The combined market for the prescription forms of Pepcid, Tagamet, and Zantac is more than two and a half billion dollars. The revenue for the over-the-counter forms of these drugs which are lower dosages of the prescription formulas, must also be impressive considering the advertising dollars being spent by the manufacturers. Obviously, heartburn and reflux esophagitis are common ailments although these drugs are also prescribed in the treatment of stomach and duodenal ulcers. Histamine stimulates stomach cells to produce acid. Pepcid, Tagamet, and Zantac belong to a class of medications called H2-blockers that inhibit the action of histamine on the stomach cells thereby reducing stomach acid production. Tagamet should not be used by persons taking Coumadin (warfarin) or Dilantin (phenytoin). Major side effects include confusion, hallucinations, enlargement of the breasts and impotence. Nursing mothers should not use Pepcid. Major side effects include agitation, anemia, confusion, depression, easy bruising or bleeding, hallucinations, hair loss, irregular heartbeat, rash, visual changes, and yellowing of the eyes or skin.
Normally, the lower esophageal sphincter, a band of muscle around the lower esophagus, acts as a valve to prevent the contents of the stomach from flowing back into the esophagus. When the esophageal sphincter is not working properly, the resulting back flow is called gastroesophageal reflux. The burning sensation - heartburn - is the result of stomach acid coming in contact with the lining of the esophagus. If a person experiences chronic reflux, inflammation and/or ulceration of the esophagus may result - a condition called reflux esophagitis. The condition can be very painful and may even cause chest pain which mimics the symptoms of a heart attack. Over an extended period of time, scarring and narrowing of the esophagus from esophagitis may lead to difficulty in swallowing, chronic cough, hoarseness, sore throat, and asthma.
Approximately half of the patients with severe reflux have problems with delayed gastric emptying. If the stomach remains full, it produces excessive amounts of acid which in turn worsens the reflux symptoms. Many other people experience heartburn during the night. These people should eat a light supper early in the evening which is low in fat and easy to digest. If the stomach is empty, reflux will not occur. In severe cases, Reglan (metoclopramide) or Propulsid (cisapride) may be prescribed. These drugs help the stomach to digest food more rapidly and strengthen the lower esophageal sphincter, but common side effects include headache, diarrhea and adomininal pain.
Diet and lifestyle changes should be your first course of action before seeking a prescription drug. Eat smaller meals more often, avoiding foods you know cause you distress. Carbonated beverages, coffee, alcoholic beverages, chocolate, onions, fatty foods, and peppermint should be avoided because they have been found to weaken the lower esophageal sphincter. Smoking increases acid production and weakens the lower esophageal sphincter. If heartburn awakens you during the night, sleeping on a foam wedge may help.
The goal is to heal your esophagus, but you have to be patient because it may take several months, but you should notice steady improvement if you work diligently at modifying your diet and lifestyle to control the problem. Many people have reported that Pure Green Power, taken prior to meals, has greatly reduced the number and severity of their heartburn attacks.
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