So do we know if it is the acid that hurts the esophagus?

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theacidrefluxman
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Date Joined Oct 2009
Total Posts : 739
   Posted 1/1/2013 9:26 PM (GMT -6)   
We all know that even on medication and without symptoms, we aren't cured from reflux. In fact we are refluxing all of the time, just the acid is gone.

So are doctors sure it is the acid that damages the esophagus? I ask because if you are on PPI's, like me, and still have symptoms, the Dr.'s do a PH test and if it comes back OK they just send you on your way. If your acid exposure is 'normal' then your symptoms don't matter. It doesn't matter if the symptoms you are feeling are hypersensitivity to normal amounts of acid, or feeling other non-acid reflux, or what.

So how do we know that non-acidic reflux isn't damaging as well? I mean...apparently we do know it, because Dr.'s base the whole decision process on acid exposure. So should there be any fear that the non-acidic reflux could cause cancer by itself?

Thanks!

dencha
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Date Joined Feb 2009
Total Posts : 7188
   Posted 1/1/2013 10:22 PM (GMT -6)   
Hi ARM,
 
From what I understand from reading and talking to GI docs, once the acid is removed from the reflux it is no longer damaging the esophagus.  That's why, when they see inflammation, they prescribe the PPIs...later when the esophagus is rechecked, the inflammation is gone.  Mission accomplished.
 
The husband of a friend of mine was diagnosed with Barretts.  He was required to get annual endoscopies.  My understanding is that once on PPIs the esophagus is protected.  Obviously GI's want to keep an eye on problematic esophaguses, but apparently the PPIs are the magic bullet in the fight against esophageal damage.
 
That's why fewer people have been getting Nissens.  GI docs are finding the PPIs take care of the problem, so they aren't pushing as many people toward surgery.  Im fact, as you well know, it's quite the opposite.
Happy New Year!
Denise
GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”
Eckhart Tolle

ericapeace2000
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Date Joined Mar 2012
Total Posts : 1110
   Posted 1/2/2013 9:54 AM (GMT -6)   
Unfortunately, non acid reflux can be just as painful as acid reflux. The GI doctors seem to be at a loss of what to do since like Denise said, the esophagus can look normal but the pain in bad. There are some people on the forum who have had surgery due to non acid reflux. As far as cancer, it is rare. There have not been ties to cancer from non acid reflux from what I know.
GERD Moderator; Diagnosed GERD, no other medical conditions (this one is enough)

sunbeam48
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Date Joined Jun 2011
Total Posts : 795
   Posted 1/2/2013 10:09 AM (GMT -6)   
I think that Dr. Koufman's reasearch has focused on the damage from pepsin, which can be activated by small quantities of acid.
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