Mark Spitz has a gold medal solution to acid reflux.

By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

Instead of worrying that Michael Phelps might break his Olympic record of seven gold medals, you might be surprised to learn that Mark Spitz has been rooting for Phelps to re-energize the sport of swimming. What really gives Spitz heartburn is acid reflux.

"I probably had acid reflux the entire time I was training but didn't know it," says Spitz, whose record seven gold medals will last at least another four years after Phelps placed third in Monday night's 200 freestyle final. "I had indigestion a lot and figured it was because I used to eat before and after I swam my practice or was from training indoors and breathing in chlorine. I got in the habit of thinking that if I didn't have that burning pain, then I must not have trained hard enough."

But after Spitz retired from competitive swimming, the heartburn continued and he knew something more serious was wrong.

"About ten years ago I went to the doctor and told him about the heartburn feeling and how it would get worse toward the end of the day when I would lie down," recalls Spitz, who is now a paid spokesperson for AstraZeneca, makers of Nexium. "Back then they called it GERD and he thought that was what I had. I tried to manage it as best I could. A couple of years ago he prescribed Nexium which inhibits the cells in your stomach from producing quite as much acid and therefore reduces the symptoms of acid reflux."

Spitz says his acid reflux improved dramatically after taking Nexium and years later was more than willing to help raise awareness about acid reflux disease, because he knows personally that there is actually something effective that can be done about it.

Acid reflux basics

Acid reflux disease is defined by heartburn-like symptoms that occur more than twice weekly. Acid reflux happens because lower esophageal sphincter -- the valve separating the esophagus and stomach - does not close properly, allowing stomach acid to back up into the esophagus.

Spitz is far from alone.  An estimated 21 million Americans experience acid reflux.

"This is Western disease," states Cedric Bremner, an expert in acid reflux disease and a professor of surgery at the USC Keck School of Medicine. "We're not sure why but we do believe it is acquired rather than genetic, because it is something that has occurred in the last 30 or so years and exploded in the last 20."

According to Bremner, 18% of Americans experience heartburn weekly; 4%-7% experience it daily. Severe acid reflux which causes erosions in the esophagus afflicts about 2%. This is compared to the United Kingdom where 10%-15% experience the disease weekly. Only 0.07% in Japan experience acid reflux weekly.

"We believe it probably involves the diet," says Bremner, who is a foregut surgeon. "We know that 60% of Americans are overweight so it may be related to our diet's fat content. Fat causes a long delay of emptying in the stomach. So the stomach is full for longer periods of time. We believe it might be related to distention of the stomach for prolonged periods of time. The lower esophageal sphincter tends to open up with distention of the stomach."

Bremner says that America's love affair with sodas may also contribute to acid reflux, because it also distends the stomach.

Whatever the cause, Spitz tried to treat his symptoms by limiting his intake of spicy and fatty foods. But relief was not forthcoming and the problem got worse. He started to experience asthma-like symptoms - three-hour coughing spells after training and felt like he constantly needed to clear his throat. At one point, Spitz was placed on asthma medications.

"I saw a pulmonologist because I developed what they call self induced asthma," Spitz says. "I didn't have asthma I actually had acid reflux. I had wheezing but was never really out of breath. The coughing and the stomach irritation was the acid reflux."

Gold medal treatment

Spitz's doctor finally recommended he take the proton pump inhibitor Nexium.

Proton pump inhibitors not only reduce the amount of acid produced by the stomach and therefore limit acid reflux but also have been shown to help heal esophageal erosions. 

"Over-the-counter medications are not nearly as effective as the proton pump inhibitors," Bremner notes. "The PPIs are extremely effective but also extremely expensive. Some people choose surgery to correct the valve damage, because they cannot afford to be on the pills indefinitely and insurance does not always cover it."

Bremner recommends getting as early a diagnosis as possible, preferably by endoscopy.

"Many general practitioners will put patients on PPIs for two weeks and if the heartburn goes away they will determine the patient had acid reflux," Bremner explains. "But a gastric ulcer or a gastric cancer can sometimes improve on PPIs so you need to rule these conditions out first."

Spitz says he suffered far too long not knowing what was wrong with him and urges people to see their doctor if they have heartburn more than two or three times a week.

With his Olympic record still in tact and his acid reflux treated, Spitz hopes swimming will also experience a healthy resurgence. And in his opinion the man to do it will be Phelps.

"I personally think records are made to be broken," states Spitz, who now works as a stock broker with Wachovia Securities. "If somebody sets a higher standard than the one I set, then I'll take my hat off to that person. I hope my accomplishment isn't the death of swimming. I hope someone is out there looking at my benchmark as a goal to surpass. It will likely be Phelps. He's only 19 and swimmers get better as they get older. I have no doubt he will be even better in the coming years."

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 8/18/2004  -  John Morgan & Stephen A. Shoop, M.D.
Reviewed: 8/18/2004  -  Donnica Moore, M.D.