The symptoms are likely due to a combination of factors, including exposure to environmental toxins, according to Dr. Luft. The workers not only inhaled toxic dust, but they also most likely swallowed it.
“The material had two characteristics—one, it contained a lot of different chemicals and potential toxins, but the other thing about it was the dust itself was extremely caustic,” says Dr. Luft. “The pH was very high. The feeling was that with such a high pH, it could almost cause something analogous to a chemical burn.”
Although most people think the inhaled dust might affect the nose, throat, and lungs, “it also could impact your upper digestive tract as well,” he says.
The researchers did not look at what kinds of GERD treatments the workers were using and whether one type was better than another. GERD can be treated with antacids, histamine-2 blockers, and proton pump inhibitors; in very severe cases, surgery may be recommended, although results can be mixed.
David A. Johnson, MD, a former president of the American College of Gastroenterology, calls the study “provocative” but suggests that it’s “not absolute that the two are related; there are several issues that can also play into this.”
He notes that psychological trauma can also interrupt sleep, and “sleep dysfunction may also sensitize people to recognize other conditions like reflux disease.”
However, stress can play a role too. Animal research has shown that stress can lower the resistance to stomach acid during reflux, resulting in more damage to the esophagus, notes Dr. Johnson, a professor of medicine and chief of gastroenterology at Eastern Virginia Medical School, in Norfolk. Plus, “we do know that stress in and of itself may cause people to be sensitive to gastroesophageal reflux disease,” he says.
If people truly have GERD (misdiagnosis can occur), proton pump inhibitors—drugs that are “the cornerstone of treatment”—should help, Dr. Johnson says.
Both experts recommend talking to your doctor if you have persistent heartburn symptoms.
“My advice is that they basically talk to their doctor or find a physician who is really attuned to what their particular needs are,” says Dr. Luft. “The one thing we do know for sure is that if we don’t treat the patient as a whole, dealing with both their psychic injury and their medical injury, we are not going to be able to effect a cure.”
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