Mark Spitz gave his heart to the sport of swimming, and despite some serious competition from Michael Phelps this summer, he still holds the record for seven gold medals in an Olympics. What was not on record in 1976, was that Mark Spitz lived with frequent heartburn — and now he shares his story hoping to raise awareness of the condition.
This month Spitz told USA Today that he probably had acid reflux the entire time he was training because he often had indigestion, but he figured it was due to eating before and after swimming practice and breathing in chlorine.
In an email interview with Dr. Scott Rodeo, USA Olympic Team Physician for the swimmers in Athens, Dr. Rodeo said he was not aware of any evidence suggesting chlorine plays a role in acid reflux, but the supine position—that is lying on the back—in the water can contribute to heartburn symptoms, particularly in back-strokers.
Dr. Rodeo said eating before practice can also cause heartburn. He advises the swimmers to wait at least 20 minutes after a meal before getting into the pool for a swim.
Spitz finally learned he had gastroesophageal reflux disease, or GERD, when he described his symptoms to a doctor 10 years ago. He managed the condition as best he could, and then was prescribed Nexium, 3 years ago. Spitz said the drug, a proton-pump inhibitor, dramatically improved his symptoms . He is now a paid spokesman for Astra Zeneca, the makers of Nexium, and wants to help raise awareness of ways to treat acid reflux pain.
Dr. Rodeo reportedly treated some of the swimmers at the 2004 Olympic Games for heartburn. He gave the athletes Protonix, another brand of proton-pump inhibitor. This drug, like Nexium, works by limiting the amount of acid produced in the stomach. And the medications have also been shown to heal erosions in the esophagus.
Dr. Rodeo says acid reflux is fairly common in competitive swimmers.
“On trips it may relate to change in diet,” said Dr. Rodeo. “Stress can also contribute, and stress is certainly present in this environment.”
Research has shown a higher than expected frequency of heartburn in athletes, particularly weight lifters, runners, cyclers, and swimmers. Doctors attribute the incidence to eating before exercise, body positioning during the sport, and stress.
But the incidence of acid reflux is also growing among the general population. A 2003 survey by the National Heartburn Alliance found that 26%, or 54 million American adults experience heartburn, or take medications for symptoms of heartburn, 2 or more times a week. They also found that women are 30% more likely than men to report frequent heartburn.
Most doctors suggest acid reflux is an acquired condition, which they blame largely on the American diet. The high fat content makes certain foods take longer to digest, so the stomach is full and distended for longer periods of time. Some experts believe that heartburn may be due to distention of the stomach, because when the stomach is distended the lower esophageal sphincter tends to open up. Normally this circular band of muscle blocks most acid from backing up into the esophagus, but when it relaxes or weakens abnormally, more acid gets through resulting in heartburn. When this reflux leads to evidence of esophageal inflammation or irritation—the diagnosis is GERD.
Many people can manage the discomfort of acid reflux with diet and lifestyle modifications. Smoking is associated with a higher incidence of acid reflux. Alcohol, fatty foods, caffeine, and peppermint relax the esophageal sphincter allowing stomach acid to reflux. So avoiding these things can help reduce symptoms.
Antacids are available over the counter, as well as H2 blockers for immediate relief of heartburn pain. And doctors can prescribe the proton pump inhibitors for more severe cases, but they are much more expensive than over the counter medications.
The point Mark Spitz wants to make is that acid reflux is a treatable condition. It’s important to see a doctor for a diagnosis early before the condition worsens and the symptoms become too difficult to treat.