Asthma and Acid Reflux
Once a year, the largest pulmonary meeting in the world is held by the American Thoracic Society (ATS). This year, it was in San Francisco, with over 16,000 attendees. One of the major topics is asthma. I reviewed all of the asthma abstracts (short summaries of research done during the previous year), so during the next couple of months, I will blog about some of the highlights from the ATS meeting.
40% of patients with cough variant asthma (CVA) have acid reflux (GERD). Both of these disorders are common, but how common depends on exactly how one defines mild disease and how many medical tests are done to confirm an abnormality and rule out other possible causes for the symptoms of cough and heartburn.
For decades, people who over-indulged with food got heartburn and just treated it with cheap antacids, like TUMS. Then expensive, and somewhat more powerful acid-blocker pills became available. An a couple of years ago, an even more expensive proton pump inhibitor (PPI) that blocks all stomach acid production went off-patent and over-the-counter.
Now patients with heartburn symptoms are sought by multi-million dollar ad campaigns, which suggest that only an expensive PPI should be used for GERD.
Over half of people with asthma are over-weight. Obesity makes acid reflux much more likely. Both asthma and GERD can cause a chronic cough; therefore, asthma and GERD often co-exist. GERD can sometimes (but certainly not more than half of the time) worsen asthma.
So should everyone with asthma and a chronic cough take a PPI every day? Should everyone with a chronic cough get a 500 dollar, 24 hour pH test for acid reflux?
I think that a more reasonable approach is to try a PPI for several weeks to see if it makes a substantial reduction in coughing and generally improves asthma control. For an objective comparison, you should maintain a daily asthma symptom diary for two weeks before you start the PPI and for two weeks while using the PPI.
Please help others by posting your experience on our WebMD asthma message board.
Related Topics: Technorati Tags: asthma, acid reflux, GERD, medication, health and wellness
40% of patients with cough variant asthma (CVA) have acid reflux (GERD). Both of these disorders are common, but how common depends on exactly how one defines mild disease and how many medical tests are done to confirm an abnormality and rule out other possible causes for the symptoms of cough and heartburn.
For decades, people who over-indulged with food got heartburn and just treated it with cheap antacids, like TUMS. Then expensive, and somewhat more powerful acid-blocker pills became available. An a couple of years ago, an even more expensive proton pump inhibitor (PPI) that blocks all stomach acid production went off-patent and over-the-counter.
Now patients with heartburn symptoms are sought by multi-million dollar ad campaigns, which suggest that only an expensive PPI should be used for GERD.
Over half of people with asthma are over-weight. Obesity makes acid reflux much more likely. Both asthma and GERD can cause a chronic cough; therefore, asthma and GERD often co-exist. GERD can sometimes (but certainly not more than half of the time) worsen asthma.
So should everyone with asthma and a chronic cough take a PPI every day? Should everyone with a chronic cough get a 500 dollar, 24 hour pH test for acid reflux?
I think that a more reasonable approach is to try a PPI for several weeks to see if it makes a substantial reduction in coughing and generally improves asthma control. For an objective comparison, you should maintain a daily asthma symptom diary for two weeks before you start the PPI and for two weeks while using the PPI.
Please help others by posting your experience on our WebMD asthma message board.
Related Topics: Technorati Tags: asthma, acid reflux, GERD, medication, health and wellness
32 Comments:
I had an allergist tell me that I had a slight asthma condition. A few years later, I had a test which was diagnosed as a hiatal hernia. At that time, the doctor told me to take an antacid for my heartburn. I didn't have heartburn. A few months later, I developed heartburn. Yes, I am overweight. I also have a chronic cough which I thought was a result of bronchitis. My family doctor said I am wrong. I don't have any signs of asthma. I disagree with him because I do have a chronic cough and sometimes find myself wheezing. I take one prescription pepcid tab for the heartburn, a claratin and use nasal spray. You can't contradict the doctor so, I get no where. He told me to continue taking one claratin, one pepcid tab and use my nasal spray every day. It helps, but it doesn't end it. I cannot write prescriptions so I live by the doctor's order.
For years I suffered through chronic and debilitating asthma and allergies. Both my allergist and pulmonary specialist continued to prescribe strong medications, including steroids, which only had very temporary success. My sister suggested that I may be allergic to yeast which can have the same symptoms as allergies and asthma. I did some research, stopped eating yeast and within two days I was no longer wheezing, coughing or allergic to my dog. It's been a few months and I am not only symptom free but medication free as well. The medical profession should also look at remedies other than higher dosages of medication. I had to save my own life.
