Does Magnesium Help GERD?

GERD, or gastroesophageal reflux disease, is a more serious form of the more common acid reflux. Both acid reflux and GERD occur when the esophageal sphincter either closes improperly or opens when it shouldn’t, allowing stomach contents to spill back into the esophagus. Treatment for GERD can involve both lifestyle changes and either prescription or over-the-counter medication. Often, the first medication suggested to treat GERD is the humble antacid, made from the salts of minerals calcium, aluminum and magnesium.

GERD Overview

While simple acid reflux — caused when digestive acids and food come up through the open sphincter and spill into the esophagus — is quite common and not necessarily a cause for concern, GERD is more serious. If you regularly experience acid reflux more than twice per week, you may have GERD. Adults with GERD experience frequent heartburn or acid reflux, while children who have GERD generally do not. Instead, children who have GERD may have a persistent cough and difficulty swallowing. Experts cannot explain why people develop GERD. However, smokers, women who are pregnant, and people who are obese are more likely to develop GERD.

Magnesium Antacids for GERD

Get Gaviscon Alumina and Magnesium Trisilicate/Antacid

If your GERD symptoms are not severe, your physician will likely suggest you try to first treat it with antacids. Antacids work to help GERD by neutralizing stomach acid and may even help the stomach’s defensive systems by stimulating the production of mucus secretions and increasing levels of bicarbonate. One form of antacid is magnesium salts, sold as magnesium carbonate, magnesium trisilicate and magnesium hydroxide or milk of magnesia. While effective at neutralizing acid, magnesium salts can cause diarrhea. Products like Maalox and Mylanta include aluminum with the magnesium salts to help to balance the laxative effect.

Other GERD Treatments

If magnesium salt or calcium carbonate antacids to not adequately address your GERD symptoms, your physician may recommend a different type of treatment. According to the National Digestive Disease Information Clearinghouse, other commonly prescribed medications for GERD include: foaming agents that prevent reflux by filling your stomach with foam, H2 blockers that work to slow your stomach’s acid production, proton pump inhibitors which also work to help heal your esophagus; prokinetics, which help to improve the function of your sphincter and the digestive muscles in your stomach; or a combination of several therapies. Talk with your health-care provider about which treatment approach is best for you.

Magnesium Contraindications

While magnesium is a mineral and may therefore seem “safe,” you should consider it a drug, like any other treatment, and take appropriate cautions. Magnesium in doses under 350 mg is considered “likely safe” for most people, including pregnant women, by the National Institutes of Health. However, there are some situations in which you should avoid magnesium or take it with caution. If you have a heart block or kidney disease, you should not take any forms of magnesium because they could be harmful to your health. You should exercise caution taking magnesium if you are taking some antibiotics: aminoglycosides, quinolones and tetracycline antibiotics can all be impacted by magnesium. Muscle relaxants, calcium channel blockers and bisphosphates also shouldn’t be taken with magnesium. Consult with your physician about possible drug or herbal remedy interactions before you begin any treatment regimen.

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Heartburn Pills

Many people have the wrong impression that as long as they take their heartburn pills, the symptoms would go away. This is not necessary true all the time. Read about this news:

No one had a clue that busy businesswoman Neth (not her real name) was suffering from pain literally emanating from the pit of her stomach.

Neth, all 185 pounds of her packed into a 5-foot frame, was diagnosed with Gastroesophageal Reflux Disease (GERD) and gastritis in August of 2009 when she underwent endoscopy at a well-known Manila hospital.

Though commonly called dyspepsia, heartburn or acid indigestion, medical experts call these collectively as GERD when they become chronic occurrences in an individual, according to nutrition expert Phyllis A. Balch, author of “Prescription for Nutritional Healing.”

GERD is characterized by a burning sensation and pain in the stomach and/or chest, behind the breastbone. It may be accompanied by bloating, gas, nausea, shortness of breath and/or acidic or a sour taste in the throat.

