Dr. Eisner Answers Your Questions About Acid Reflux
What can I do to avoid having attacks of esophageal reflux this time of the year?
With the holidays just around the corner, whether you have a history of gastroesophageal reflux disease or not, think twice about what and when you eat to avoid that uncomfortable feeling of heartburn. Most people are aware that caffeine-containing foods such as chocolate, fatty foods and spicy foods can induce reflux. Just as important, however, is the amount of food. Pay special attention not to overeat, as the increase in abdominal pressure itself can worsen reflux.
Additionally, by overeating, your tight-fitting clothes, by putting increased pressure on the abdomen acts to force stomach contents up into the esophagus, thereby worsening reflux and regurgitation. Eating late at night at holidays, especially when alcohol is involved, will also lead to more episodes of reflux when you lie down for bed at night. Special attention should be given to avoid lying flat for a few hours after eating to prevent this.
While exercise is important, be sure not to exercise on a full stomach, as most types of exercise will lead to an increase in intra-abdominal pressure and force contents from the stomach into the esophagus. If you do have esophageal reflux, and you are going to indulge, it is wise to take your usual medication, and possibly even an over the counter product such as antacids, H2 receptor blockers like Zantac or Pepcid, or a proton pump inhibitor like Prilosec OTC to prevent an attack.
With holiday time approaching, and our depressed economy, I am having a hard time affording my acid reflux medication. Any suggestions?
Acid reflux medications, while very effective, tend to be costly. This burden is especially noticeable this time of the year, when many patients on the Medicare Part D reimbursement have exceeded their allowable drug coverage. Depending on your insurance benefits, some of the prescription proton pump inhibitors can cost close to $4-$5 a pill. Occasionally, patients may need to take two pills a day to experience relief of their symptoms.
Thankfully, there are both over the counter and generic formulations of proton pump inhibitors. Both over the counter Prilosec, and generic Omeprazole (Prilosec) and Pantoprazole (Protonix) are available for a fraction of the cost of the brand name drug. You should check with your physician as to what the best option for you might be. Additionally, most of the drug companies that manufacture proton pump inhibitors offer both samples, as well as patient assistance programs in order to make these drugs available. If you cannot afford what your doctor is recommending, ask about such programs.
Every year around the holidays, I end up in the emergency room with food stuck in my esophagus. How can I avoid this?
Food impaction is not unusual during the holidays. Patients will have an underlying disorder in the esophagus, such as an esophageal narrowing or stricture, or a muscular ring. Impactions are more likely to occur when one drinks alcohol, as well as when one is talking and socializing while eating and not paying attention to chewing food well. Foods such as steak or chicken, because of their consistency are more associated with food impactions as well.
If you do suffer from esophageal reflux or difficulty swallowing related to prior food impactions, staying on medication to decrease inflammation in the esophagus, avoiding alcohol, chewing food well, and staying away from tough, dry food will decrease your chance of a recurrence. If you do suffer an impaction, which would typically manifest as an inability to swallow any liquids, even one's saliva, contact your physician immediately so that an urgent upper GI endoscopy can be arranged.