Monday, September 25, 2017

Acid Reflux? Try Going Vegetarian

A mostly vegetarian diet may provide relief similar to widely used medications for people with acid reflux, a new study suggests.

The study looked at close to 200 patients at one medical center who had been diagnosed with laryngopharyngeal reflux.

It’s a condition where stomach acids habitually back up into the throat, and it’s distinct from the much better-known gastroesophageal reflex disease (GERD) – or what most people call heartburn.

People with laryngopharyngeal reflux usually don’t have heartburn, explained Dr. Craig Zalvan, the lead researcher on the new study. Instead, they have symptoms like hoarseness, chronic sore throat, persistent coughing, excessive throat clearing and a feeling of a lump in the throat.

Still, the problem is often treated with GERD drugs known as proton pump inhibitors (PPIs). PPIs include prescription and over-the-counter drugs like Prilosec, Prevacid and Nexium, and they rank among the top-selling medications in the United States.

PPIs do help some people with laryngopharyngeal reflux, said Zalvan. He’s chief of otolaryngology at Northwell Health System’s Phelps Hospital, in Sleepy Hollow, N.Y. And Zalvan, himself, used to prescribe them regularly. However, it became clear that the medications were not effective for many patients, Zalvan said. At the same time, he noted, studies began raising concerns that PPIs are not as safe as thought.

Zalvan encouraged patients to go 90% plant based – eating mainly vegetables, fruits, legumes, and whole grains and nuts. Meat and dairy were to be limited to two or three modest servings per week. In addition, Zalvan gave his patients the standard reflux-soothing advice to avoid coffee, tea, alcohol and fried or fatty foods.

For the new study, Zalvan’s team looked back at patient records to see how that diet approach compared to the old PPI way. When it came to treating the patients’ symptoms, “the diet was as good, if not better than, PPIs,” Zalvan said.

After six weeks, 63% of patients on the diet were showing at least a 6-point drop on a scale called the reflux symptom index. That’s considered a “clinically meaningful” improvement, Zalvan noted. That compared with 54% of PPI patients, according to the report.

The findings were published online Sept. 7 in JAMA Otolaryngology – Head & Neck Surgery.

My Take:
Studies have shown that PPIs increase the risk of heart attack, kidney disease, dementia, osteoporosis and anemia. Elderly patients are often prescribed PPIs. The running joke is if you burp, your need a PPI. As a result, PPIs are first drug that clinicians attempt to discontinue in combating polypharmacy in the elderly.

Unfortunately, discontinuing a PPI ultimately results in “rebound” with the body producing excess stomach acid as an initial response to stop the drug. This can be managed using Zantac or some other acid neutralizing agent to ween off the PPI.

The Bottom Line:
If you suffer from acid reflux, either laryngopharyngeal reflux or GERD, try a plant based diet as described above. Give it six weeks and you will be amazed by the improvement. If you are currently taking a PPI, you will probably need the help of a qualified nutritionist to ween off the drug.

Source: September 7, 2017 National Institutes of Health

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