I KNOW IF THE FDA AND THOSE WHO TAKE CARE OF OUR HEALTH ARE NOT DOING WHAT THEY SHOULD A I THINK AMERICANS NEED TO VOTE OUT HMO AND ANYTHING THAT DOESN'T HELP OUR HEALTH THAT INCLUDES MEDICATION.
Ok, I'm a little overweight, and for years my asthma symptoms just got worse and worse. The reflux was terrible too, mostly at night, and sporadic. Took the occasional Pepcid and just went on. MD finally had me on Singulair, Advair, using Combivent puffer, and Albuterol in a nebulizer. The mg's just kept going up and up. Sent me to an allergist, he upped levels more. I finally asked "which medicine is doing WHAT, exactly?" and no one could say. I hear about the reflux-asthma link studies, and stopped taking ALL my asthma meds cold and started taking a Prilosec OTC each day for 2 weeks. Asthma magically VANISHED. A year later, I've lost 20 lb (20 more to go) and occasionally use the Combivent if there's an elephant on my chest. Still taking the Prilosec, half every other day. Remember: Docs are just PRACTICING medicine; maybe someday they'll be perfect.
I am a 72 year young white male. I am not over weight.(168 lbs)
Had a heart attack and quad bypass
three years ago. I have had GURD
and also my speaking voice is very
tight lately. Some evenings when
talking to my seniors group at church, I can't talk very well at all. My wife says I snore and have
weezing while sleeping.
I am taking Pepsid Complete now and it is helping my voice. I take one
each evening.
To the 72 year old young man. LOL You might want to check into having a sleep study--sounds like a CPAP machine would help you. Also, you might want to see about having a scope done of your esophagis, as GERD with reflux can damage it big time and could account for your voice issues.
I've had asthma for several years. Even though doctors address breathing, my own sense has always been that it's mostly related to ingested substances, especially since the symptoms typically begin two or two and a half hours after I've consumed an offending substance. Beer and wine are clear triggers, as well as aged cheese and salami, so I suspected sulfites. I've cleared the asthma by eliminating all grains, seeds, nuts, and legumes, but never could figure out which it was. I also suspect yeast. I recently read about histamine in foods; specifically, that some people lack sufficient diamin oxidase in their intestines. I'm now trying to restrict eliminate all suspicious things and I feel much better.
I have often wondered about the link between my heartburn and my asthma, as well as my tendency to have issues with chest colds, immediately after aspirating stomach acid during the night time.
At age 12, I was diagnosed with having a probable stomach ulcer, but in fact, back in 1975, they didn't readily diagnose acid reflux as the cause, which I later learned was the issue.
At times, I would, and still do, wake up in the middle of the night, having just aspirated stomach acid into my lungs. It is followed by hours of painful and continuous coughing. Within days, I usually have some kind of chest cold or lung related illness. It seems like common sense, that I am doing damage to my lungs via the stomach acid, opening me up for lung illnesses, including asthma.
I have been on a PPI for 2 years, with great success as far as my acid reflux is concerned, but I fear, that at age 44, I have done enough damage to my lungs over time, that my lung illnesses and asthma may not subside.
Has anyone else had similar experiences? Or, has a doctor chimed in on the subject and what are any long term risks????
I have often wondered about the link between my heartburn and my asthma, as well as my tendency to have issues with chest colds, immediately after aspirating stomach acid during the night time.
At age 12, I was diagnosed with having a probable stomach ulcer, but in fact, back in 1975, they didn't readily diagnose acid reflux as the cause, which I later learned was the issue.
At times, I would, and still do, wake up in the middle of the night, having just aspirated stomach acid into my lungs. It is followed by hours of painful and continuous coughing. Within days, I usually have some kind of chest cold or lung related illness. It seems like common sense, that I am doing damage to my lungs via the stomach acid, opening me up for lung illnesses, including asthma.
I have been on a PPI for 2 years, with great success as far as my acid reflux is concerned, but I fear, that at age 44, I have done enough damage to my lungs over time, that my lung illnesses and asthma may not subside.
Has anyone else had similar experiences and if so, has a doctor chimed in on the subject???pmmrigt
To fldodreams & fellow GERD & asthma sufferers...
