Yes, heartburn without acid reflux

Do you have chronic heartburn or GERD? Did you know that many patients with heartburn (chronic acid reflux) or gastroesophageal reflux disease (GERD) do not get relief even from the strongest acid blocking medications also known as proton pump inhibitors PPIs. Lack of response in "GERD" or chronic reflux patients may occur due to a variety of reasons which include:

1. Some patients may require higher than normal dose, for example twice a day PPI instead of once a day. This can be documented by doing 24 hour pH monitoring while taking the medication.
2. Although heartburn in majority of patients is due to acid reflux, it may be also occur as a result of reflux of non-acid gastric contents into the esophagus. Obviously, acid blocking medications are not going to help if the refluxate does not have much acid. These patients may be helped by anti-reflux surgery to prevent any kind of reflux.
3. A small fraction of patients may have symptoms of heartburn in the absence of any kind of reflux, acid or non-acid. Assuming cardiac etiology has been excluded, this is believed to be in part due to lowered pain threshold. Medications that raise pain threshold may be helpful to some extent. A combined pH monitoring and impedance testing can help distinguish this from acid and non-acid reflux.

Do you or someone you know have GERD or heartburn? What treatments have been effective and to what degree? Please feel free to share your thoughts. By the way, do not forget the potential benefit of lifestyle measures on chronic gastroesophageal reflux disease.

Comments

[Jordan]

I think one of the worst things you can do if you suffer from GERD or acid reflux is to use over the counter ant-acids. They temporarily relieve symptoms by suppressing acid production but sometimes it's not an overproduction of stomach acid that causes discomfort but rather a lack of. Acid blockers like tums, rolaids, prilosec, or xantac can greatly interfere with the natural process of digestion. The body needs a certain amount of hydrochloric acid in order to break food down properly. Some of the remedies that I think are helpful are organic aloe vera juice or a little concoction that consists of fresh squeezed lemon, 2tbs of braggs apple cider vinegar, and 2tbs of raw unpasturized honey. Do this before bed for about 5 nights in a row and it can relieve the discomfort of most heartburn. In general things that aggravate this condition are foods that are spicy, caffeine, alcohol, even nicotine. Also, if you suffer from acid reflux it may be helpful to sleep slightly propped up with a pillow at night to prevent acid from climbing upward.