Stomach acids going up

Heartburn often occurs when stomach acids make their way up instead of staying down. Hydrochloric acid used by the stomach to digest food backs up into the esophagus (the tube or passageway of food between the throat and the stomach), causing sensitive tissues lining the esophagus to become irritated. Balch cited that normally, the esophageal sphincter muscle pinches itself shut and prevents stomach acid from surging upward. However, if the sphincter is not functioning properly, the acid can leak past it and into the esophagus, causing GERD.

Neth said GERD would feel like “muriatic acid climbing up my esophagus, resulting in pain behind the breast bone.” Sometimes, she added, she would experience chronic asthma, and she would suffer coughing fits. And when she starts drinking coffee and eating pizza, she would feel as if her heart palpitated.

She went to the doctor and underwent laboratory tests, which didn’t yield any conclusive results. It was only after endoscopy that the doctor saw she had GERD and gastritis. She was asked to drink a proton pump inhibitor and a drug (Domperidone). However, months on drugs and therapy didn’t cure her.

More acids

She tried putting off weight, which she did, until she reached 112 lbs. “I also realized that too much antacids and the proton pump inhibitor itself gave me more acids and my stomach had a harder time to digest food.”

After doing her own research, she was recommended by a classmate to plant-based nutrition-dietician Dr. Blecenda Varona. Varona immediately removed animal protein (including dairy) from her diet, and Neth became totally vegetarian.

“My only drug was ginger ale [nilagang tinadtad ng luya]. I used hot bag compresses every evening for my stomach, near my esophagus. My rice was red or unpolished. When I woke up in the morning, I drank 3 to 4 glasses of alkaline water, after 1 hour, 1 glass of fruit blend [papaya and pakwan] and then rice with mushroom soup with carrots or potatoes.

“I drank two glasses of water again after two hours. That’s how my lunch and dinner also went. My lunch was monggo with malunggay, or steamed spinach, then after two weeks, I added tofu without oil, without tomato sauce, without vinegar. That’s how it went for three months.”

Every day, Neth also exposed herself to 30 minutes of the morning sun and had 30 minutes of exercise. Slowly she started eating textured vegetable protein [or vege-meat].

Neth never had any GERD attack afterward. Now she is GERD-free after two years.

Diagnosed with GERD

Rico (not his real name), 28, an Internet marketer, was diagnosed with GERD in 2007. The attacks varied, and he ranked them in levels.

“I’ve had two gastroscopies done on me, one colonoscopy and a number of other related tests to check the status of my GERD over the last four years. I’ve been in and out of the ER, and the prescription is still the same hospital wise.”

He also did his own research, took a vacation in the province, and generally slowed the pace of his life.

“Two things made a big difference for me as of late: going vegan and adapting to a healthier consistent lifestyle, as per my dietitian and nutritionist Blecenda Varona.”

“Various spiritual and mental techniques has also helped calm my mind and body.”

These techniques have also kept Rico’s stomach acids stay put.

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Nearly 13,000 Americans will be diagnosed with esophageal cancer this year, and it could be fueled by something as common as acid reflux.

But thanks to new guidelines doctors can zap away the damage before the cancer can form.

A normal day for Tom Geocaris consists of a lot of exercising. You can’t tell by looking at him, but just a few years ago, Tom’s life went from normal to near deadly.

“It started out as occasional heartburn maybe after big meals and holidays, and then it got to be more frequent,” said Tom.

His acid reflux had developed into Barrett’s Esophagus. It’s where the lining of the esophagus is damaged by stomach acid. If left untreated the condition could turn into cancer.

“About a 300-fold increase in the risk of cancer of the esophagus in people with Barrett’s Esophagus,” said Dr. George Triadafilopoulos, a gastroenterologist at Stanford Hospital.

In the past, Barrett’s was often treated with surgery that included serious risks and side effects. Triadafilopoulos used a newer and less-invasive approach to burn off Tom’s pre-cancerous cells.

During the half-hour radiofrequency ablation procedure, a tool is inserted into the esophagus and touches the Barrett’s tissue. Then the balloon is inflated and releases energy that literally burns the Barrett’s away.

The balloon is then deflated and removed with minimal complications or pain.

Until now doctors took a wait-and-see approach with high-risk Barrett’s patients to see if cancer would develop, but new recommendations say these patients can’t afford to wait and should be treated immediately.

