How To Individualize Your Diet Plan If You Have Heartburn
An anti-inflammatory diet and lifestyle provide an excellent foundation for combatting acid reflux disease naturally. After that, its critical to then tailor your diet to help decrease stomach acid and avoiding triggers. Theres no one-size-fits-all when it comes to the diet for heartburn. Individuals with acid reflux have unique biochemistries and subsequent sensitivities that result in a heartburn flare.
Always be mindful of the foods you eat and observe if heartburn episodes seem connected to a certain food. It may help to keep a food diary to make it easier to assess patterns.
Data Extraction And Quality Assessment
Data extraction was performed using predefined forms. Data extracted from these papers were verified by another investigator. Discrepancies were resolved by consensus. The extracted information included the following items: the first author, publication year, study country or area, study design, sample size, methods used for NAFLD diagnosis, diagnosis of GERD, outcome of interest and covariates adjusted in multivariate regression analyses. The most up-to-date or comprehensive data were included when multiple publications exist.
Two investigators evaluated the risk of bias independently. Quality assessment was based on the Newcastle-Ottawa scale as recommended by the Cochrane Collaboration. NOS was developed to assess the quality of nonrandomized studies with its design, content and usability. A âstar systemâ has been proposed where a study is assessed in three domains: selection , comparability and exposure/outcome . We judged studies with a score of at least eight stars to be at low risk of bias, indicating the high quality of these studies.
Development Of Fatty Liver
NAFLD is not a transmissible condition . Rather, it is a condition that occurs most often in individuals who have one or more of the following risk factors for developing the disease:
- sedentary lifestyle
- the use of certain medications
The medical community does not yet know exactly why NAFLD affects some people with the above conditions and not others. It is also not completely understood why, for some people, fat will accumulate in the liver but not cause significant damage , whereas in others, it results in significant damage .
As the prevalence is very high in Canada, if you have one or more risk factors for the disease, it may be reasonable to discuss with your healthcare provider whether you are a candidate for further testing. However, at this time, there are no firm accepted guidelines as to who needs further investigation for this condition, other than those who have unexplained liver enzyme abnormalities.
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What Are The Symptoms Of Insufficient Stomach Acid
Each of the symptoms below may give you clues that your stomach is not producing enough acid:
- Abdominal bloating after meals
- Weak and thinning scalp hair
- Red cheeks
- Bad breath
- Eczema and acne
Antacid medication does provide relief from heartburn and reflux but it can worsen all the other symptoms. By lowering the amount of acid in your stomach, they can put you at risk of stomach and intestinal infections, raising your risk of food poisoning and gastroenteritis .
Your stomach produces hydrochloric acid as soon as some food enters it. The acid specifically helps to digest protein rich foods, by activating protein digesting enzymes called proteases. Therefore people with low stomach acid typically experience bloating and indigestion after eating foods like red meat, fish, eggs and poultry.
It is normal for the level of acid in your stomach to decline as you get older. Interestingly, many elderly people stop eating red meat because they say it gives them indigestion. It is wise to avoid eating foods you know upset your digestion, but there are ways to treat the cause of the problem and boost your stomach acid.
Living With Your Diagnosis
Most patients with NASH are unaware they have the problem because they usually have no symptoms. Some patients may have nonspecific complaints of fatigue, abdominal discomfort, and just not feeling right. On examination, your physician may feel an enlarged liver or spleen, but in general most patients have no symptoms and no major findings.
Many times your physician may come on this diagnosis accidentally while evaluating another complaint. One common scenario leading to the diagnosis of NASH is the finding of abnormal liver function blood testing. In this case, your physician will proceed with a detailed history, physical examination, and additional workup to exclude common causes of abnormal liver function blood tests, for example, hepatitis A, B, or C alcohol hemochromatosis autoimmune hepatitis and so forth. In addition, your physician may order special x-ray examinations, an ultrasound , computed tomography scan , or magnetic resonance imaging scans .
