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ARE MILLIONS OF US BORN with a genetic defect that makes us produce too much stomach acid? Do we just have a major evolutionary design flaw that requires us to take powerful acid-blocking drugs to prevent heartburn and reflux? I believe that the answer to all of these questions is a resounding “no.” In this week’s blog, I’ll explain why, but more importantly, I will outline a simple 3-step approach that will help you prevent acid reflux and heartburn by treating its underlying causes. 数以万计的美国人生来就有胃酸过多的遗传缺陷吗？而又是因为人类进化的需求，所以必须使用强抑酸药物来防止胃灼热和反酸症状吗？ 我相信针对以上问题的答案都是 “NO” ！在这篇文章中，我会解释原因并列出三个基本步骤，从根源上来进行预防。 The Truth about Acid-Blocking Medications At least 10 percent of Americans have episodes of heartburn every day, and 44 percent have symptoms at least once a month. Overall, reflux or GERD (gastroesophageal reflux disease, also known as heartburn) affects a whopping 25 to 35 percent of the US population! As a result, acid-blocking medications are the third top-selling type of drug in America today. 关于抑酸药物的真相。 Studies show that people who take acid-blocking medications for the long term can become deficient in vitamin B12. 研究表明，长期服用抑酸药物会造成体内维生素B12缺乏。 Things have certainly changed since I was in medical school. In those days, GERD wasn’t even considered a serious disease. Instead, people had heartburn or ulcers, but that was pretty much it. When acid-blocking drugs first came on the market, even the pharmaceutical representatives warned us how powerful these drugs were. They told us not to prescribe them any longer than 6 weeks and only for patients with documented ulcers. 从我在医学院学习到现在的这段时间里，变化已经悄然发生了。那时候GERD没有被认为是一种严重的疾病，只是有烧心症状或溃疡而已。当抑酸药物进入市场后，甚至医药代表也警告我们药力有多么强大，建议开药不要超过6周，而且只能给有明确溃疡诊断的患者。 Now, these drugs are given like candy to anyone who ate too many hot dogs at a ball game — and one drug, Prilosec, is available without a prescription. Their manufacturers have created the illusion that we can eat whatever we want with no consequences, just by popping a pill. They even have commercials showing a family rushing to stop their father from eating a big sausage with fried onions and peppers — and he tells them not to worry because he took his acid-blocking pill! 然而到了今天，这些药物就像糖果一样随意发放，比如热狗吃多了就可以服用奥美拉唑，甚至不用医生开处方就可以买得到。药品制造商给我们形成这样的一种幻觉——任何时候你都可以用一片药来解决问题！甚至有的商业广告是这样的：一家人企图制止父亲不要吃一个带有洋葱和辣椒的大三明治，但他说“不用担心，因为我吃了抑酸剂”。 I know someone who used to work for the makers of Pepcid, another acid blocker. He told me that when it first became available over the counter, teams of drug company representatives would stand at the gates of county fairs and southern barbeques and hand out free samples. 一个曾经在制造法莫替丁的公司的员工告诉我，当这个药物首次作为非处方药物出现时，药厂团队甚至在游乐场外面发放免费的试用装。 In reality, acid-blocking drugs are a double-edged sword. Let’s look at some of the recent research on the dangers of these drugs. 事实上，抑酸剂是一把双刃剑，让我们来回顾一下近期有关药品危害的报道。 What the Research Tells Us about Acid-Blocking Medications Acid blocking drugs obviously block acid that can cause symptoms of heartburn and reflux. But your body actually needs stomach acid to stay healthy. Stomach acid is necessary to digest protein and food, activate digestive enzymes in your small intestine, keep the bacteria from growing in your small intestine, and help you absorb important nutrients like calcium, magnesium, and vitamin B12. 抑酸药确实可以抑制会导致烧心和反酸症状的胃酸，但事实上，我们的身体是需要胃酸的！它可以帮助身体有效的分解蛋白和食物，刺激小肠中消化酶的活性，并抑制小肠坏菌的产生，帮助吸收营养物质，如钙、镁、维生素B12。 There’s evidence that taking these medications can prevent you from properly digesting food, cause vitamin and mineral deficiencies, and lead to problems like irritable bowel syndrome, depression, hip fractures, and more. 有数据表明服用抑酸药物可以导致消化不良，营养素和微量元素缺乏，并有可能引起IBS（肠易激综合征）、抑郁、髋骨骨折，甚至更严重的疾病。 For example, studies show that people who take acid-blocking medications for the long term can become deficient in vitamin B12,(iii) which can lead to depression, anemia, fatigue, nerve damage, and even dementia, especially in the elderly. 还有研究证明长期服用抑酸剂的人群可能缺乏维生素B12，甚至抑郁、贫血、疲乏、神经损伤，痴呆（尤其是老年人）。 The research also tells us that taking these drugs can cause dangerous overgrowth of bacteria in the intestine called Clostridia, leading to life-threatening infections.(iv) For many more people, low-grade overgrowth of bacteria in the small intestine leads to bloating, gas, abdominal pain, and diarrhea (many of the common “side effects” noted in the warnings for these drugs). This can cause irritable bowel syndrome. 研究同样证明长期服用这些药物可造成肠道孙内梭状芽胞杆菌的过度生长，严重感染者可威胁生命。对于大多数人来说，低级别的肠道坏菌过度繁殖可导致腹痛、胀气、腹泻（常见的药物副作用），进一步引发IBS。 