Dolores Dean suffered from chronic heartburn for 10 years.

"It was awful," Dean said. "It's just heat bubbling up."

Heartburn is essentially caused by pressure on your stomach, which squeezes acid and bile into your esophagus. The top triggers include:

  • Obesity & over-eating
  • Trigger foods — like fried foods, citrus, onions, tomatoes, chocolate, alcohol & coffee
  • Chronic constipation
  • Even tight clothing

Over the past decade, desperate for relief, Dean took several heartburn medications called proton-pump inhibitors (PPIs), such as Nexium, Prevacid and Prilosec, to help to stop acid production in her stomach.

"Anything to try to help," Dean said.

Heartburn Medications

PPIs are among the top selling drugs in the country and have become a billion dollar industry, but a new study out of the Washington University School of Medicine says long-term use of those drugs could increase the risk of early death.

"That is very scary," said Dr. Sharona Ross, an advanced GI surgeon, who specializes in a minimally invasive procedure to fix acid reflux.

In addition to this latest study showing an increased risk of early death, past studies also indicate a possible increased risk for:

  • Kidney disease
  • Bone fractures
  • Dementia
  • Pneumonia

Using PPIs long-term is the main concern. The recommended dosage is generally only four to eight weeks, but many people take them daily for years.

"When the proton pump inhibitors first came out it was like a miracle pill, because they did help the symptoms,” Dr. Ross explained. “So, it was an operation for acid reflux or this magic pill that took away all the symptoms."

Now, with the growing list of potential risks after years of study, many patients are considering alternatives.

 

“I’m always fearful of side effects,” Dean said.

Dolores Dean used over-the-counter medications for years to try to ease her heartburn symptoms. (Photo: Bay News 9)

Alternative Treatments

Your first line of defense to combat heartburn is to change your lifestyle and eating habits.

Here are key changes to try:

  • If overweight, lose weight
  • Avoid food triggers
  • Don't smoke
  • Eat smaller meals

Surgical Option

If lifestyle changes don't work, you can get tested to see if you're a candidate for a minimally invasive operation which corrects the mechanical problem that creates reflux.

The lower esophageal sphincter (a ring of muscle right where the esophagus meets the stomach) opens to let food in and closes to keep stomach acid out.  If it opens too often or doesn’t close tightly enough, stomach acid and bile can reflux into the esophagus, creating that burning feeling.

The operation to fix it is called a nissen fundoplication and can be done laparoscopically with a single incision through the belly button; and sometimes even through the mouth, with a procedure called a transoral incision-less fundoplication.<

"It's a wrap where you take the top of the stomach and wrap it around the esophagus, in order to create more pressure at the end of the esophagus and beginning of the stomach," Dr. Ross explained. "It's the same procedure we used to do with a big incision (on the stomach), but now we're doing it with a small incision. The only difference is technology."

The result of the procedure is to fix the problem that allows acid and bile to back up into your esophagus from the stomach.  Dr. Ross says it has about a 90-percent success rate.

Dean had the procedure, and now, is back to enjoying life and eating, heartburn-free.

"It's great," Dean beamed. "I love it now."

Bottom line: be careful about using heartburn drugs or any drug long-term, unless there is a clear medical benefit that outweighs the potential risk. And understand there are alternates you can explore if you suffer from chronic heartburn.