Nexium Side Effects - Heartburn and Celiac Disease: Gluten Sensitivity as a Reversible Cause of Gastroesophageal Reflux
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One of the symptoms many population caress often and most population have had sometime in their adult life is heartburn. The curative term for this is pyrosis, from the Greek word pyro meaning fire or heat. Heartburn is the first-rate symptom of gastroesophageal reflux (Ger) or reflux. Most population have heard of these terms now because you can't sit straight through an hour of television these days without seeing at least one market if not some advertising antacids like tums or acid blockers like Pepcid Ac and Nexium. Most population are not aware that heartburn is a common symptom of gluten intolerance or sensitivity.
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Celiac disease, which is a severe intolerance to gluten (the major storehouse protein in wheat and similar proteins in barley and rye resulting in intestinal damage) is estimated to influence 1 in 133 population in the U.S. And almost 1/100 worldwide. Most of these population are undiagnosed. Many are being treated for reflux, irritable bowel syndrome, gas-bloat dyspepsia, lactose intolerance, or just suffering ill health unaware that a gluten free diet (Gfd) might ease their symptoms if not heighten them significantly.
Dyspepsia is a curative term for stomach upset, indigestion or gas-bloat abdominal discomfort. This ordinarily occurs in celiac disease. Stomach contractions have been shown to be impaired in celiac disease contributing to the bloating sensation. This is confirmed by diagnostic studies revealing poor stomach emptying. Delayed stomach emptying is often accompanied by low pressures in the lower esophageal sphincter (Les) of the esophagus or swallowing tube. The Les is supposed to be a barrier to regurgitation of stomach contents up into the esophagus. When stomach juice that is acidic refluxes into the esophagus a burning pain is typically felt in the chest that is described by most population as heartburn.
When acid often regurgitates up into the esophagus a burn of the lining occurs that is termed esophagitis or reflux esophagitis and defines gastroesophageal reflux disease (Gerd). Celiac disease patients have been shown to have a high prevalence of Gerd and reflux esophagitis. Rehabilitation with a gluten free diet has been shown to decrease the rate of relapse of Gerd symptoms. In clinical practice, many of us have observed that a gluten free diet results in marked correction of heartburn symptoms in not just celiac disease but in many people.
As a practicing gastroenterologist, (www.thefooddoc.com) I have had patients referred to me for reflux symptoms along with some who were being carefully for possible surgery for Gerd. Upon discovery of celiac disease or non-celiac gluten sensitivity and custom of Gfd they have had correction or resolution of symptoms. Personally, I experienced frequent sufficient heartburn that I was taking a daily acid blocker. When I discovered that though I had symptoms of gluten sensitivity and was Dq2 inevitable I had negative blood tests but elevated fecal gliadin IgA and tissue transglutaminase IgA antibodies, I initiated a Gfd. My heartburn went away and I stopped taking a daily acid blocker. Now I only have heartburn rarely, commonly with inevitable dietary indiscretions like too much coffee, chocolate or wine.
My friend and colleague, Dr. Rodney Ford, who practices pediatric gastroenterology in New Zealand, has communicated to me his similar caress with children. Since addition gluten free diet to those children he suspects of gluten sensitivity, not just those in whom celiac disease is confirmed by primary or first-rate precise diagnostic criteria, he has noted a marked decrease in the number of children with Ger. He states it has been many years since he has had to refer a child for surgery for reflux.
There have been concerns about clinical significance of known acid suppressive therapy impairment of digestion though so far the worries about the increased risk for cancer seen in lab rats have been unfounded. Recently, an growth risk of community-acquired pneumonia attributed to loss of acid discount of bacteria in the stomach was found in patients with persisting lung disease or with other risk factors. There also is the on going deliberate upon about the high costs of the newer, more effective acid blocking drugs as well as their possible side effects. Some also raise concerns of an increased risk of food intolerance or allergy while on acid suppression. These issues and the risks of undiagnosed celiac disease not withstanding should give one pause to the idea of persisting acid suppressive therapy without investigating the possibility of undiagnosed celiac or gluten sensitivity with a trial of Gfd.
Copyright 2006 The Food Doc, Llc. Http://www.thefooddoc.com
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