For people who have been on PPIs long-term, I recommend slowly tapering off over two to three weeks. Although some people do claim benefit, there isn’t any good evidence for cider vinegar or aloe vera extract in relation to GERD, and I don’t recommend them. Recurrence of symptoms after slowly tapering off the omeprazole is a reason to consider endoscopy, especially if not done before. Some people will need long-term PPIs, but far, far fewer than those who are taking them now.
DEAR DR. ROACH: Medical advice is to reduce sugar consumption. Does this apply to 100 percent fruit juices, fresh fruit, sweetened cereal products or other fruit-sweetened products? — R.B.
ANSWER: I think it makes sense to limit sugar intake, as most North Americans take in remarkably large quantities of sugar. This week, while giving a lecture at the medical school, I noticed that the carbonated sodas served contained 45 grams of added sugar per can. That’s more than the American Heart Association recommends in a day (no more than 25 grams of added sugar per day for women, 40 grams a day for men)! Be careful of products that claim to be sweetened by fruit juice or fruit sugar; this still counts as added sugar.
I do make an exception for fruits, as the body processes natural sugars from fruit differently. You can try this out at home by eating four medium-size oranges or drinking its equivalent in an 8-ounce (250 ml) glass of orange juice. I think you will find a big difference in how full you feel.
Although reducing sugar is critical for diabetics and is very important for anyone trying to lose weight, even for people with no sugar or weight problems, the evidence is accumulating that eating too much added sugar increases future risk for heart disease and diabetes.
Diabetes has become epidemic in North America. The booklet on it provides insight on its diagnosis and treatment. Readers can order a copy by writing: Dr. Roach — No. 402, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Keith Roach is a syndicated columnist.