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OTC acid reflux prevention
Jeffrey
Veteran
I have taken antacid tablets for years. I use TUMS. I was just wondering to try an OTC (over the counter ie no prescription) preventer such as Zantac (ranitidine). Anyone do these?
1
Comments
I won't take the prescribed meds my doctors tell me is okay, because I'm older and need all the stomach acid I can get - even though I sometimes get that acidy feeling -- it's easily quelled by drinking water or a little bubbly beverage - soda - just enough to ease the sensation. Sipping these things is much better I think. So anyway, I googled and these are the side effects from WebMD: "SIDE EFFECTS: Minor side effects include constipation, diarrhea, fatigue, headache, insomnia, muscle pain, nausea, and vomiting. Major side effects are rare; they include: agitation, anemia, confusion, depression, easy bruising or bleeding, hallucinations, hair loss, irregular heartbeat, rash, visual changes, and yellowing of the skin or eyes."
Do the side effects you read about apply to Zantac? Or other?
I have it only at night when my body is horizontal. Sometimes I have acid go into my mouth and nose and it is very uncomfortable. I get up and get TUMS and then it is usually ok.
Zantac. Here's the link: Actually it's from medicinenet: http://www.medicinenet.com/ranitidine/article.htm
The side effects might be less risky than the acid that goes into my esophagus and mouth. I should have asked my doc at my checkup the other week. I think acid in the esophagus can cause cancer or other tissue damage.
All I can tell you is that I will go for the simplest home remedies and give them time to work, and to strategize before I will shell out money for other than simple soda or baking soda and stuff like that!
Yes, I have developed rather severe stomach acid, although the acid reflux is much better now (in other words, my stomach is still a problem, but it has stopped going up my throat).
I have to take a combination of omeprazole and Zantac (both OTC). The problem I worried about was the affect on absorption of calcium, so my doctor does occasional blood tests to assure that is normal. So far no problem.
Some more information for you>
Acid Reflux: Truth vs. Myth?
Heartburn Acid Reflux
With appreciation to Dr. Richard Sewell, MD for the graphic.
In the center of your chest, there is a small, muscular tunnel that separates the end of your esophagus from your stomach. Think of it like a fist that can be closed tightly or loosely. It’s a muscle called your lower esophageal sphincter (LES). When you’re eating, the fist should be open and loose, so food can travel to your stomach. But at all other times (unless you need to vomit), the sphincter should be tightly closed. This prevents all food and digestive fluids from traveling upward. Despite many myths otherwise, acid reflux is just having a loose sphincter when it should be tight.
Your stomach produces a few different digestive juices. But the dominant one is hydrochloric acid (HCl). One of nature’s strongest acids, HCl is designed to make light work of breaking down the tough meat in that burger you just ate. If you put HCl directly on your hand, it would quickly burn you – badly. The stomach acid produces pepsin, a digestive enzyme that breaks down protein. The cells of your stomach lining are coated with mucus to protect them from acid and pepsin (otherwise, they would digest your stomach). The lining of your esophagus is not coated. So when the LES is loose and acid bubbles upward, it hurts and can damage the tissue.
There are many reasons why you might have acid reflux. But let me put one myth to rest: having too much overall stomach acid production is an extremely rare cause (I’ve only seen it once in my practice). Remember that reflux is just a matter of having acid and pepsin in the wrong place (the esophagus). For almost everyone, there are controllable drivers for reflux that you can address for a painless, drug-free new year! I’m going to share some of my top tricks for making your acid reflux go away. Not because you have to pop a TUMS or use a PPI drug, but because you can get rid of the root cause(s). And your long-term health depends on it!
Slow Down and Chew, Chew, Chew. The average American chews each bite of food only a few times before swallowing it down hard. Often with a gulp of water as a chaser. Most of us eat so quickly that meals feel like a race. I’ve written before about the importance of chewing. Try to chew your food until it’s liquid. This significantly reduces the work of your stomach. I know this seems simple. But you would be stunned to know the number of clients I’ve seen cure their reflux this way. Just by chewing their food 20-30 times per bite and not drinking much liquid with meals (below).
Drink as little liquid as possible with your meals. Yes! In between meals is by far the best time to hydrate. Liquids during meals just dilute your stomach acid and make it less potent, leading to belching and bloating. Food can hang around in your stomach longer than it should and ferment. Gas builds up and blows open your LES – causing reflux. Have only a small glass handy during meals to help clear your palate (e.g. 4 oz). Too much liquid during a meal can also increase the pH of your stomach juices and make your esophageal sphincter work less effectively.