In addition, a recent study in the Journal of the American Medical Association found that chronic use of acid-blocking drugs leads to an increase in the development of osteoporosis and increase in hip fracture because blocking acid prevents the absorption of calcium and other minerals necessary for bone health. 另外，近期发表在《美国医学协会杂志》上的一个研究表明长期应用抑酸剂影响维持骨质健康的钙和矿物质的吸收，这会导致骨质疏松和髋骨骨折风险的增加。 All this is only part of the problem. There have even been some reports that these drugs may increase the risk of certain cancers. 这只是其中的一些小问题而已，更有研究表明这些药物可能会增加某些癌症的发生。 These are serious health concerns, and it’s pretty clear that in this case, the “cure” of acid-blocking drugs is worse than the “disease” of GERD. But that’s of little comfort when you’re suffering from heartburn. 这些都是值得重视的健康问题，我们要很清楚的一点是，抑酸药物的“疗效”不及胃食管反流病带来的“危害”更大，但当人们经受胃灼热的痛苦时还是会有一些改善的。 So if drugs are not the answer, what is? We need to find the real causes of reflux and heartburn, get rid of them, and use the right foods, nutrients, and lifestyle therapies to heal the problem. 如果药物不能解决问题，那应该怎么办呢？我想，我们应该找出烧心和反酸症状的真正原因并避免它，从食物、营养和生活方式的干预上来从根本上解决问题。 What Causes GERD? Fried food, alcohol, caffeine, and soda can all trigger reflux. Spicy, tomato-based or citrus foods may also cause problems for some people. Smoking also increases the risk of reflux. Being overweight and having your belly fat push up on your stomach can prevent it from emptying, triggering reflux. Having a hiatal hernia (where your stomach pushes up through your diaphragm) can also cause trouble and can be diagnosed by x-ray. Eating large meals and eating before bed are two other main reasons for reflux. These are the most obvious causes, and the ones you have probably heard about. However, there are a few more that bear mentioning. 到底是什么引发了GERD? 油炸食物、酒精、咖啡因、软饮料都会引起反酸，而辛辣、以番茄为原料或柑橘类的食物也都有可能造成人们的不适感。吸烟会增加反酸的风险，肥胖或腹部脂肪过多会妨碍胃的排空，引起反酸。食管裂孔疝（可以通过X线检测来确诊）也同样造成影响。另外两个重要诱发因素就是暴饮暴食和睡前2小时内进食。这些都是最常见的、你可能听过的诱因。然而，还有一些可能是鲜为人知的。 Stress contributes to reflux. Clearly, food is supposed to go down, not up, when you eat. That’s why there are two main valves, or sphincters, that control food going in and out of your stomach — the one at the top (or the lower esophageal sphincter) and one at the bottom (the pyloric valve). When you’re stressed, the valve on the top relaxes and the valve on the bottom tightens up. This may result in food traveling back up your esophagus. Practice active relaxation and you mitigate this problem. 压力可以导致反酸。很显然，吃进去食物的时候是向下的，而不是向上，这就是为什么我们的身体有两个阀门（括约肌），控制着食物在胃里的进出，一个在胃的顶部（食管下端括约肌），一个在胃的底部（幽门瓣）， 当压力来袭时，胃顶部的阀门放松，但底部的阀门收紧，这就会导致胃内容物涌入食道。尝试练习放松，可以缓解这个问题。 Magnesium deficiency is another cause of reflux because magnesium helps the sphincter at the bottom of the stomach relax, allowing the food to go down. 另一个导致反酸的重要原因是镁离子缺乏，镁可以使胃底部括约肌松弛使食物向下。 While controversial, I believe that a common infection can cause not just ulcers but reflux as well. This bug is called Helicobacter pylori and can be identified by a simple test blood or breath test. In my experience with patients, this treating the bacteria can eliminate reflux even if you don’t have an ulcer. 尽管有争议，我依然认为这种常见的感染不仅可以引发溃疡，也可以导致反流——就是幽门螺旋杆菌（可以通过血液或呼吸测定）阳性。在我医治患者的经验中，即使没有溃疡的存在，治疗幽门螺旋杆菌的感染也是可以有效抑制反流的。 Food sensitivities or allergies can also cause reflux. Common culprits include dairy and gluten-containing foods like wheat, barley, rye, and oats. Plus, overgrowth of bacteria in the small bowel or yeast overgrowth in the gut can cause reflux. 食物敏感或不耐受也是导致反流的一个原因，常见的“元凶”包括奶制品、含麦麸蛋白的食物如小麦、大麦、黑麦、燕麦。另外，小肠中过度的细菌或霉菌生长也是可以导致反流。 These are all treatable conditions that you don’t need powerful acid blocking drugs to fix. 以上就是不需要强力抑酸制剂的一些状况。 To properly diagnose the causes of your reflux, you may need to do the following. 要准确找到引起反流的原因，可参考以下几点： 1. Ask your doctor for an H. pylori blood antibody test or breath test. 2. Consider a test for IgG food allergies and celiac disease. 3. Get a breath or urine organic acid test to check for small bowel bacterial overgrowth. 4. If you don’t get better with the suggestions below, consider getting an upper endoscopy or upper GI series x-ray to see if there is anything else wrong. 1. 血液检测或呼吸实验诊断是否有幽门螺旋杆菌感染。 3 Steps to Permanently Overcoming Heartburn and Acid Reflux Step 1: Treat the Bugs if You Have Them
三步骤帮助你克服烧心和反酸 第一步：修复
Step 2: Change Your Diet
第二步：改变饮食习惯
Step 3: Try Some Natural Remedies to Help Soothe the Gut
第三步：尝试一些舒缓肠道的自然疗法。
As you can see, there’s no need to suffer from heartburn and reflux — or to take expensive and dangerous acid-blocking drugs. I hope the changes I’ve suggested here will soothe your stomach and have you feeling healthy in no time! 所以，你并不一定要忍受烧心或反酸的痛苦，亦或使用昂贵、危险的抑酸类药物，我希望今天给出的建议可以帮你舒缓胃部不适，保持健康的状态！ |
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