I've had it all, wieght loss of even 15 pounds has helped significantly (from about 25# overweight)with both.
PPI's put me into a state of uncontrolled high blood sugars, and with my family history of diabetes, my Dr. told me never to take them again.It took a few months to completely go away.I am fortunate not to have permanent diabetes, which Dr. says is among serous effects now showing up in patients with long term use of PPI's.
This was after the county Dr. told me it was not possible for PPI's to cause any such problem, despite the fact that the small print patient/Dr. informational packet with the meds indicated possible "hyperglycemia/diabetes, which may be permanent" as side effects noted in trials.
Always check with your pharmacist re. side effects, my Dr. says they know more than him on this & it should be a routine part of my responsibility for my own health care.
Become educated, study meds, how they work, and get to the bottom of the matter.
It is not an overabundance of acid that causes reflux, it is hiatal hernia, loose LES valve (sphincter at bottom of throat), etc. that are the problems.
I am finally undergoing tests on the path to surgery that will put my hernia back into place and tighten my loose LES. But Dr.'s require a course of every acid blocker/PPI and then testing before getting to the real cause-typical Western medicine and simply a bandaid approach that prolongs the agony-especially if you get the painful side effects.
My sister just had the surgery, and finally is better.
I am looking forward to the same-treating the underlying bio-mechanical dysfunction rahter than the symptoms of it.
Education is power, you can and must get help & info. to best advocate for your care.
Remember, you are paying these Dr.'s to work for you, not the other way around!
Best of health to you, hope something I've said is helpful to someone.
One useful remedy for heartburn and indigestion I have found to be fresh mint. If you feel reflux coming on you might try chewing a sprig of fresh mint. For centuries, the herbal remedy was mint or mint tea made with fresh mint leaves. Oh how far we have come from past herbal and homeopathic remedies!!!
I was having s/s of acid reflux and asthma. Methocholyne challenge test and GI worked out confirmed. Also diagnosis with fibromyalgia. I will admit some foods make me horse and breathing more labored. PRo-air does not work during those times. When I over do it my fibromyalgia acts up and I have the same sysmptoms of asthma. My pro-air is not effective during those times. Therefore, I feel GERD, asthma, and fibromyalgia make it difficult for DR's and pt. to diagnosis.
About 7 years a very good allergist informed me of the link between acid reflux and asthma. I went for years with chronic and constant burn and wheeze. Now I have a new doctor and she will give me a prescription for the stronger stuff, but only for 30 days and tells me to adjust my diet to stave off the reflux. I am about 40lbs overweight, but I am at the point where almost everything gives me heartburn and resulting wheezing. Thanks for the tip on mint. Any other natural remedies?
A crazy thing I found out while dieting using the Southbeach diet (good carbs, good fats/whole grains, low sugar diet). I was taking Prilosec everyday to combat my horrible acid reflux which Zantac wasn't helping anymore. After being on the diet for a few days I ran out of Prilosec, but didn't have any acid reflux. Now, I notice that everytime I eat non-whole grain (ie white bread) or sugary deserts in large quantities I get heartburn. If I stick to the Southbeach Diet's guidelines pretty closely (mainly reduce sugar and refined wheat/white rice(non-whole grains). I don't have to take antacids! It might not work for everyone, but it might work for some of you. Its nice to be free of the burn!
About the mint heartburn reliever and how great homeopathic remedies are...if they were so great then why do drug companies spend millions coming up with drugs they know we want/need? Because the old remedies didn't really work. They were just the best thing that people had to work with. Once we get the medicine that works the homeopathic/herbal stuff falls to the wayside. Just because it says "natural" on the package doesn't mean its better or by any means safer than rigorously tested FDA approved drugs! Mint, however would be a pretty safe thing to try. Worst case would be my wife gives me more kisses, which, in case you are in doubt, is a good thing!
Tonight I woke up with a slight cough to realize that I had asperated into my lungs and my throat and lungs were on fire and my cough was getting worse. Having never experienced this before I started trying to drink water, no help, chewed a Tums, some help, but wheezing not going away nor the burning, pulse getting faster, drink a little more water, no help, cough a little more, extreme fire, wheezing worse, another tums, a small drink of milk, minor relief, walking around trying to think and calm down. tying to decide whether to call 911. cough again, more fire, another tums, more water more relief. This goes on for about and hour and a half. That led me to here. I have no insurance and am worried about a hospital bill, afraid to go to sleep, but knowing I don't have anything that will work in my house. I can totally understand the rollercoaster ride of no sleep, the worrying, and then mad because the probs won't go away.