While Tom still has occasional heartburn, his Barrett’s is gone, he’s cancer-free and he’s back to his normal routine.

“I feel pretty secure about the situation. Normal’s very good,” said Tom.

After the procedure, most patients still have to take medication to control their acid reflux.

Doctors say if you have frequent heartburn and your symptoms become significantly worse, it’s a good idea to get it checked out.

Radiofrequency ablation is covered by Medicare and some private health insurance plans.

[Source: ABCNews]

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News: FDA Warnings on Acid Reflux Drugs—Lansoprazole

According to recent reports, the U.S. Food and Drug Administration (FDA) has issued a warning on the use of TEVA-manufactured generic drug for acid reflux, lansoprazole. The FDA recommends “patients using the orally disintegrating tablet (ODT) form of lansoprazole via oral syringes or feeding tubes not take the version manufactured by Israel-based Teva” due to some clogging problems.

PREVACID is a trademark registered in the U.S. Patent and Trademark Office and SoluTab is a trademark of Takeda Pharmaceuticals North America, Inc. and used under license by Takeda PharmaceuticalsAmerica, Inc.)

People taking lansoprazole should tell their doctor if any of these symptoms are severe or do not go away

- stomach pain
- constipation
- diarrhea
- nausea
- headache
- dizziness

Some side effects can be serious. Persons experiencing any of the following symptoms should call their doctor immediately:

- rash
- blistering or peeling skin
- hives

This is not the first difficulty that has occurred with drugs prescribed for acid reflux, however. “Prokinetic drugs like metoclopramide and cisapride [have been] used in conjunction with other measures in patients suffering from nausea or bloating in addition to heartburn.” Cisapride (Propulsid) is no longer available in the U.S. due to some of its side effects and Metoclopropamide (Reglan) may cause Tardive Dyskinesia.

In fact, “Patients who have ulcers or some form of gastrointestinal bleeding should not take Reglan. In addition, Reglan is known to aggravate symptoms associated with asthma, Parkinson’s Disease and kidney disorders. It can also raise blood pressure and have an impact on patients diagnosed with clinical depression.”

TEVA, the Israel-based pharmaceutical company, has voluntarily withdrawn the drug from the marketplace, but consumers should note there still may be product on pharmacy shelves. No difficulties have been reported in patients who have been administered or taken the drug orally (by mouth).

Lansoprazole is a generic form of Prevacid™, a proton-pump inhibitor (PPI) that prevents acid reflux and treats ulcers. The PPI class of drugs, i.e. Prilosec, Nexium and Prevacid are the agents of choice doctors prescribe for their patients to achieve symptom relief, improving quality of life, healing, and prevention of mucosal injury in GERD (gastroesophageal reflux disease) patients. As a class, these drugs have been thought to be extremely safe.

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Acid Reflux Drugs May Increased Your Risk of Fractures - Latest Study

Recently, the Annals of Family Medicine study shows that long term regular usage of acid reflux drugs known as proton pump inhibitors (PPIs) such as Nexium, Prevacid, Prilosec, and Protonix seem to have an increased risk of fractures.

The researchers found that this class of acid-suppressive drugs raises the chances of breaking a bone by nearly 30%.

PPIs work by reducing the secretion of gastric acid. They are commonly recommended for patients with gastroesophageal reflux disease (GERD), peptic ulcer disease, erosive esophagitis, and Barrett’s esophagus. Furthermore, the are easily available by prescription as well as over the counter,

For patients with potentially serious conditions, the benefits offered by PPIs often outweigh the risks associated with them, says James M. Gill, MD, MPH, president of Delaware Valley Research Outcomes in Newark, Del., and lead author of an editorial accompanying the study.

“For certain things, PPIs are clearly indicated,” he says. The problem is that “many doctors don’t follow guidelines” and prescribe PPIs “willy-nilly.”

“This study is not a game changer in terms of guidelines,” Gill continues, “but it should encourage physicians to pay closer attention and be more cautious with these medications when they prescribe them.”

