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Even Presidents get Acid Reflux

President Obama

I just heard on the news that President Obama was evaluated at a Virginia hospital for a chronic sore throat that was diagnosed as acid reflux. I am a fan of President Obama- as I think he is an eloquent man trying to do an impossible job. A job that comes along with a lot of stress (we’ll address why that is important shortly).

Acid reflux also called heartburn in lay terms, is generally due to hyperacidity in the stomach which can lead to acid tracking backward up into the esophagus. We all see the commercials for Rolaids (“Rolaids spells relief”), or Nexium (“the purple pill” puts out the stomach fire).

Acid reflux is a common problem not just affecting elected officials- almost everyone has episodes of acid reflux. But the real concern begins when it is chronic because it can damage the lining of the esophagus – and even lead to cancer!

When I treat acid reflux, I address 3 aspects that I believe are key to getting better and staying well:

  1. Diet and lifestyle
  2. Breathing exercises and
  3. Stress management
Diet and Lifestyle…

…as we all know, can set anyone up for acid reflux. If you love those tomato sauces on your pasta or pizza, along with any other greasy foods like French Fries, you are giving your stomach more acidity than is manageable. When the stomach acidity becomes too strong, certain enzymes are released that can damage the stomach lining. Also, acid reflux is more common when the valve that sits at the end of the esophagus becomes lax due to certain beverages: coffee, alcohol and carbonated drinks all decrease this valve pressure and the acid can trackback up the esophagus.

In President Obama’s case, I’m not sure how much caffeine he drinks daily (although I’m sure he needs a good amount) but I’m concerned because it’s been said he is a smoker and nicotine can also affect the acidity in the stomach and valve pressure. Even Nicorette gum, that supposedly the President chews to avoid smoking, can trigger acid reflux. The key to avoiding acid reflux is what is termed an alkaline diet. Alkaline foods are found in almost all vegetables and some fruits. The more processed the food the more likely it is acidic.

I also recommend light foods on the digestive tract, such as fish or lean turkey or chicken. Avoid red meat – the stomach has to work hard to digest it. A good book to know which foods are acidic or alkaline is called dropping Acid by Dr. Jaime Kaufman.

Breathing Exercises…

…are one of my favorite ways to help patients with chronic acid reflux. You are probably wondering: what does breathing have to do with acid reflux?

The anatomy of the major muscle separating the stomach from the chest(heart and lungs) is the diaphragm. The diaphragm is a huge muscle- its thickness is like a radial automobile tire- that divides the chest from the abdomen.

It also has a very important role in a minute to minute breathing: if you injure your spine in the neck(C3,4,5), you are not only paralyzed but unable to breathe because these nerves control the diaphragm. You would need to be on a ventilator for life.

When the diaphragm is very tense or contracted, anatomically it squeezes the esophagus which is like a straw that dips into the stomach. The acid just squirts back up into the chest and throat- causing heartburn or a chronic sore throat.

By doing special yoga breathing exercises, you can learn to expand your chest and abdomen- and relax your diaphragm. In my book, The Allergy and Asthma Solution, I actually have a section on breathing exercises that demonstrate the proper technique.

Stress Management…

…is also a key in treating and preventing acid reflux, as in many other medical conditions. It is well known that the vagus nerve, the 9th cranial nerve in the nervous system, directs the stomach to secrete acid when we are nervous, tense and excited in any way, good or bad. We can’t stop life’s challenges and stressors but we can find ways to mitigate them.

Interestingly, certain personality types are more likely to get acid reflux than others. You might guess it is the shouters and screamers, but actually it is those individuals that hold in the stress. Yes, the quiet people you know that seem to handle everything can be prime targets for acid reflux.

I think the President’s moniker: “No drama Obama” makes him a more likely acid reflux candidate. Acid reflux doesn’t discriminate between Democrats or Republicans! My advice to the President is not to yell at the First Lady or his beautiful girls, but to realize although everyone expects him to fix every crisis he’s only human and needs to find an outlet. He should find his way back to the basketball court to shoot some hoops!

But Wait! What About Medicine?

As you can see I didn’t give any mention to medications in my advice on treating acid reflux. I do believe there can be a place for these medications in the short-term relief arena. However, the key dilemma is that acid-blocking medications are far from an optimal solution long-term for several reasons:

  • One, these medications can make the stomach not acidic enough to digest food and as a result, you get slow down indigestion- which is uncomfortable.
  • Secondly, in some of these medications, constipation, and diarrhea can be problems.
  • And finally, the most recent finding is that long term use of acid blockers decreases the absorption of minerals and makes users more susceptible to osteoporosis and fractures.

My best advice to President Obama this holiday season to reverse his acid reflux: Board Air Force One and head to your homeland, Hawaii! Serenity will go a long way to healing your acid reflux. We all should be so lucky to have that option!

– Dr. Dean Mitchell
Mitchell Medical Group, NYC