Digestive Health Archive

Sales of cannabidiol-infused products are expected to top $2 billion by 2021. But is CBD right for you?

Cannabidiol (CBD) is touted as a natural wonder that can help treat symptoms of everything from anxiety to arthritis pain. The plant extract comes from two varieties of cannabis — hemp and marijuana — and is available in creams, tinctures, oils, patches, gummy bears, capsules, and more. You can even add CBD to a latte if you walk into a coffee shop in some cities.

But is CBD safe for older adults? There haven't been a lot of large studies of CBD's safety, but more traditional medicines for pain and anxiety are not free of adverse effects, either. "I think CBD is likely safer than many other treatments people use for pain, insomnia, or anxiety," says Dr. Peter Grinspoon, a primary care physician with Harvard-affiliated Massachusetts General Hospital. Other physicians don't think we know enough about the safety profile of CBD to be sure.

But these remedies aren't the best choice if you have frequent heartburn.

You feel the familiar sensation in your chest: heartburn. Again, you find yourself reaching for the bottle of antacids in the medicine cabinet. It's something you've done a few times a week for the past six months. Is it okay to keep popping over-the-counter acid reducers, or is it time to see a doctor?

We asked two experts, Dr. Jennifer Nayor and Dr. Molly Linn Perencevich, both instructors in medicine at Harvard Medical School, for their thoughts on heartburn, including when it's okay to use over-the-counter antacids and when you should seek other treatments. Below are their responses.

Ask the doctors

Q. I recently had diverticulitis. I'd like to avoid a recurrence. Is there anything I can do to prevent this painful condition in the future?

A. As people age, small pouches often form in the wall of the large intestine, a condition called diverticulosis. If food or bacteria become trapped in these pouches, they can become inflamed or infected, which is known as diverticulitis.

A muscular ring called the lower esophageal sphincter (LES) separates the esophagus from the stomach. Normally, the LES works something like a gate. The muscle relaxes when you swallow, opening the passage between the esophagus and stomach and allowing food to pass into the stomach. When the sphincter tightens, it closes the passage, keeping food and acidic stomach juices from flowing back into the esophagus. In people with acid reflux (gastroesophageal reflux disease or GERD), the LES relaxes when it shouldn't or becomes weak and doesn't close tightly. Either problem allows the contents of the stomach to rise up into the esophagus. The LES is controlled by various nerves and hormones. As a result, foods, drugs, and certain emotions such as anxiety or anger can impair its function, causing or worsening acid reflux. The following factors are under your power to change:

• Certain foods. Coffee, tea, cocoa, cola drinks, and other caffeine-containing products loosen the LES and stimulate gastric acid production. Mints and chocolate, often served to cap off a meal, can make things worse by relaxing the LES. Fried and fatty foods contribute to heartburn. Some people say that onions and garlic give them heartburn. Others have trouble with citrus fruits or tomato products, which irritate the esophageal lining. 
• Eating patterns. How you eat can be as important as what you eat. Skipping breakfast or lunch and then consuming a huge meal at day's end can increase pressure in the stomach and the possibility of reflux. Lying down soon after eating will make the problem worse.
• Smoking. Smoking can irritate the entire gastrointestinal tract. In addition, frequent sucking on a cigarette can cause you to swallow air. This increases pressure inside the stomach, which encourages reflux. Smoking can also relax the LES.
• Overweight and obesity. Being overweight or obese increases the odds of having GERD and experiencing heartburn. Actually, any weight gain increases the risk of frequent GERD symptoms. In addition, eating larger meals distends the stomach, pushes the contents up toward the esophagus and loosens the LES.
• Certain medications. Some prescription drugs can add to the woes of heartburn. Oral contraceptives or postmenopausal hormone preparations containing progesterone are known culprits. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) can irritate the stomach lining. Other drugs—such as alendronate (Fosamax), used to prevent and treat osteoporosis—can irritate the esophagus. And some antidepressants, bronchodilators, tranquilizers, and calcium-channel blockers can contribute to reflux by relaxing the LES.

To learn more about GERD and heartburn, read Controlling Heartburn from Harvard Medical School.

Constipation tends to be more common in women and may get worse with age.

 Image: © krisanapong detraphiphat/Getty Images

Like gray hair and wrinkles, constipation is something you're more likely to experience as you age. "Constipation is a very common complaint; mild irregularity is probably even more prevalent," says Dr. Judy Nee, an instructor in medicine at Harvard Medical School. "Women are more likely than men to be constipated."

More than one in three adults ages 60 and older have experienced constipation symptoms, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Constipation is typically defined as having fewer than three bowel movements a week; having stool that is hard, dry, and difficult to pass; or feeling that you aren't able to void completely when you use the bathroom.

There are two ways to get more good bacteria into your gut: fermented foods and dietary supplements. Fermented foods are the most natural source. Probiotic supplements, which are typically sold over the counter, are reserved to treat specific ailments as suggested by your doctor, and not recommended for everyday use. Plus, supplements do not have the same FDA oversight as medications do.

So, a big question remains: How  many probiotic foods do you need? That's not easy to answer.