Reflux disease prevalent, harmful

Do not take heartburn lightly. While ads and TV commercials indicate relief can be found in an array of over-the-counter and prescription pills and potions, they do not fix the underlying problem. And that underlying problem may lead to far more serious ailments.

The condition usually responsible for heartburn is gastroesophageal reflux disease, or GERD. Its symptoms become apparent when digestive acids in the stomach make their way into the esophagus.

"The prevalence of reflux disease in people over 50 is pretty close to 50 percent," says Dr. Jamie Koufman, director of the Voice Institute of New York and a professor of clinical otolaryngology at New York Medical College.

Since the mid-1970s, the number of people with reflux disease has grown about 300 percent, but that's not the most alarming statistic. "Cancer of the esophagus has increased 850 percent during the same period," Koufman says. "If you look at the prevalence of cancer of the esophagus and pre-cancer, it is clearly related to reflux."

While most people with GERD exhibit heartburn symptoms, a growing segment of reflux patients rarely have indigestion, according to Koufman. This "silent airway reflux" doesn't stop at the esophagus. "Airway reflex means everything from the nose to the sinuses to the throat to the breathing tubes to the lungs," she says. Instead of heartburn, there is a collection of seemingly unconnected and often misdiagnosed symptoms including postnasal drip, hoarseness, coughing after eating and chronic throat clearing.

Koufman believes the increases in reflux and esophageal cancer are directly related to what she calls the acidification of the American diet. She is the co-author of "Dropping Acid: The Reflux Diet Cookbook & Cure," which offers recipes and advice for a low-acid, low-fat diet. She also offers tips on refluxcookbook blog.com.

You can blunt the effects of reflux by eating high-acidic foods with lower acidic foods. "If you're going to have strawberries, have them in low-fat milk," Koufman says. The acid test for foods is pH value. Generally, foods with a pH under 4.0 are high acid, above 4.6 they are low acid. For a list of pH values of common foods, go to 1.usa.gov/pH-FDA.

Averting GERD means eliminating "trigger foods" such as coffee, white wine, tomatoes and soft drinks. As for the most problematic food, it is not sweet news.

"No. 1 biggest trigger food is chocolate," Koufman says. "I'd change it to spinach if I could."