My wife refuses to sit in the room with me when drug ads come on the television. I have a hard time not talking back to the TV when these ads are playing, and I roll my eyes when the disclaimers about the risks of the drug take three times longer to read than the benefits.
The worst are the heartburn ads. My favorite ad shows the Larry the Cable Guy holding a bottle of Prilosec, saying that he is not just an actor, he actually uses it.
Did you notice he’s standing in front of a “Colossal Corn Dog” stand? The message is subtle but clear — eat whatever you want, as much as you want, and let the drug take away the pain of these poor food choices.
Of course, the drugs do give relief to millions of people. That’s not the point. The point is that they do nothing for the problems that cause heartburn, they just ease the pain of it. If the underlying cause goes uncorrected, the problem tends to worsen over time.
As a wellness provider, I have been trained to look for the cause of a problem, and try to correct it, if at all possible. A healthy stomach is very resistant to the acid it makes to digest our food. A common cause of heartburn is inflammation of the lining of the stomach, which lowers its resistance to the point that the normal acidity of the stomach causes pain. That resistance can be broken down by chronic stress, poor food choices — corn dogs, anyone? — and many drugs, especially the anti-inflammatory class of drugs called NSAIDs. This includes aspirin, ibuprofen, Celebrex, Vioxx and Toradol. (I actually saw an ad for a heartburn drug that suggested it be used to counteract the heartburn caused by the meds given for arthritis.)
A leaky valve at the top of the stomach also can cause heartburn. This allows the acidic contents of the stomach to slosh back up into the throat, which, unlike the stomach, is not designed to handle it. This type of heartburn is called Gastroesophageal Reflux Disease, or GERD.
Notice that neither of these conditions involve overproduction of acid by the stomach. A drug that lowers the acid production of the stomach may make the pain go away, but it won’t fix the problem. Some of my patients who have been on these drugs for a while find they need to increase the dose, or even add another drug, to control “breakthrough” heartburn, because their underlying problem is still worsening.
Of course, the whole body is dependent on the acidity of the stomach; long-term use of these drugs can lead to osteoporosis due to poor calcium digestion — calcium needs a normally acidic stomach to be digested. It also can cause lower digestive problems such as irritable bowel syndrome due to the fact that the stomach is not doing its part, sending undigested food into the colon. Stopping stomach acid production does not improve the health of the stomach, it just causes another problem — low stomach acid — to lessen the effect of the first problem — a leaky valve or an inflamed lining.
Naturally, there are alternatives to drug therapy. The goal of wellness-based treatments is to restore normal function to the body, including healing inflammation. If the stomach inflammation is caused by another drug the person is taking for pain somewhere else in the body, we need to begin by treating that other pain so the person can stop the pain meds. Also, the patient should be checked for food sensitivities; I have found elimination of wheat and dairy products to be helpful for many patients. A diet of whole, natural foods is easier on the stomach than the processed foods we eat so much of. Chronic stress needs to be addressed, as stress is a major cause of gastric distress.
From a treatment standpoint, I have found acupuncture to be very helpful for this condition. It not only can reduce inflammation, but also can help control the stress that causes heartburn and GERD.
From a chiropractic perspective, there are often spinal problems in the middle back that relate to stomach inflammation. Treating the stomach can help the spinal pain, and treating the spine can help stomach function. We also use supplements to help heal the lining of the stomach and reduce the backwash of the stomach contents into the throat. Of course, the most effective treatment is to combine all of them.
Most of my patients are not aware of any of this. They tell me they don’t have any stomach problems, despite the fact that they take a drug for heartburn daily. It’s difficult convincing someone they still have a problem when the drug takes away all the pain. And it’s hard going up against a health care expert like Larry the Cable Guy.
Dr. Michael Noonan practices chiropractic, acupuncture and other wellness therapies in Old Town.