Eat more often and less at once. Sometimes our LES gets blown open by the sheer volume of food we try to cram into our bellies. This is especially true when we eat at restaurants. Yes, the stomach will stretch. But only so far. Research shows better digestion and better healthy weight maintenance for people who eat smaller meals 4-5 times per day. Note this is not the same as “grazing”. Your body needs a break from digestion, so eating here-and-there all the time isn’t helpful. But small meals every 3-4 hours is ideal. Then stop eating when you are 80% full. You have to leave (literal) room for digestion to take place. Think about how hard it would be to stir a pot of soup if it was full to the very top of the rim!
Wear loose clothing around your midsection. If you wear a tight belt or waistband, you put tremendous pressure on your digestive organs. This can push food and digestive fluids physically upward and beyond your LES. Muffin-Tops and Belted Beer Bellies, take particular note of this one!
Fix your magnesium deficiency. I talked in a prior issue about the importance of magnesium and how widespread this deficiency is in the US! Low magnesium can cause specific (or all of your!) muscles to be too tight or to spasm erratically. This includes your LES. If you also struggle with any regular constipation, headaches, irritability, leg spasms, or tight muscles, be sure to give this supplement a try (start with 400mg magnesium citrate).
There's more to this article, so here is the link:
https://www.eatonpurpose.com/nutrition-newsletter/196/
Thanks @silver. I want to look into the magnesium deficiency. I chew a lot and have always been a slow eater; I rarely drink with meals my mom thinks this is odd. I think a main one is caused by my before bed dose of clozapine which makes me restless and hungry. It is the like a hungry ghost I eat but it does not satisfy me but seems unaviodable because I have so much discomfort. So I am not sure how to improve that, but maybe hope magnesium can help.
Our whole family suffers from reflux and hiatal hernias. If I eat within three hours of bedtime I wake up with heartburn. But taking Prevacid and those 'pill' type remedies deplete calcium levels, which is bad for all women (especially middle age and older like me) and bad for older guys. They contribute to osteoporosis, and I'm not sure if all the TUMS or Ca+ supplements are the correct calcium molecule to replace what is depleted . . .
So I heard once that pickle juice kills heartburn. I love pickles, and tried glugging a bit o pickle juice and BAM, heartburn gone.
The components in pickle marinade, especially FENNEL (a common spice) are what neutralize the acid, and there's no worries about depleting calcium levels in the body. Some kind of mild concoction of fennel and ginger root are the most common I've heard of. Google 'reflux and fennel' and you'll get more info than you need.
pickles should be acidic? how odd?
That is interesting, @Hamsaka. The pickle juice trick sounds vaguely familiar, but don't remember about the fennel- you can probably chew raw fennel or something like that - maybe that would help, instead of drinking the juice.
After sorting out my gut bacteria which were out of alignment partly due to diet, I never experienced acid reflux again
http://drhyman.com/blog/2013/09/26/7-steps-reverse-acid-reflux/#openModal
actually many foods that are acidic in nature become alkaline after consuming them. Lemons are another one.
It is often caused by diet and/or stress. Keeping a detailed log might help you narrow down what is setting it off.
fennel is a lot like licorice root, which has the same effect.
Also, especially for people with stomach acid issues, it isn't recommended to drink much of anything with a meal. Too much liquid actually dilutes the stomach acid and makes it less effective, making digestion take forever.
Keep a log, it'll help.
how do they become alkaline after consuming them? from my chemistry background it doesn't seem to make sense to me.
Keeping a log is a good idea - if I were that disciplined, but after the fact I realized that a few days ago, I had a terrible bout with the acid reflux problem and after reading the thread here, and reading the list of worst offending foods, I realized that the stress of my heart flutter/speed-up, I gravitated towards foods I don't normally partake - chocolate and tomato sauce (spaghetti) - and mint tea - in the past 3 days.
My doctors said to drink lots of water.
It doesn't make sense, Jeffrey. I can eat very spicy food and have no problem at all. I can sometimes drink water and have a problem. There's no logic to it. As @karasti said, keep a log. But also be practical. It's not always a food you eat. Sometimes it is the combination of foods that will trigger it. I can eat pasta 20 times and have a problem once.
The real problem if it is coming up your esophagus is Barrett's esophagus, which can progress into cancer over a long time. That's why it needs to be treated by a doctor, not Dr. New Buddhist. I am old enough that there is not really time for that to happen, but I did have to have an EGD to assure that it had not progressed to that point.
@Jeffrey I'll see if I can find what I read about it. I shouldn't have said that it's true, just that I read that is what happens.
No need to panic, @Jeffrey -- of course. Just take a little extra magnesium or work it into your diet. Try some things that after reading this stuff that your intuition says it might work.