I also have been taking Zantac 150 twice a day for awhile a noticing it was not working anymore, so I would take another. I am afraid that is what caused this flair up tonight, but not sure. That is why I am here reading and letting the wheezing subside so that I can prop all my pillows and what ever else I can so I can sleep in a sitting position. Scared to death to go to sleep, but full time college student and need the sleep. Prilosec OTC here I come. Along with a call to the doctor tomorrow.
Thanks for listing. And maybe somewere in that rambling someone can see a problem and has some helpful advise. THanks again.
Re: natural remedies. I’ve had acid reflux since my gall bladder was removed a decade ago, and my father had it as well. We both found keeping our heads higher than our bellies when sleeping helped a lot. He had his king size bed permanently raised at the head. I use a large wedge-shaped foam pillow – not my favorite, but it works very well & I only use it when I need it – a barcalounger will work well too. I also use a tea that was concocted by a highly skilled herbalist (villageherbshoppe dot com) – it has chamomile, slippery elm, alfalfa, spearmint, comfrey leaf, fennel, peppermint and fenugreek. It works as a preventative and also calms reflux in action. It actually works better than pepcid for me – but making loose tea can be inconvenient, so I do use pepcid when I’m out & about.
As for the dude who thinks “…drug companies spend millions coming up with drugs they know we want/need … Because the old remedies didn't really work”, I gotta wonder how many natural remedies he’s actually worked with… Personally I think we have so many drugs because of a flaw in our economy – capitalism. Though I do agree with his statement “Just because it says "natural" on the package doesn't mean its better or by any means safer…” (the FDA allows a lot of terms to be used loosely on packaging) which is why I recommend serious healing remedies to come from a skilled herbalist rather than off the grocery store shelf – I know my herbalist’s standards for quality and freshness – I have no idea what the standards are for mass-produced teas – most of them don’t even say where the herbs are coming from, and we’ve all heard in the news about how some other countries (China in particular) have lesser standards for their food products – who knows how poisoned their agricultural soil is, eh?
The best natural remedy one can use is to control what and when you eat. I don’t know anything about the Southbeach diet, but I know sugar, cooked fat, and acidic foods like chocolate and orange juice can aggravate my reflux. I generally refrain from eating close to bedtime. I’d thought that would be hard for me, but the so-called “willpower” is easy to find once I’d spent a few nights waking up with reflux and hugging the toilet puking my guts out for hours pretty much makes me tow the line… good luck!
I'm 45 year old female, a few pounds over weight but I really watch everything I eat. About 4 years ago I got a chest cold that changed my life. My doctor diagnose me with adult on set asthma and now acid reflex. He put me on acifex daily and adver when needed . I only have asthma symptoms when I'm sick but I have trouble keeping food down in my stomach. I constantly have fluid running up and down my esophagus and often choke on small particles of food. I have a fast acting inhaler for emergencies but sometimes is doesn't work. I sleep in an upright position and do not eat before bedtime but I still wake up with fluid in my air ways. One doctor suggested doing a stomach rap. Any advice, will this surgery help, I want my life back.
For the past 10 plus years, I had what I thought was mild acid reflex. I also had asthma that became a problem with allergy or cold, flu. Inhalers never worked. July I had a lung function test, Dr. said I did not have asthma, I should see throat Dr. Because I had a throat problem. I had scar tissue, caused from GERD. I have had 3 throat surgeries and 1 stomach surgery, I now have a Trak.
For 9 years I took asthma medications, starting when I was about 40 years old. At the end I took 2 drugs every day (Serevent, Advair) and 3 other drugs (Albuterol, Theophyline, Prednisone) occasionally when I was doing worse. I also had other medical problems that came on in the last several years. I met someone who was trained in natural healing and began following his suggestions. I completely changed to a whole-food vegan diet (no milk!), started using a juicer, cleansed my colon, liver, and kidneys with herbs. Within 6 weeks I stopped taking any asthma drugs because I no longer needed them. That was over 6 years ago. Most of my other medical problems went away also. Needless to say, I’m not too fond of drugs any more - they only treat the symptoms and not the cause of disease.
to ananomous:
check out wheat allergies or try a gluten-free diet for a while, it's called celliac. I cooked this diet for my husband for 6-months. I think it might be easier to have a doc research it or you could test the food thing on your own.
good luck !