Analyzing Fracture Risk

The present study, by researchers at Seoul National University Hospital in South Korea, is an analysis of 11 previously published studies in which researchers examined the possible link between fracture risk and PPIs. Overall, the risk of fracture increases by 29% with the use of PPIs. Hip fracture risk rises by 31%, vertebral fractures by 54%.

The researchers also report that they were unable to find a significant association between fracture risk and histamine H2-receptor antagonists, another class of acid-suppressing drugs, marketed under brand names such as Axid, Pepcid, Tagamet, and Zantac.

The researchers explain that the increased risk of fracture likely occurs in part because PPIs interfere with the body’s ability to absorb calcium, leading to weaker bones that are more prone to break.

Fractures are not the only risk factors associated with PPIs. PPIs may raise the risk of GI infections, while taking them for more than a year may lead to low serum magnesium levels, which can cause muscle spasms, irregular heartbeat, and convulsions, according to the FDA, which issued a warning to that effect in March of this year.

“As with all medications, there are risks and benefits,” a representative for Prilosec maker Procter & Gamble write in an email. “Like other OTC PPIs, Prilosec OTC should only be used as directed for 14 days for the treatment of frequent heartburn.”

As Gill writes in his editorial, physicians should not hesitate to prescribe PPIs to treat potentially serious conditions. But for patients with uncomplicated GERD, for example, Gill holds that patients would be better off taking a PPI “on-demand,” meaning on a short-term basis to control symptoms and reduce the risk of side effects.

“The over-the-counter PPIs warn consumers not to use them for more than two weeks at a time,” he says. “That’s probably a good rule of thumb overall.”

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NEWS: Medical Board Issue Statement On The Management Of Barrett's Esophagus

Endoscopic removal of pre-cancerous cells in patients with confirmed, high-risk Barrett’s esophagus is recommended rather than surveillance, according to a new “Medical Position Statement on the Management of Barrett’s Esophagus,” published by the American Gastroenterological Association (AGA) Institute. The medical position statement was published in Gastroenterology, the official journal of the AGA Institute.

In patients with Barrett’s esophagus, the normal cells lining the esophagus are replaced with tissue that is similar to the lining of the intestine. The goal of endoscopic eradication therapy is to permanently eliminate all intestinal-type cells in the esophagus. A small number of people with Barrett’s esophagus develop a rare, but often deadly, type of cancer of the esophagus.

“The AGA’s recommendations for the treatment of patients with Barrett’s esophagus are based on the best data currently available within the medical literature,” said John M. Inadomi, MD, AGAF, chair of the AGA Clinical Practice & Quality Management Committee. “When considering whether surveillance or endoscopic eradication therapy is the preferred management option for patients with Barrett’s esophagus, the AGA strongly supports the concept of shared decision-making between the treating physician and patient.”

The AGA recommends endoscopic eradication therapy with radiofrequency ablation (RFA), photodynamic therapy (PDT) or endoscopic mucosal resection (EMR), as follows for various patient groups:

* Patients with confirmed high-grade dysplasia (advanced pre-cancerous cells): endoscopic eradication therapy is recommended.
* Patients with confirmed low-grade dysplasia (beginning pre-cancerous cells): endoscopic eradication therapy is a treatment option and should be discussed with patients as such.
* Patients with Barrett’s esophagus without abnormal cells: endoscopic eradication therapy is not recommended.

If eradication therapy is not indicated, is not available or is declined by a patient with Barrett’s esophagus, surveillance by endoscopy should be performed every three months in patients with high-grade dysplasia, every six to 12 months in patients with low-grade dysplasia, and every three to five years in patients with no dysplasia.

“The recommendations in the medical position statement were made under the assumption that a patient’s diagnosis and the presence or absence of low and high grade dysplasia would be accurate to the highest degree possible using the best current standards of practice,” according to Stuart J. Spechler, MD, AGAF, a member of the AGA Institute Medical Position Panel. High grade dysplasia is an abnormal growth that has a high risk for cancer development.

[Source: MedicalNewsToday]

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They have offices in Lehigh Acres and work out of Lehigh Regional Medical Center.

“The TIF procedure can significantly improve quality of life for our patients,” Barrios said.

