A few years ago, watching the upbeat drug commercials on the evening news, with their recitations of dire side effects accompanied by breezy music, I saw an ad for something called the Purple Pill. It got my attention because the commercial never mentioned the name of the drug or the condition it was supposed to treat. The idea seemed to be that the people who needed this pill already knew what it was, as though they were members of an exclusive club.
The drug, Nexium, treats acid reflux, and the club is far from exclusive. Although I didn’t realize it at the time, I was already a member, and so were at least half the women I knew. Apparently it’s not just your neck that starts to go slack after 50. Your lower esophageal sphincter, which may have seen you through many a pile of jalapeño nachos in your careless youth, becomes less adept at keeping your stomach contents where they belong. If that sphincter relaxes when it’s not supposed to, digestive acid backs up into your esophagus, where it can wreak several kinds of havoc. The medical name for this condition is GERD—gastroesophageal reflux disease—and the classic symptom is heartburn. I didn’t have heartburn. I was arrogant enough to believe that people bedeviled by that burning sensation were simply eating the wrong foods (fried, spicy, heavy) at the wrong time (right before bed), and I was way too nutritionally evolved for that.
So I was surprised, and annoyed, when an ear, nose and throat doctor told me he saw signs of mild acid reflux disease in my esophagus. As far as I knew, I had no symptoms. It didn’t occur to me that the times I woke up coughing and choking with what felt like bad postnasal drip were actually reflux episodes.
Not that I had many of those. Because, without realizing it, I’d gotten into the habit of taking Pepcid Complete practically every night. These chewable tablets contain both an ant-acid and a histamine blocker, so they’re more serious medicine than plain old Tums or Rolaids. I found myself reaching for them after meals I’d once been able to manage without difficulty. Pasta with pesto? Make it a Pepcid night. Alcohol? If I had half a glass of wine with dinner or a swallow or two of cognac before bed, I’d wake up with what was undeniably reflux: the sensation that I’d just thrown up in my mouth and swallowed again. I’d pad down to the kitchen and take another Pepcid, thinking, ewww! and feeling old (at 53). I wasn’t overweight, didn’t overeat and wasn’t a late-night snacker. But the reflux persisted, and my whole digestive system felt out of whack. I got to the point where I couldn’t manage a post-workout fried-egg sandwich and cup of coffee at the local diner.
I complained to my personal trainer, Frank, who told me he’d had a major reflux problem of his own. Frank, who is fond of eating large quantities of fried food late at night, developed a condition called Barrett’s Esophagus, which, very rarely, can lead to esophageal cancer. A proton pump inhibitor cleared up the damage, but he expects to be on medication forever. Reflux, I realized, could be serious. (Never mind that it usually isn’t.) I felt a sudden acute need for the strongest medicine I could get.
So I lied to my internist. Well, not lied exactly, but I led him to think I had heartburn when I didn’t, and that my coughing episodes were more frequent than they actually were. Lo and behold, he prescribed the Purple Pill. I expected those pills to be magic bullets, and within a few days, I did start to feel better. But when your stomach is on the fritz, better is a relative term. I still had to be careful about what I ate, opting for small portions of bland food and cutting out alcohol entirely. And I’d still wake up with a sour stomach unless I propped myself up with lots of pillows—good for my digestion, not so great for my neck. So I bought a bed wedge (very easy to find online), a slanted foam pillow that elevates your upper half. This was probably the single most effective step I took to foil nighttime reflux. But it wasn’t ideal: When you have a hot flash on a foam pillow, the thing radiates your body heat back at you like a down jacket in June. And somehow, lying in bed at an angle made me feel very formal, like the corpse at an open-casket viewing.