared to 8 or 9 days on Losec. If inflammation of the esophagus is causing the trouble healing occurs in 82 percent of cases in four weeks compared to 8 weeks with Losec.”

Today we know that peptic ulcers are no longer due to stress and faulty eating habits. Rather, a bacterium H. pylori is often associated with this problem.

Patients with peptic ulcer are prescribed a combination of Nexium 20 mg, and two antibiotics amoxicillin 1000 mg and clarithromycin 500 mg, all twice a day for seven days.

Nexium is well tolerated, but since all medications can have side-effects talk with your doctor about them.

Dr. Richard Hunt has sombre news about the health of Canadians. He claims that only one-third have no heartburn, one™third have occasional trouble and another third are chronically affected. And since heartburn often affects young and middle-aged people, industry loses millions annually in lost worker hours.

I agree with Dr. Hunt that you can lead a righteous life and still suffer from heartburn. But never forget that a faulty lifestyle can exacerbate acid-related upper abdominal pain. Don’t try to mimic the man in the T.V ad who exclaims in distress, “I can’t believe I ate the whole thing!”

Also don’t be your own doctor. If you have upper abdominal discomfort that persists see your doctor.

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Dr. Gifford Jones  Bio
Dr. Gifford Jones Most recent columns

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He’s been a ship’s surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: http://www.mydoctor.ca/gifford-jones



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