“Gastro esophageal Reflux Disease or GERD is an anatomical problem which needs an anatomical solution. Reflux medication like PPIs (proton pump inhibitors) can help relieve patients’ heartburn symptoms but don’t solve the underlying anatomical problems. Even on PPIs many patients are still unable to eat the foods they want or have to sleep sitting up,” he said.

In addition recent studies have shown that long-term use of PPIs can lead to inadequate absorption of minerals such as calcium and can result in bone fractures.

After the TIF procedure, clinical trials show that most patients can eat and drink foods they avoided for many years. Reflux no longer impacts their life like it previously did, Barrios said.

The TIF procedure is based on established principles of surgical repair of the antireflux barrier, except that it is “surgery from within” performed trans-orally.

The procedure repairs the valve between the stomach and esophagus restoring the natural, physiological anatomy to prevent reflux. Because the procedure is incisionless, there is reduced pain, reduced recovery time and no visible scar, Barrios said.

The TIF procedure is part of a revolutionary new way of performing surgery termed “incisionless surgery.”

“Incisionless surgery is the next step in the evolution of surgery to less and less invasive techniques. It uses the body’s natural orifices such as the mouth to allow surgeons access to the abdomen,” Denk added.

With millions of Americans suffering with daily symptoms of reflux and many not fully satisfied with their current treatment therapy, TIF offers an excellent alternative.

“Recent studies show that TIF can reduce patients’ dependency on medications with 79 percent of patients remaining off their daily medications after two years and experiencing a dramatic improvement in their quality of life,” Denk pointed out.

Barrios and Denk offer the latest in minimally invasive surgical treatment for gastrointestinal disease and weight-loss surgery in Southwest Florida, according to officials at Lehigh Regional Medical Center.

They are both national and regional leaders, having performed many “firsts” from advanced laparoscopic, to single-incision, to incisionless procedures, LRMC officials said.

Barrios joined LRMC in 2009 and has become a leader in single-incision laparoscopic abdominal surgery in the Fort Myers greater area. GI diseases he has treated with single incision laparoscopic surgery include gallbladder, appendix, hernia, acid reflux problems, stomach, and colon problems including cancer.

Barrios says he has found patients recover faster, have better cosmetic results, and have less pain from single-incision surgery.

He also performed the first Incisionless ROSE (Repair of Surgery, Endolumenal) for weight-regain following gastric bypass in Southwest Florida in December of 2009.

Denk performed the first Incisionless POSE (Primary Obesity Surgery, Endolumenal) in the United States in February of 2009. Denk was part of the team of surgeons that performed the first NOTES Transgastric Natural Orifice Cholecystectomy (Incisionless gallbladder removal through the mouth) in the United States in May of 2007.

Building on the experience of incisionless gallbladder surgery with decreased patient post-operative pain and faster recovery, Denk helped develop incisionless treatments for obesity, LRMC officials said. He has extensive experience with the ROSE procedure and has taught nearly all surgeons performing ROSE today, officials said. Their offices are located at 1530 Lee Blvd., Suite 1100, in the building next to the hospital.

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Heartburn Help: Proton Pump Inhibitors Being Overprescribed?According to an article in the Star Tribune (10/02/10), there were more than 119 million prescriptions written for proton pump inhibitors—a class of drugs that includes Prevacid, Nexium and Prilosec—in 2009. That 119 million does not include sales of over-the-counter versions of the proton pump inhibitors.

The issue, though, is whether people need to take so many proton pump inhibitors, especially given the serious PPI side effects. In some situations, the patient might do better to stop eating certain foods rather than taking a medication to mask the problem. That way, the patient is not put at risk of developing side effects from using proton pump inhibitors long term.

Furthermore, because the proton pump inhibitors work so well, some patients might take them on a daily basis for the long-term to prevent any issues of gastroesophageal reflux disease (GERD)–commonly called acid reflux or heartburn–from arising.

Speaking with the Star Tribune Dr. Marcus Thygeson, a gastroenterologist, says proton pump inhibitors are “like front-line therapy if you so much as belch,” and notes that the pills are “handed out like water.”

