Gastroesophageal reflux disease (GERD) is a condition that is highly common in the United States. When one has this condition, the valve separating the esophagus from the stomach allows acid into the unprotected esophagus, often causing an unpleasant sensation.
Between 10-20% of people experience weekly symptoms, and $13 billion in prescription pharmaceuticals were spent treating this condition. The identification of the causes of GERD is a matter of some controversy right now which has significant implications in how the disease is treated.
Most people believe that GERD is caused by too much stomach acid. The vast majority of medicines that are given to people to treat GERD lower stomach acid.
While these are effective, there is a lot of evidence that the exact opposite scenario is true. Too little stomach acid could be causing GERD, and treating it with most prescription pharmaceuticals could make the condition worse in the long run.
The first thing someone should notice with regards to the too much stomach acid hypothesis is that most people experience dramatic drops in stomach acid when they age.
As a result, one would expect that GERD would become less and less of a problem if the high stomach acid cause hypothesis were correct. However, the exact opposite is observed. The incidence of GERD actually increases as one ages.
Why are young people not getting GERD in huge numbers given their large amounts of stomach acid? The main reason is that the valve separating the stomach from the esophagus normally works.
If it fails at all, then it does not matter if you have a little stomach acid or a lot. It is going to cause a problem. The reason why is the esophagus just is not protected against the corrosive effects of the acid.
This fact also explains why many people get systemic relief from pharmaceuticals. By dramatically decreasing the stomach acid that is flowing into the esophagus, one will get less symptoms. However, if the valve is not functioning well, there will always be small amounts of acid corroding the esophagus.
Recent evidence indicates that even silent GERD, that is when symptoms are not noticed, is dangerous and can even lead to a much greater risk of esophageal cancer.
The underlying dysfunction of the valve is believed to result from the unnatural expansion of pressure in the stomach, which pushes stomach juices out of the valve.
There appear to be two things that cause this increase in pressure. The first is an overgrowth of bacteria in the gut, and the second is the accumulation of improperly digested carbohydrates.
Both of these underlying issues actually can be the result of lower stomach acids. Bacteria cannot survive well in the stomach when the pH drops below 3. If one weakens the acid of the stomach, then this bacteria will overgrow causing increased stomach pressure.
The presence of undigested carbohydrates also helps to feed such bacteria. The reason that the carbohydrates are undigested also largely relates to the fact that the stomach acid is not powerful enough to quickly reduce them.
As a result, when people consume medicines such as proton pump inhibitors, they could be temporarily relieving their GERD symptoms while weakening their stomach acid, which is only making the underlying problem worse.
In contrast, many physicians have found that providing hydrochloric acid supplementation to boost the acid content of the stomach actually resolves the disease.
Thus, understanding the causes of GERD has very important implications towards changing our current treatment paradigm. If you currently suffer from GERD, you should seriously consider going off the prescription medications and taking actions to increase the acid content of your stomach.
Most parents expect some sleepless nights after they bring home a new baby, but things usually settle down once a routine begins to form. There is less fussing, crying and discomfort as parents learn the cues for what their baby needs.
However, there are babies that continue to fuss, cry and appear to be in pain long after those first few weeks are over. If your baby seems to be suffering or uncomfortable, he may be suffering from acid reflux which is also known as gastroesophageal reflux.
Acid reflux symptoms in babies can make life miserable for both you and your baby. Therefore, it is vital to understand this disease in order to properly deal with it.
Symptoms of Acid Reflux in Babies
There are several common symptoms of acid reflux in babies, but not every baby will experience all of them. Common symptoms are:
- Fussiness from one feeding to another
- Spitting up more than the usual, expected amount
- Projectile vomiting
- Little interest in eating
- Obvious misery (crying, arching the back and frequent waking during sleep)
Causes of Acid Reflux in Babies
In a normal baby, there is a circular band of muscle, the lower esophageal sphincter or LES that keeps the stomach separate from the esophagus. As food enters into the stomach, this band contracts like a one-way valve keeping the contents of the stomach and acids from being regurgitated into the esophagus.
If a baby has an immature LES, the acids and contents of the stomach can be regurgitated causing the same type of pain that adults call heartburn. This condition is usually temporary, however, there are ways to lessen the pain and make baby feel more comfortable until the LES matures and the acid reflux resolves itself.
How to Help a Baby With Acid Reflux
Acid reflux in babies is usually outgrown by six to nine months of age. However in severe cases, there are medications that will keep stomach acid production to a minimum. Some tips for keeping baby more comfortable include:
Keeping your baby in an upright position after feeding. Gravity will help to keep the stomach contents from refluxing, reducing discomfort and pain. It is best to keep him in the upright position for approximately thirty minutes.
Feed frequent, smaller meals. Smaller meals are digested more quickly, leaving less time to be regurgitated. A good idea is to feed baby half the usual amount, but cut the time between meals in half.
Watch what you feed your baby. Breast milk is the best milk for a baby, so it should be continued if at all possible. Breast milk helps by digesting more quickly than formula and contains enzymes that aid in digestion. Also, babies can be allergic to formulas which aggravate acid reflux.
Make your baby comfortable for sleep. Lying flat can cause stomach contents to reflux, so if your baby is waking frequently or seems to be in pain, raising the head of his crib about thirty degrees can help gravity to keep stomach contents down.
Get some support. There are support groups dedicated to the families of babies who suffer from acid reflux. Ask a pediatrician for advice on where to look for local groups. Support can help to lessen the stress and frustration of dealing with this condition.
As you can see, babies with acid reflux suffer just like adults and we know that can be quite painful. Keeping in close contact with a pediatrician, as well as using these tips to comfort your baby will ensure he is getting the best comfort and care that he needs.