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Heartburn - What To Do?
It used to be the case heartburn was a middle-age problem, but there's emerging evidence there are teens affected as well. They share a love of pizza, burgers and, when age permits it, plenty of beer to wash it down. The reason, apart from taste, is the cost. Ignoring the diners and pubs that offer challenges to waive the bill if you can eat all a particular meal, the regular portions are really cheap. The reason is the highly subsidized cost of the corn products that show up in most of of our fast foods. So you have all the bad habits in place at an early age, overeating all the wrong foods. How do we know this is happening? Since most younger people ignore warning signs, probably thinking all they need is more to drink to solve the problem. Except, if you do nothing, more acid is released into the esophagus where it stays longer. This produces damage called Barrett's Syndrome where the cells lining the esophagus change. The bad news is that, untreated, this can turn into cancer. This is the difference between the young who often think they will live forever, and the older people who wisely take pills to reduce the amount of ...
... acid produced for digestive purposes. Young men, in particular, ignore mild pain. Excess gas and burping is a joke rather than a symptom of possible disease.
Barrett's affects about 10% of all patients with heartburn. In more advanced cases, the doctors will recommend surgery to remove the affected part of the esophagus. So the moral of this story is that, regardless of age, if you are getting heartburn on a regular basis, there's pain under your breastbone, you have trouble swallowing and sometimes cough up blood, you are seriously at risk of Barrett's. The only way to be certain of the diagnosis is to insert a camera and surgical tools into your digestive tract and take a sample of the cells for biopsy. But all this assumes you allow the problem to get this bad. Perhaps the real moral of this story is that once heartburn starts to become a noticeable problem, you should always take action.
Proton pump inhibitor (PPI) drugs are the first line of defense. They work by reducing the amount of acid produced in the stomach. This means there's less acid available to leak into the esophagus, effectively cutting off the cause of Barrett's. As an aside, we should note the drugs can be useful in treating Barrett's, but are completely ineffective in preventing the cells from becoming cancerous. It's better not to allow any longer term damage to the esophagus.
As a general warning, the PPI drugs like Nexium are only supposed not be taken for relatively short periods of time - usually not more than three months. Yet many people take these drugs for years. If tolerance builds up, patients decide to increase the dosage without getting advice. We should never treat drugs of this class as if they were like candy to be popped after every meal. If you do take Nexium for too long and then stop, the acid reflux can come back even more painfully. Don't take risks with your own health. Always get proper advice.
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