Acid reflux occurs when the liquid content of the stomach backs up into the esophagus. This liquid, which often contains acid and pepsin and can contain bile, can inflame the lining of the esophagus. Acid reflux is a chronic condition and is thought to occur frequently in the population. Patients who have GERD, however, may have a higher concentration of acid in the liquid that backs up to the esophagus.

Some foods, including fatty foods, chocolate, alcohol and caffeinated beverages, reduce pressure in the lower esophageal sphincter. That sphincter is responsible for preventing liquid from backing up into the esophagus—with reduced pressure, the sphincter is less effective and acid reflux is more likely to occur. Therefore, patients who suffer GERD are often advised to change their diets.

Unfortunately, because proton pump inhibitors work so well, they are often seen as the easier alternative, despite reported side effects. Patients who take proton pump inhibitors for more than a year (in the case of prescription proton pump inhibitors) or more than 14 days continuous use (in the case of over-the-counter proton pump inhibitors) are at an increased risk of serious PPI side effects including fractures, including hip, wrist and spine fractures.

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The Yale study shows that zinc salts can offer relief in much less time – sometimes minutes, compared with 24 to 36 hours for omeprazole – and without recurrent symptoms or the side effects of PPIs that may include headaches, diarrhea and dizziness.

CBS News Medical Correspondent, Dr. Jennifer Ashton shared details about the findings with “Early Show” co-anchor Erica Hill.

Ashton noted it’s important to mention the study’s limitations as well the good news it seems to contain.

In this case, she said, the study has “a lot of limitations” because it only looked at 12 people.

“It is far away from coming to a theater near you in terms of being able to go to a drugstore, buy this element, zinc, as a treatment for your heartburn,” Ashton said. “But the good news is that there is the potential for more research that may show that this actually is very helpful for heartburn.”

For some people, heartburn is really debilitating. Current treatments always carry side effects.

Ashton points zinc was found to be quick, effective and largely safe and free of those side effects.

“Right now, if are you suffering from heartburn, the first thing a doctor will tell you is to modify your lifestyle. Behavioral changes are really the first line,” she explained. “After that, you can go to over-the-counter antacids or … blockers, and if those don’t work, then to reduce the acid secretion, a doctor may write a prescription for a proton pump inhibitor or a PPI. But again, every time you take a medication, it’s risk-benefit. You have to factor in cost, side effect, all of those.”

In addition to lifestyle changes, heartburn sufferers should watch for triggers, which include foods high in caffeine, chocolate, spicy foods, acidic or fried or fatty foods.

How do you know if it’s chronic problem?

“Self-medication and self-treatment and diagnosis is a big problem for any disease. You don’t want to ignore heartburn. It can potentially lead to serious, even precancerous or cancerous changes in the esophagus,” Ashton explained.

“If you are suffering from heartburn more than twice a week, over-the-counter, lifestyle containing are not working, you really want to see a doctor. Maybe in the future, something as simple as zinc might give you some relief,” she added.

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However, by doing the right type of exercise with a few precautions, the chronic sufferers may actually improve the condition and get much relieve from the diseases and reduce the dependence of drugs. Studies have found that short bouts of fairly moderate exercise at least a couple of times a week can cut the risk of gastroesophageal reflux disease, or GERD, in part because it reduces body mass index, a primary risk factor.

One study published in 2004, which included more than 3,000 people who reported reflux, found that a half-hour session of exercise once a week or more (along with regular consumption of high-fiber foods) helped cut the risk of the condition in half.

Two steps can help: avoiding food for two hours beforehand, and steering clear of high-carbohydrate sports drinks.

But the specific exercise is crucial. Scientists found that aerobic exercises with the highest “agitation of the body,” like vigorous running, consistently induced acid reflux, even in people who did not have chronic heartburn. Less agitating exercise — pedaling on a stationary bike, for example — caused fewer problems.

Another factor is body position. Bench presses, leg curls or any other exercise that involves lying flat sharply raise the risk of acid reflux. One study in 2009 showed that surfers have several times the risk of GERD as other athletes. The study said that,  “Paddling in the prone position on hard surfboard surfaces leads to increased intra-abdominal pressure,” the authors wrote.

Important thing to take note: Moderate exercise, with the right precautions, can reduce reflux.

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