This https://thechronicleflask.wordpress.com/2013/08/28/amazing-alkaline-lemons/
suggests that lemon juice is acidic in the stomach though in the following notes (in response to public comments) the author acknowledges that foods can also affect pH of urine (which is hopefully not in the stomach!)
Jeffrey, I find that I do get acid reflux when I don't eat enough vegetables or fruit at meals, especially after dinner. With me, it's definitely related to eating too much acidic food (meat & other protein). I always eat a salad with dinner (vinegar calms acid stomach; even though it's acidic itself, it turns to alkaline in the digestive process), and some steamed vegetables. It makes a big difference. Avoid sweets (sugar). They contribute to acid stomach.
And I agree with the article's statement about supplementing with magnesium. Magnesium is good for a lot of things. It's subtly relaxing, too. There's a powdered magnesium product called "Natural Calm" that you add to water, and it makes a fizzy drink that some people find helpful to take before bed. It's a nice way to add extra mag to the diet. It comes in plain and flavored varieties.
It didn't cross my mind at first, but maybe the prescriptions you are taking are depleting your magnesium and/or other important minerals. I've had more problems with this myself since the doctors put me on more medications.
Here's my advice. Take all you've read here and elsewhere online. Make notes with questions you'd like to ask your doctor. Then let a doctor decide the various issues involved.
I am pretty skeptical that vinegar can be made alkaline in the stomach. It depends what you mean. You could say it 'becomes alkaline' when the bicarbonate from the pancreas hits it (later than the stomach), but that is misleading because if you add a (lot of a) base to anything it will become more alkaline. It is like saying when you add water to a shirt it becomes wet.
http://chriskresser.com/the-ph-myth-part-1/
I'm only getting 13% magnesium from my multi-vitamin
The meaning of saying acetic acid (vinegar) is a base in the stomach is to say that it's structure is such that it acts as a base in water. The liquid in the stomach is water that everything else is dissolved in. But it doesn't act as a base. In the Arrhenius definition the vinegar does not produce hydroxide. In the Bronsted definition it does not accept a proton. Accepting a proton is not going to happen in acetic acid because of it's chemical structure. Accepting a proton would make a very high energy structure that would not be stable or would not be found.
So what happens when the bicarbonate of the pancrease is added? Ok acetic acid donates a proton to bicarb and in this it is acting AS an acid because it is donating a proton (Bronsted acid). The bicarbonate is acting as a base in accepting a proton.
Part and parcel with Bronsted acid theory is the notion of acid/cojugate base pairs and base/conjugate acid pairs. If something donates a proton it is an acid. But once it donates the proton it has a 'slot' (you could say) to in turn receive that (or a different proton) back. Since an acid who has already lost a proton can accept that (or a different) it can act as a base. There is an equilibrium going back and forth between acid <-> conjugate base. http://en.wikipedia.org/wiki/Conjugate_acid
acid:
H-A (proton donor) + B (proton acceptor) --->
A (lost a proton now conjugate base) + H-B (now conjugate acid)
The relative stabilities of acid and conjugate base determine how favorable the equilibrium goes towards. For example a strong acid is unstable as an acid and stable as a base.
So acetic acid can only be a proton donor in the stomach because the chemical structure has no 'slot' for a proton. But it can be an acid because losing a proton results in a stable conjugate base.
In the intestine after the pancrease adds bicarb then the bicarb is the base and acetic acid is the acid. The conjugate base of acetic acid is acetate which is a weak base. Strong acids have weak conjugate bases. Strong bases have weak conjugate acids. Acetic acid is strong for an organic acid, but weak compared to hydrochloric (stomach), nitric, and sulphuric.
So even in the intestine with bicarb acetic acid acts as an acid. It does become acetate which is the conjugatae base of acetic acid.
Arhenius acid -> reacts to make hyrdronium H3O+
Arhenius base -> reacts to make hydroxide OH-
Bronsted acid -> proton donor (forms a conjugate base that can be a proton acceptor)
Bronsted base -> proton acceptor (forms a conjugate acid that can be a proton donor)
Cystitis is an acute imbalance of alkaline in the urine.
I wouldn't wish a severe attack on my worst enemy.
I tried drinking water and lemon juice once, to counteract the amount of alkaline in my urine, but it only made it feel worse. My doctor explained that it was because my system had converted the lemon's acidity to an alkaline. He advised me to drink alka seltzer, and as much barley water as I could stand.
I did. After 2 days, the attack was gone.
Making nettle tea, dandelion tea, or goosegrass (cleavers) tea also helps enormously, particularly the last...
yes it could be different in urine. http://chriskresser.com/the-ph-myth-part-1/
I used to drink nettle tea until my supply ran out. I should buy some more.
