Proton Pumps Halt Acid Production

According to officials at the U.S. Department of Health and Human Services, more than 7 million Americans suffer from gastrointestinal reflux disease (GERD).

The disease has become so prevalent that national media campaigns target baby boomers during the evening news with information about the latest pharmaceutical answer to controlling symptoms.

The symptoms of GERD include heartburn, a sour taste in the mouth, difficult swallowing and chest pain. The disease is caused from a weakening of the sphincter that connects the lower esophagus and the stomach. Acid escapes up into the lower esophagus from the stomach causing a variety of complications including: esophageal erosions, esophageal ulcers and esophageal strictures.

When the disease is left untreated for a long period of time, Barrett's esophagus can develop. This condition has been linked to cancer of the esophagus.

Researchers from the National Cancer Research Institute in Genoa, Italy have found patients with Barrett's esophagus frequently have problems with GERD, hiatal hernias and alcohol use as well. Barrett's esophagus, coined after British surgeon Norman R. Barrett, is the inflammation and ulceration of the lower esophagus. The report shows that in Western societies, where diet often plays a significant role in gastrointestinal diseases, environmental factors can contribute to such illnesses.

There are many treatment options for GERD, from over-the-counter acid relievers to prescription drugs.

Prelief, manufactured by Pleasantville, NJ-based AkPharma, Inc., reduces the acid content of food. Offered in granulate or tablet form, the product is taken with acidic foods and beverages. Company officials report Prelief, which is not a drug, "allows persons highly sensitive to food acid to enjoy normal comfortable eating of a regular diet." The product is available at many national pharmacy and grocery store chains.

Nexium, the highly publicized "purple pill," is a pharmaceutical option for those who suffer from heartburn two or more days per week. The AstraZeneca drug has shown to heal esophageal erosions as well as provide sustained relief from GERD. Nexium, which is prescribed for short-term therapy of four to eight weeks, works by deactivating acid pumps in acid producing cells.

Aciphex, manufactured by Janssen Pharmaceutica and Eisai Inc., was approved by the U.S. Food and Drug Administration in 1999 to treat GERD. The drug is indicated for maintenance of healed erosive GERD, the healing of duodenal ulcers and treatment of these conditions, as well as pathological hypersecretory conditions including Zollinger-Ellison syndrome. Aciphex is also a proton pump inhibitor. The drug is usually prescribed in one 20 mg enteric-coated tablet daily.

Science also fuels new pharmaceutical options. Australian and Swedish researchers have teamed together to determine whether the GABA receptor type b agonist baclofen, a muscle relaxant and antispastic, could reduce gastroesophageal reflux in patients suffering from GERD.

Their report, published in Gut, suggests baclofen inhibits the lower esophageal sphincter relaxation -- one of the top causes of reflux. The team studied 20 patients to see if this would also occur in those suffering from GERD.

The group was randomly given 40 mg of oral baclofen or a placebo 90 minutes before eating a meal consisting of minced meat, mashed vegetables, milk and ice cream. Those who received baclofen experienced a 40 percent reduced rate of reflux three hours after the meal.

The team concluded that baclofen may not be a cure to GERD, but may help control the symptoms in patients who are not responding to other methods of treatment.