Heartburn is something that most Americans have tangled with at some point in their lives. Some people have to deal with it more than others, suffering from chronic, severe heartburn on a regular basis. In spite of how widespread and how common the experience of heartburn is, we've just recently begun to really understand the mechanisms behind heartburn, and there's still so much to learn. Heartburn is also known as acid reflux. Chronic heartburn is also scientifically referred to as GERD or Gastro-Esophageal Reflux Disease. It's estimated that one in every five people struggle with some form of upper gastrointestinal pain.
What Causes Acid Reflux?
Until recently, heartburn had been considered merely as a dangerous influx of stomach acid in the esophagus. As research has continued and the body of evidence has grown, however, our conception of acid reflux has evolved. Current research strongly suggests that acid reflux is the symptom of a more complex set of physiological issues, and is only part of the problem. Recent studies have shown that stomach acid secretion is mostly the body's response to an underlying theme: esophageal inflammation.
One of the most significant changes in how medical science views illness and disease is an increased emphasis on the damaging effects of chronic inflammation. In fact, it appears that this inflammation may be a primary factor in chronic heartburn and acid reflux, impairing digestion and leading to a damaging feedback loop between inflammation and high stomach acid levels.
Learning More about What Causes Heartburn: The Evolution of GERD
What we first understood of as chronic heartburn we have now reclassified into a more accurate term: Gastro-Esophageal Reflux Disease, or GERD. This new medical terminology further illuminates the fact that chronic heartburn isn't merely a condition caused by stomach acid reflux, but a more complex set of factors. Heartburn isn't the whole scope of GERD, but the defining characteristic directly experienced by the patient. Chronic heartburn treatment has revolved around medications to reduce acid secretion for decades, but medical science suggests there may be a better way to treat GERD at the source effectively.
The History of Heartburn Medications
The first modern medical treatment for heartburn was the calcium pill, the primary form of medicine in the first 2/3rds of the 20th century. The first sophisticated prescriptions for heartburn were first generation acid blockers, the two most recognizable being Zantac and Pepcid.
Around the year 2000, newer drugs became available which were more effective than 1st Gen acid blockers for many patients, called Protein Pump Inhibitors (PPIs). Some of the brand names for these drugs include Prilosec, Protonix, Prevacid, Aciphex, and Nexium.
To date, Protein Pump Inhibitors are the most prescribed medication for those that struggle with chronic acid reflux. The problem is that even these sophisticated PPIs also come with their own set of significant drawbacks, and don't necessarily treat the entire issue. Medical scientists are working hard to try to discover the next form of heartburn treatment -- one that addresses not only acid reflux but also the underlying inflammation associated with GERD, hopefully with a reduced incidence of side effects.
In a study conducted in tandem by the University of Texas Southwestern Medical Center and the Dallas Veterans Administration Medical Center, research has revealed what is likely the underlying cause of chronic heartburn: Cytokine-illicited inflammation. Cytokines are a tool that our immune systems use to stimulate inflammation. Often, chronic inflammation is an autoimmune response, the result of the human body attacking itself, in a misguided attempt to protect itself. This very well may be the case for GERD-sufferers as well.
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