However, the only definite way to diagnose NASH is by obtaining a liver biopsy. A biopsy requires cutting out a piece of the liver that will be examined under a microscope.
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What Causes Low Stomach Acid
Low stomach acid is an incredibly common problem and there are several factors responsible:
- Stress, anxiety and tension are your digestive systems worst enemies. If you eat while in an emotional state, you will not be making enough stomach acid or digestive enzymes.
- Food allergy, intolerance or sensitivity. The irony is that low stomach acid makes you more likely to develop a food allergy, and having a food allergy can inhibit normal acid production. It is very important to identify and remove problematic foods. Gluten and dairy products are a common culprit but there could be others. Our book The Ultimate Detox contains a gluten and dairy free eating plan.
- Mineral deficiencies. Zinc and sodium are required for hydrochloric acid production. Zinc deficiencies are very common, especially among vegetarians. Sodium deficiency is not common it can occur in athletes or people who have experienced diarrhea or vomiting.
- High sugar diets.
- Inflammation of the lining of the stomach, known as gastritis can inhibit acid secretion.
- Food allergy, autoimmune disease and infection with the bacteria Helicobacter pylori can all result in gastritis.
Acid Reflux Medication & Liver Disease
Our stomachs produce acid to kill ingested microbes. By taking a medication that suppresses the secretion of these gastric acids, it changes the composition of the gut microbiome.
Researchers at University of California San Diego School of Medicine uncovered evidence in mice and humans suggesting that stomach acid suppression may promote liver injury and the progression of three chronic liver diseases: alcoholic liver disease, nonalcoholic fatty liver disease and nonalcoholic steatohepatitis , as a result of these microbiome changes.
Specifically, researchers found that the lack of gastric acid promotes the growth of the bacteria Enterococcus in the intestines. When this bacteria translocates to the liver, it worsens inflammation and chronic liver disease. To confirm the increased Enterococcus bacteria was behind the effect on chronic liver disease, the team colonized mice with Enterococcus faecalis to mimic the overgrowth they had observed with acid suppression. The results? Increased Enterococcus alone was sufficient to induce mild steatosis and increase alcohol-induced liver disease in these mice.
A large, randomized, controlled clinical trial is needed to definitively show the link between PPIs and the risk of chronic liver disease in humans, but this introductory data brings to light a major concern with these all-too-common acid reflux medications.
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Altered Ba And Fgf19 Signaling In Hepatic Triglyceride Metabolism And Nafld
An important physiologic role of FGF19 is suggested by the predictable postprandial increase in circulating levels specific to dietary fat content, implying a role as an enterokine for integrating homeostatic metabolic regulation in addition to regulating BA synthesis.
- Abbreviation: SS, simple steatosis.
This inverse correlation between circulating FGF19 and NAFLD in humans remains even after adjusting for potentially relevant clinical confounders, such as body mass index, age, and gender. The hypothesis that FGF19 deficiency leads to worsening hepatic steatosis is further supported by a randomized trial with an FXR antagonist, UDCA, in morbidly obese patients undergoing Roux-en-Y gastric bypass surgery. Obese patients pretreated for 3 weeks with UDCA exhibited lower serum concentrations of FGF19 and increased severity of hepatic steatosis, as detected on an intraoperative liver biopsy.
Digestive Healthcare Center & Gastroenterologist Located In San Antonio Tx
You dont have to deal with discomfort after a big meal, especially one you know will trigger acid reflux. At Digestive & Liver Disease Center of San Antonio PLLC, gastroenterologist Robert Narvaez, MD, MBA, diagnoses and provides treatments for acid reflux. Get reprieve from your symptoms by calling the office in San Antonio, Texas, or requesting your appointment online today.
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Liver Abscess Or Cyst
A bacterial, fungal, or parasitic infection in your liver can form an abscess, or a pocket of pus. The top right side of your abdomen may be tender. Your doctor may be able to feel that your liver is enlarged. Usually, youâll also have fever and chills.