There is a definite link between an asthma attack and indigestion. I am a fit rugby and squash playing 42 year old male. Over the last 20 years I have had five severe asthma episodes (three required ER admission) all of which were precipitated by gastro-intestinal problems (heartburn, excruciating stomach cramping followed by chest tightening and the rapid onset of wheezing) usually in the early hours of the morning. Studies on the link between asthma attacks and indigestion are critical. I have been able to check the onset of a severe attack by recognising the symptomatic connection and administering (in high doses) salbutamol and beclomethisone inhalers. Symptom recognition is important as I feel certain that without that, the chances of an ensuing critical asthmatic episode dramatically increases.
I was diagnosed last year with my hernia. MANY nights I would wake up and I was aspirating the stomache acid into my lungs! It would get soooo bad that when I would sleep I would put rolaids in the sides of my cheeks and when I would wake up from hearburn, I would just slide the rolaids from my cheeks and chew them. But I soon realized that it was a MAJOR choking hazard! So, now I sleep in my recliner every night. My fiancee is getting frustrated because he (as well as I) would like to sleep next to one another. I am looking into having surgery to fix my hernia. Anyone that has had the surgery, PLEASE e-mail me and let me know how it was for you! Thank you!
I am a 37 year old female.Three years ago on new year's eve I went to the hospital to find out that I have sarcardosis(Lung Disease). A few months (Octber) earlier I was diagnosed with asthma. So for the next year and a half I was on predisone 40mg. After being weened off the steriods I developed a chronic cough. So after another round of tests followed my lungs were clear, new diagnosis ACID REFLUX. I have tried prilosic, zantac, natural remedies, change of diet, and now I am currently on protonix. I have no success with the meds, some significant improvemnet using natural remedies. I always wonder if the prolong use of steriods is the cause of my ACID REFLUX. Any one else out there with two lung disorders and acid reflux.Any advice would be invaluable
I have been having the same symptoms as the college guy above has been having...........I have had acid reflux for years I am 56 yrs old...I used to take rolaids by the roll.......sometimes 2 rolls a day...........then progressed up to zantac 150's which helped for awhile ...then on to ppi's ....protonix 40 mg a day ......for a cpl years....then 40mg twice daily....and now I have added 150mg zantac before bed..............but I still aspirate into my lungs.......and cough up gungus for 2 weeks after each episode.................I can find ro rhyme or reason as to when it will happen....sometimes a month may go by or more sometimes I have it 2 nights in a row BUT EVERY time I get it I have the SAME taste in my mouth and my lungs burn like I have snorted battery acid.....doc had me do a scope test looking for barettes eshophagus.....but was ok......when this happens it varys as far as sympoms...I think it's because it depends on how much acid or medication aspirates into my lungs.............but like he said I have been up at 3am trying to clear my lungs ....drinking milk to cool it down......(only helps as long as you are swallowing)coughing up stomach acid and holding the phone to dial 911 all at the same time...........I have tryed eating a banana before bed and after taking night meds with a measure of some success......but I came here looking for asthma symptoms because I wonder if what I aspirate is the meds or stomach contents............as I said it ALWAYS tastes the same ...kinda soapy is how i can best describe it...................one doctor said try nexium.......(might have been prilosec)but whichever one it was my insurance doesn't cover.....one thing I know is it WILL be back........attacks usually last 90 minutes approx..when an attack comes I quickly take another dose of both protonix and zantac......and usually the next day I have diarehha..(probably the meds)..I keep a bottle of Mylanta in my headboard....and if I get the taste in my mouth and get mylanta down before I aspirate I can beat it....but it only happens when I am asleep and laying down so I usually don't catch it in time..................I gasp for breath and actually do think I am gonna die........it's horrible...... it has affected everything in my life....can't go on trips...sometimes afraid to sleep ...lay there for hours.....my bedroom looks like a pharmacy..........any help would be appreciated
anonymous,
To ask questions about your specific condition, please visit Dr. Enright's message board.
Thank you.