Make your own! I used to have a 'wild patch' in my garden with an entire corner dedicated to dandelions and nettles. I used to make soup with them, and gather great bagsful of the young shoots (wear rubber gloves and long thick sleeves!) and I use to lay them in shallow baskets and dry them off. When completely dry, I would simply crush them to make them like loose-leaf tea, then store them in hermetic jars.
Some doctors advise patients to take a capful of cider vinegar with water if they wake up with acid reflux at night. I've done that, and it does work. I just looked it up, and it turns out that the reasoning is that sometimes, reflux is caused by insufficient acid in the stomach. So you add acid to it, which causes the sphincter to stay closed.
Some research results in the last couple of decades say that we need more magnesium than previously thought. The balance of calcium to magnesium that we take in needs to be higher on the magnesium side. So whatever mag is in multi-vitamins, or even in cal/mag supplements (for older people, to prevent bone loss) isn't enough.
Cider vinegar is good, because it's made from apples. The old adage 'an apple a day keeps the doctor away' holds a huge amount of truth. Apples are extremely good for the liver, too.
Wine or malt vinegar isn't so good....
@Dakini as I said that contradicts my understanding of chemistry. Acetic acid (in vinegar) cannot accept a proton thus it cannot act as a base.
Off and on, I've tried the vinegar trick - even watered way down but it still burns my throat. I've had a severe problem with GERD - whatev - the past 3 days - when I wake up, it's severe especially this morning and I was afraid to eat for fear it would make it even worse but it's when I had a bite to eat (leftover chicken and a bagel with whipped cream cheese) that the pain subsided. Go figure!
It's not reducing the acidity. It's increasing it. The sphincter that closes off the stomach from the esophagus requires a certain amount of acidity to stay closed. When there's insufficient acidity, it pops open. So taking cider vinegar adds to the acidity, to keep it closed.
I don't believe that but that's ok.
Here's this, from "15 Natural Remedies For Heartburn and Severe Acid Reflux"
In many cases though, acid reflux is caused by having not enough acid in your stomach, rather than having too much, as over-the-counter or prescription “acid blockers” imply (although that can also be the case, among other factors.) It is the acid itself that tells the lower esophageal sphincter to tighten and close off. If you don’t produce enough acid, your LES is going to think it’s no big deal to loosen up for a little bit. Then of course, you get a reflux of acid into your esophagus. If you think this may be your case, try drinking some pure, raw, unfiltered apple cider vinegar to see if this prevents your reflux, or cuts it off.
http://everydayroots.com/heartburn-remedies
You're on the right track!
Here's this, from the same site:
7. Eat a banana or an apple
Bananas contain natural antacids that can act as a buffer against acid reflux. If you want to try out the simplest home remedies for heartburn first, try letting a few bananas ripen up nicely and eating one every day. Another option is to try an apple a day. Slice one up and eat it a couple of hours before bedtime to relieve or prevent discomfort.
yeah I should try it. but I wonder where they are drawing their conclusions from? Has someone studied the effect of higher acidity on the sphincter? there is always some acid in the stomach so I am curious how the acetic acid added affects the sphincter?
From the perspective of wanting a remedy for my stomach I am eager to try vinegar. From the perspective of being interested in chemistry I am critical.
That does seem to make sense, @Dakini especially since paying attention to my situation this morning - after eating, it got better. The body works in mysterious ways, I guess. And eating the wrong foods, too. I think it all proves just how unmindful we can be about our bodies, eating and our health.
Well, yes. That would be part of the Anatomy and Physiology coursework medical professionals do in their training. I think basic A & P should be part of everyone's basic education, like a highschool science class. You learn a lot of interesting things, like the various electrical aspects of the body, and how they work. Things that some people consider to be "woo-woo" are just basic science.
Sometimes, @Jeffrey it's necessary to suspend scepticism and just have a bit of confidence in what others are telling you.
Sure, there's no guarantee everything works for everybody; but these remedies are natural, and the dosage is neither toxic nor life-threatening.
While I agree it's a healthy policy to 'question everything' it shouldn't be done to the extent that we either prevent ourselves from moving forward, or improving our health.
Louis Pasteur tried his remedies on himself, and exposed himself to dangerous diseases in an effort to ascertain the efficacy of his theories....
Also the pH is already 1-2 in the stomach. Acetic acids pKa is 4.5. At 4.5 pH acetic acid is 50% dissociated. 50% is acetic acid and 50% is acetate. The acetate is there because it has lost a proton and formed hydronium (H30 or 'acidic water').