Cysts are also pockets of fluid, but they arenât usually infected. If they are large, they may make you uncomfortable, mostly because youâll feel âfullâ in your abdomen. Cysts sometimes can bleed, which can cause sudden, severe pain in your upper right belly and shoulder. Learn about polycystic liver disease symptoms, causes, and treatment.
Obesity And Fatty Liver Disease
Non-alcoholic fatty liver disease is strongly associated with obesity. Excess fat causes insulin resistance and inflammatory signals. Insulin resistance means that the pancreas has to produce more insulin in order to maintain normal blood glucose levels, and is the first step towards developing diabetes.
Patients who have hypertension , have high cholesterol, are overweight or obese, and have diabetes or insulin resistance are at greater risk to develop fatty liver disease. Physicians and scientists do not fully understand why the excess fat causes these liver changes. They do know that by losing weight, liver enzymes may normalize and liver inflammation may improve.
- Ingestion of poisonous wild mushrooms.
Like many progressive diseases, you may not notice any signs or symptoms of liver disease in the early stages. But, as liver function begins to decline, you may begin to notice some physical changes in certain areas of your body.
A swollen abdomen can point to a condition called ascites, in which liver malfunction leads to an imbalance of proteins and other compounds, and fluid builds up in the tissues.
The main symptom, potbelly, often signals cirrhosis.
Sometimes swelling occurs in the hands, feet and ankles, as gravity draws excess fluid down to these extremities.
A damaged liver produces fewer of the proteins necessary for blood clotting, which means you may bleed and bruise more easily.
Fatigue and Weakness
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Data Synthesis And Statistical Analysis
The outcome measure was the presence of either GERD symptoms or endoscopy-confirmed reflux oesophagitis. The ORs or HRs with 95% confidence intervals were regarded as the effect size for all the included studies. When studies had multiple adjustment models, the model maximizing the number of potentially confounding variables was extracted.
Odds ratios or hazard ratios were pooled with their 95% confidence intervals , with the assumption that these are comparable measures of association. The overall estimate of effect size was calculated using a random-effects model where any differences between studies were considered even if no statistically significant heterogeneity exists. The statistical heterogeneity among studies can be quantified as low, moderate and high, with upper limits of 25%, 50% and 75% for I2 statistics, respectively. Publication bias was evaluated with funnel plot and Egger’s test.
To explore the potential sources of heterogeneity between the included studies and to test the robustness of the associations, we conducted subgroup analysis by the types of study. To assess the excessive influence of individual studies on the pooled result, we also performed a sensitivity analysis by sequentially omitting each study to analyse the effect of individual studies at a time.
All statistical tests were two-sided and used a significance level of P < .05. Statistical analyses were performed using the stata version 12.0 software program .
Diagnosis Of Fatty Liver Disease
Fatty liver disease isnt regularly picked up because it doesnt always cause symptoms. You usually only know you have it if abnormal numbers are picked up during a standard liver function tests or you have a scan of your abdomen for another health reason.
Its a good idea to have your liver function checked if you have risk factors for developing fatty liver disease like Type 2 diabetes, metabolic syndrome, or obesity, or if you take certain prescription medications like steroids and amiodarone.
If you do experience any of the following symptoms, youre condition has likely already progressed to cirrhosis of the liver:
- Nausea, loss of appetite, unexplained weight loss
- Jaundice with yellowing skin and whites of the eyes
- Abdominal pain or fullness in the upper right side of your belly
- Extreme tiredness and weakness
- Swelling in your arms and legs
If you have any of these symptoms, make an appointment at our offices right away for an evaluation.
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What Causes Liver Damage
Liver damage or liver disease can be caused from a variety of causes. In fact, there are over 100 different diseases of the liver.
Here are some of the most common contributing factors to developing liver damage:
- Hepatitis A. Causes swelling of the liver and poor function. It is caused by the HAV virus.
- Hepatitis B. Also causes swelling of the liver and can progress to scarring of the liver and/or liver cancer. This one is caused by the HBV virus.