I am a 34 year old female who worked in a smokey enviornment for 6 months. During the fifth month I noticed some shortness of breath, it ended up sending me to emergency. They said my lungs were filled with smoke, they didn't say I had asthma but they did give me an inhaler. I then began noticing a burning sensation that came from the pit of my stomach and ran straight up to my throat which increased the shortness of breath. After a number of doctor's visits, hospital runs, and a purse full of different medications, they finally say here's the best medicine,"PROTONIX". I started with one a day, and have now graduated to two a day. Is it working well let's just say I'm still sitting here waiting for it to work.
I've had some GERD issues along with a 'PTE' {pulmonarythromboendarterectomy} surgery a few years ago. Doc turned me on to some simple tips regarding sleeping/propping up pillows.....Too many pillows will give you pains in the neck and joints. Instead, just get a few small, evenly cut pieces of wood from 1/4'' to 1/2'' inch and raise the head of your bed by putting one piece under each leg of your bed! You may be pleasantly surprised.....{it reminded me of the joke/riddle of 'an obvious' answer when the 10 yr old kid tells all the adults how to get the stuck big truck out from the underpass...''just let the air out of the tires!'}
I've been diagnosed w/hiatal hernia and acid reflux. However the surgeon doesn't want to do the surgery due to " a problem w/the motility test in the esophogus". Am I now s.o.l.? The heartburn is getting worse every day, the insurance company doesn't want to pay for the nexium, which helped somewhat(throwing pez at a fire really) I have allergies to boot and find after this last bout of a sinus infection I can't shake the irritating little cough. I honestly can say I hate these people sitting somewhere behind their desks with my file in their hands making the decision that "she doesn't need that medicine, they have something over the counter that will work". sigh... sorry for the rant ...twiddling in florida
i am so glad to find this! I had been told by doctors that Ihad toomany symptoms-suffered with wheezing,cough,hoarseness,feeling like I was hit in the throat with a lead pipe for one year-no acid-but after endoscopy-which i found out i needed by looking on Web md,i do have a hiatal hernia-and acid and atypical GERD-so I am noit crazy-been onprotonix for 3 months but I am getting off-it eats away at calcium etc. I am not overweight, I workout and I think there MUST be other ingredients out there to take-has anyone ever tried drinking Aloe?
I too have been startled awake at midnight feeling like I am drowning. It all started out a few years ago with croninc heartburn which rollaids no longer controlled.It became so bad I went to my doctor and he put me on the ppi's; like prilosec, prevacid but not zantc. Zantac wasnt strong enough. The ppis were and still are a miracle! They have saved my life and worked miracles at controlling the constant heartburn. Only problem is if I eat too late in the day after 7:00 or so I WILL wake up drowning with stomach acid in my lungs burning like hell fire, thinking I am dying. If we eat too late then go to bed the food in our stomachs hasnt had enough time to digest and if you have a hiatal hernia etc . it will reflux.
My advice is keep up with the ppis and dont eat large meals for dinner and try to eat at least 4 or more hours before going to bed.
email me if you want at solidwoodchesstables@chess.com
Listening to the sheer amount of problems that people are having here reminds me alot of what I went through some years back. Since I was small I had always suffered with a bad chest and with acid reflux. When I got into my teens I was practically incapable of having a conversation without regularly clearing my throat. After a while it became a bit of a standing joke among my friends and they would regularly say things like "I knew it was you coming around the corner because I could hear you clearing your throat." Although I can see the funny side of this, I couldn't help but feel frustrated and embarrassed at times. Then in my early twenties I began to to lose my voice too. It went like a permanent whisper and was all one-tone, and so I pretty much stopped socialising altogether for a period of about two years because I could no longer contribute to a conversation and I also lost my job as a result. My charisma went completely out of the window and I sank into a deep depression. I had visited my GP on numerous occasions, both before and after this particular problem had occured, and had been prescribed all kinds of things, some of which really helped, and some of which didn't. But because of the nature of modern medicine, (typically masking problems as opposed to permenantly getting rid of underlying problems) I never stopped looking for a more permanent solution. Then A few years back, I happened upon a book called the PH Miracle by Robert Young. Almost as soon as I had started reading this book, I knew it was the answer to my problems. After changing my diet somewhat, I managed to completely get rid of my asthma and my heartburn and my voice problem has also completely disappeared. Because of the nature of the information contained in the book i'm also feeling almost as clear headed, and as healthy as I was when I was back in school, no exageration. I think this book could really help some of you, so please look it up. I promise you won't be sorry.
Paul, Cheshire England
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