Question: I am a 63 year old woman having difficulty with stomach acid. I am taking acidophilus with Activa yogurt. What else can I do to help?
Dr. Hibberd's Answer:
Stomach acid actually is beneficial for digestion. Problems are related to over-secretion (which is rare), or the acid’s effects on tissue that has either lost its cytoprotection, been damaged by infection, trauma, surgery or tumor; or repeatedly exposed to an acid medium that it is not designed for.
Cytoprotection is provided by production of prostaglandin in the stomach lining. This protects the stomach lining by various mechanisms. NSAID medications, such as Advil, Aleve, and most of our anti-inflammatory and arthritis medications, deplete production of this local prostaglandin causing loss of cytoprotection and allowing the development of gastric irritation and ulcers.
A bacterial infection by H. pylori may also cause ulceration and loss of cytoprotection. There are many other causes that I cannot go into here, but I recommend you not self-treat.
Acidophilus and yogurt may actually induce more acid secretion in some people, so before starting on gastric medications, such as Prilosec, Zantac, and Tagamet, try stopping your supplements first. Then, see your doctor for evaluation if your symptoms persist. Acid refluxing back into the esophagus can be improved by small frequent meals and raising the head of your bed. Most reflux damage occurs while we are lying down in bed at night. It will also help if you avoid eating within 2-3 hours of bedtime.
Some patients with chronic reflux will benefit by evaluation for strictures and evaluation for tissue damage and ulceration that may be correctable by surgery.
Also, be aware that heart conditions from coronary ischemia (from underlying coronary artery disease) may masquerade as reflux-like symptoms. This is a common presentation to those of us on the front lines of diagnosing and treating heart disease. Always seek professional consultation before you "try" remedies for acid reflux or dyspepsia.
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