You can solve exactly what's going on with the Henderson Hasselbach equation but the take home is that you add a weak acid to a strong acid and not much happens. The pH is already 1-2.
http://en.wikipedia.org/wiki/Henderson–Hasselbalch_equation
I can't introduce all the concepts needed for a calculation. Basically there is an equiibrium
1: H-A (acetic acid) + H20 -------> A minus (acetate) + H30+
pH is the anti-log of concentration H30+ thus there is a relation ship between pH and the equilibrium of #1
the Ka is concentration acetate (A minus) * concentration H30+ all that divided by concentration HA
a bigger equilibrium concentration of H-A means less reaction AS an acid. the equilibrium is Ka. pKa is the minus log of Ka.
You can use lechatelier's principle to see what happens when pH is 1-2. At that pH the concentration H30+ will be already quite high and the H-A will hardly have acted AS an acid.
Adding a weak base (antacid) to a pH 1-2 (stomach) is a different story. In particular the conjugate acid of bicarb is carbonic acid which decomposes to carbon dioxide and water. The carbon dioxide gas leaves the equilibrium floating out of your stomach. Again use lechetelier's principle and the gas leaving from the products drive the reaction to products.
This isn't directed at Dakini (neccessarily) but in general there is a lot of woo-woo. I have found in unfruitfull to discuss these on the other hand.
And as I said I am both interested in a relief of my stomach and also in the science behind it. I cannot ignore the science. So if you say acetic acid affects the pH which makes the sphincter do such and such I cannot accept that scientifically. On the other hand in practicality I would try a little vinegar and see if it helps. Who cares about science if it makes my stomach feel better?
the author of those remedies is not an MD
http://everydayroots.com/claire
http://everydayroots.com/heartburn-remedies (listed below from the site)...
This was also listed in the article:
'natural' is a form of vitalism. http://en.wikipedia.org/wiki/Vitalism
Until like 1850 people believed organic material (found in bodies) such as urea were infused with a 'breath of life' presumably by God?? They theorized that organic materials could not be made from inorganic (such as minerals etc). This was disproven when urea was synthesized by Woehler by heating ammonium cyanate in the abscence of oxygen.
Even with that experiment many thought it was organic molecules from the chemist that got into the flask that gave the 'breath of life'. But with 100s of further results that idea (vitalism) lost acceptance.
Today we have a form of vitalism in that we generalize that 'natural' (non-man made) are more healthy or safe. The key word is generalize. Natural molecules can also be dangerous or inert and synthesized molecules can also be safe or potent. We have to test things if they are true. That testing could be studies or general experience. By general experience I include centuries of human consumption suggests at least a limited safety. But even with that history of consumption there can be 'natural' foods that are not safe (to perfection) such as gluten.
My limited study of gluten leads to the 'news' (for me) that modern wheat is NOT the same as wheat way back when and the hybridization many times over is what has caused modern societies to suffer from eating this modern wheat not to mention that it is now GMO.
that could be. tested in civilization is worth something. but just because something is changed does not mean it is less healthy. it just means there is less history of use. GMOs could be healthy (or at least neutral). Or not. People react very emotionally to this issue. Personally I am against GMOs because it is risky and because I hate Monsanto who screw everyone over by their seed monopoly.
@silver, don't you realise that everything we eat, is GMO...? people get so up in arms about GMO foods, and how bad it must be, and how dare scientists mess with our natural foods, little realising that the majority of food eaten today, would have been unrecognisable 200 years ago, as the same thing.
Vegetables, tomatoes, strawberries, oranges, lemons, potatoes.... tomatoes were originally yellow. Strawberries were originally no bigger than your thumbnail. Potatoes were blue. Raspberries were almost inedible they were so acidic.
Everything you eat, today, has undergone drastic change.
https://www.jacobinmag.com/2015/05/slow-food-artisanal-natural-preservatives/
:snip:
:snip:
What I am talking about is 'the latest' - y'know, Monsanto etc. with the pesticides inside the fruit or vegetable? That wasn't any part of the hybridization process in the beginning. This is something that, to my comprehension of what I've read here and there, is a major factor - a very likely factor in the bee problem.
Yes, they've gauged here in the UK that actually the healthiest bee colonies are found on city rooftops and suburban and urban gardens. Seems city folk are keen as mustard to AVOID using chemicals in their gardens and open spaces, allotments and even window-boxes, because they hanker for the natural way of life, while surrounded by the busy rush of city living... so the bees kept in such places are actually less exposed to chemicals and insecticides than those out in the wide open countryside....
No, but how the stomach acid and sphincter work is explained in A & P courses. That's the answer to your question: "Has someone studied the effect of higher acidity on the sphincter".