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From: DanK
Remote Name: 128.119.232.100
Date: 09/16/02
Time: 02:53:07 PM
What both this report and reports from the pro acid supression world evade is what is causing the reflux in the first place. One symptom of having excessive reflux is heartburn (probably the biggest complaint). hyper secretion of acid most likely occurs in a small percentage of cases. The problem is inherently mechanical (what the cause of this mechanical problem and how to treat it vary tremendously from patient to patient, for some it being an incompetent les which needs to be treated surgically, for others it is one that relaxes when it shouldn't and may be treatable by a variety of drugs). Even small levels of acid in the esophagous and cause damage because the lining of the esophagous does not have the same type of barrier as does the stomach. It's irritation of the esophagous which leads to "heartburn." so, by reducing acid one reduces irritation to the esophagous and can eliminate heartburn symptoms in many cases, but the act of reflux will still occur. The situation isn't necessarilly ideal (treating the symtom rather than the cause, but for most people the benefits outweigh the risks. High does of acid reducing therapy (whether H2 blocker or PPI) will lead to a decrease in the efficiency of digestion, but for many this is preferable to heartburn (add in the serious damage you can do because of prolonged acid exposure such as barretts). In the end, as long as stomach contents are being refluxed, a problem exists regardless of acid levels. Add in the fact that the idea of swallowing vinegar is somewhat hard to imagine being a good thing (increasing exposure of the esophagous to low pH). It kind of reminds me of a friend who once did an all orange and grapefruit diet. yeah, she lost weight, but she did an amazing amount of damage to her esophagous in the process... as for helicobacter, it can be debated for hours, but the evidence is inconclusive at best as to what role it may play in reflux (some have reported that it may in fact help reflux patients and some have reported that it is a contributor...).
cheers,
dan