- Hepatitis C. Same symptoms and possible long term effects as Hepatitis B. It is caused by the HCV virus. There is currently no vaccine.
- Fatty Liver Disease. This occurs when there is a build up of too much fat in the liver due to alcohol abuse. It can cause your liver to swell and may progress to scarring known as cirrhosis. Two types:
- NASH, or Nonalcoholic Steatohepatitis. NASH is basically a form of Fatty Liver Disease that can lead to a swollen liver and associated damage. It is unrelated to alcohol.
- ALD, or Alcoholic Liver Disease. This liver disease is a direct result of consuming too much alcohol and can cause cirrhosis and ultimately, death.
Early warning signs of liver damage include nausea, loss of appetite, unusual fatigue and diarrhea. If you believe you may have liver damage, take heart the liver is able to regenerate itself. In fact, it is the only organ in your body that can regenerate and completely repair damage. However, these regenerative abilities only go so far before it is overwhelmed.
Can Fatty Liver Disease Make It Harder For Me To Lose Weight
Fatty liver disease should not make it harder for you to lose weight. However, you will have to follow a strict eating and exercise plan in order to lose weight. The doctors at Johns Hopkins may need to treat your fatty liver disease with a combination of medications in order to achieve adequate glucose control and normal cholesterol levels.
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What Is Gallbladder Heartburn
If you have heard about this type of heartburn, you must be wondering what it is and how it is related to the gallbladder. Let us find out.
Heartburn is one of the symptoms of gallbladder disease. However, there is no other link between heartburn and gallbladder. Heartburn you feel like a symptom of gallbladder disease is not ordinary heartburn. It is a similar feeling, but it is not real heartburn.
People believe that what they feel is heartburn because gallbladder discomfort occurs in the same way as heartburn does, and nearly in the same place. Gallbladder disease symptoms include indigestion, abdominal pain, belching, and nausea. Heartburn feels almost the same, so it is no wonder that people believe that these symptoms are nothing but heartburn.
Heartburn results from too much acid concentrated in the stomach. It shows the same symptoms as gallbladder disease indigestion, belching, and hiccups.
What are the causes of heartburn? There can be several. The cause number one is the food you eat. Spicy foods, caffeine, alcohol, and acidic foods are responsible for heartburn. Your lifestyle has a lot to do with heartburn. Your eating habits can contribute to this problem, too. If you eat large meals, you are likely to experience heartburn. The quality of your meals is also important. Certain types of food can trigger heartburn. Avoid junk food, acidic foods, alcohol, and caffeine.
Clinicians Should Consider Withholding Ppis
Still, as a preventive measure, healthcare professionals may want to reconsider prescribing such medication if other options are available, suggests Dr. Schnabl.
Although obesity and alcohol use predispose a person to acid reflux requiring antacid medication, he says, many patients with chronic liver disease take gastric acid suppressive medications without appropriate indication.
We believe clinicians should consider withholding medications that suppress gastric acid unless there is a strong medical indication.
Dr. Bernd Schnabl
The researchers hope that their current findings, should they be confirmed by future research, may eventually lead the way to more effective and targeted therapies for chronic liver diseases.
We might someday be able to manipulate the gut microbiome, and in particular Enterococcus faecalis, to attenuate alcohol-related liver disease associated with gastric acid suppression, Dr. Schnabl concludes.
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Helpful Foods That Decrease Stomach Acid
Foods that are non-acidic, also referred to as alkaline, will help calm the stomach and prevent heartburn.
Examples of alkaline foods include:
- Bananas: Bananas are well known for soothing the stomach, and theyre also rich in
- Bread and rice: These carbohydrates help calm the stomach. Just make sure you go for the whole-grain bread and brown rice.
- Ginger: This ancient herb has long been regarded as a therapeutic agent for the digestive system.
- Plant-based milks: Along with water, plant-based milks are generally neutral and soothe the stomach.