Gut check for reflux

It WAS 1972 when a visibly uncomfortable man leaned over the side of his bed bemoaning his indulgence with the phrase, "I can't believe I ate the whole thing." This Alka-Seltzer commercial was an early and memorable marketing effort to show how a simple pill could ease the pain of gluttons everywhere. And it was just a hint of what was to come.

More than 35 years of plop, plops and fizz, fizzes later, Americans have hardly learned their lesson.

Today, approximately 60% experience occasional episodes of acid reflux, and about 25% deal with the problem on a weekly basis. The prevalence of the condition in North America is increasing by about 5% a year, according to a 2007 study in the journal Clinical Gastroenterology and Hepatology.

A report in January from the Agency for Healthcare Research and Quality found that more than 95,000 people in the U.S. were hospitalized with acid reflux as a primary diagnosis in 2005, up 4.5% from 1998. But the number of people hospitalized with reflux as either a primary or secondary diagnosis reached 3 million in 2005 -- an increase of 216% from 1998.

Gastroesophageal reflux disease, GERD or acid reflux, occurs when the small ring of muscle at the bottom of the esophagus weakens and allows stomach acid and food to back up, or reflux, into the esophagus after a meal. Common symptoms include heartburn, difficulty swallowing, an acidic taste in the mouth and nausea or vomiting.

The increase in obesity is speculated to be one cause of its growing prevalence. Excess fat in the abdominal area pushes on the stomach's contents; stomach fat causes distention and relaxes the lower esophagus; and fat-laden foods slow down the stomach's emptying process. Other factors include Americans' notoriously poor nutritional habits and a heightened awareness of the condition induced by pharmaceutical advertising.

Medications also may be contributing to the problem.

"If people didn't have good medications to treat it and something they ate made them sick, they would avoid it -- but it's human nature to pop a pill and continue eating," said Dr. Prateek Sharma, a professor of medicine and director of the GI Fellowship Training at the University of Kansas School of Medicine.

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Medical therapy

Although medication is not a cure for acid reflux, a majority of patients find relief through prescription and over-the-counter drugs. Aside from traditional antacids, including Alka-Seltzer and Tums, there are now two main medications used to treat reflux.