GASTRIC GOLD'S BLOG

Indigestion

Indigestion is often a sign of an underlying problem, such as gastroesophageal reflux disease (GERD), ulcers, or gallbladder disease, rather than a condition of its own.

Also called dyspepsia, indigestion is a term used to describe a feeling of fullness or discomfort during or after a meal. It can be accompanied by burning or pain in the upper stomach.

What Are the Symptoms of Indigestion?

The symptoms of indigestion include:

• Bloating (full feeling)
• Belching and gas
• Nausea and vomiting
• Acidic taste
• Growling stomach
• Burning in the stomach or upper abdomen
• Abdominal pain

These symptoms may increase in times of stress.

People often have heartburn (a burning sensation deep in the chest) along with indigestion. But heartburn is caused by stomach acids rising into the esophagus.

Who Is at Risk for Indigestion?

People of all ages and of both sexes are affected by indigestion. It's extremely common. An individual's risk increases with excess alcohol consumption, use of drugs that may irritate the stomach (such as aspirin), other conditions where there is an abnormality in the digestive tract such as an ulcer and emotional problems such as anxiety or depression.

What Causes Indigestion?

Indigestion has many causes, including:

Diseases:

• Ulcers
• GERD
• Stomach cancer (rare)
• Gastroparesis (a condition where the stomach doesn't empty properly; this often occurs in diabetics)
• Stomach infections
• Irritable bowel syndrome
• Chronic pancreatitis
• Thyroid disease

Medications:

• Aspirin and many other painkillers
• Estrogen and oral contraceptives
• Steroid medications
• Certain antibiotics
• Thyroid medicines

Lifestyle:

• Eating too much, eating too fast, eating high-fat foods, or eating during stressful situations
• Drinking too much alcohol
• Cigarette smoking
• Stress and fatigue

Swallowing excessive air when eating may increase the symptoms of belching and bloating, which are often associated with indigestion.

Sometimes people have persistent indigestion that is not related to any of these factors. This type of indigestion is called functional, or non-ulcer dyspepsia.

During the middle and later parts of pregnancy, many women have indigestion. This is believed to be caused by a number of pregnancy-related factors including hormones, which relax the muscles of the digestive tract, and the pressure of the growing uterus on the stomach.

How Is Indigestion Diagnosed?

If you are experiencing symptoms of indigestion, make an appointment to see your doctor to rule out a more serious condition. Because indigestion is such a broad term, it is helpful to provide your doctor with a precise description of the discomfort you are experiencing. In describing your indigestion symptoms, try to define where in the abdomen the discomfort usually occurs. Simply reporting pain in the stomach is not detailed enough for your doctor to help identify and treat your problem.

First, your doctor must rule out any underlying conditions. Your doctor may perform several blood tests and you may have X-rays of the stomach or small intestine. Your doctor may also use an instrument to look closely at the inside of the stomach, a procedure called an upper endoscopy. An endoscope, a flexible tube that contains a light and a camera to produce images from inside the body, is used in this procedure.

What Is the Treatment for Indigestion?

Because indigestion is a symptom rather than a disease, treatment usually depends upon the underlying condition causing the indigestion.

Often, episodes of indigestion go away within hours without medical attention. However, if your indigestion symptoms become worse, you should consult a doctor. Here are some helpful tips to alleviate indigestion:

• Try not to chew with your mouth open, talk while chewing, or eat too fast. This causes you to swallow too much air, which can aggravate indigestion.
• Drink fluids after rather than during meals.
• Avoid late-night eating.
• Try to relax after meals.
• Avoid spicy foods.
• Stop smoking.
• Avoid alcoholic beverages.

If indigestion is not relieved after making these changes, your doctor may prescribe medications to alleviate your symptoms.

How Can I Prevent Indigestion?

The best way to prevent indigestion is to avoid the foods and situations that seem to cause indigestion. Keeping a food diary is helpful in identifying foods that cause indigestion. Here are some other suggestions:

• Eat small meals so the stomach does not have to work as hard or as long.
• Eat slowly.
• Avoid foods that contain high amounts of acids, such as citrus fruits and tomatoes.
• Reduce or avoid foods and beverages that contain caffeine.
• If stress is a trigger for your indigestion, re-evaluating your lifestyle may help to reduce stress. Learn new methods for managing stress, such as relaxation and biofeedback techniques.
• Smokers should consider quitting smoking, or at least not smoking right before or after eating, as smoking can irritate the stomach lining.
• Cut back on alcohol consumption because alcohol can irritate the stomach lining.
• Avoid wearing tight-fitting garments because they tend to compress the stomach, which can cause its contents to enter the esophagus.
• Do not exercise with a full stomach. Rather, exercise before a meal or at least one hour after eating a meal.
• Do not lie down right after eating.
• Wait at least three hours after your last meal of the day before going to bed.
• Raise the head of your bed so that your head and chest are higher than your feet. You can do this by placing 6-inch blocks under the bedposts at the head of the bed. Don't use piles of pillows to achieve the same goal. You will only put your head at an angle that can increase pressure on your stomach and make heartburn worse.

When Should I Call the Doctor About Indigestion?

Because indigestion can be a sign of a more serious health problem, call your doctor if you have any of the following symptoms:

• Vomiting or blood in vomit (the vomit may look like coffee grounds).
• Weight loss.
• Loss of appetite.
• Black, tarry stools or visible blood in stools.
• Severe pain in upper right abdomen.
• Pain in upper or lower right abdomen.
• Discomfort unrelated to eating.

Symptoms similar to indigestion may be caused by heart attacks. If indigestion is unusual, accompanied by shortness of breath, sweating, or pain radiating to the jaw, neck or arm, seek medical attention immediately.

webmd

Labels: GERD, Heartburn, indigestion

Is your heartburn triggered by running, aerobics, or other forms of exercise?

You exercise to feel the burn -- but not that kind of burn. Muscles, yes. Stomach, no. But when you go running, do aerobics, or go to a spinning class, there it is: heartburn. It's not just your legs that are churning, it's your last meal as well, churning right up into your throat. Your exercise heartburn has even made you hesitate to work out and made you wonder: What's going on here?
What Causes Exercise Heartburn?

Exercise can trigger heartburn if the LES muscle (the lower esophageal sphincter) is weak or too relaxed, and food or stomach acid "burps" back up from your stomach into your esophagus.

Exercise-induced heartburn can also be triggered by certain foods -- especially spicy foods like tomato sauce, acidic foods like orange juice, carbonated sodas, coffee, chocolate, and alcohol. These are the most common triggers for heartburn, according to the American Gastroenterological Association (AGA).
6 Tips When Exercise Triggers Heartburn

You don’t need to give up exercise to avoid heartburn. Instead, try these tips:

1. Problem-solve your diet. Do some simple problem-solving, says Tara O'Brien, PharmD, a pharmacy manager at Pharmaca in Seattle, a national, integrative pharmacy combining Western medicine with self-care. "Specifically, do you eat relatively quickly before going for a run? And what types of food?" Cut out the offending foods -- and hold the triple mochas before running.

2. Eat something soothing before exercise. "Some people eat a yogurt before a run and don't experience any problems, while the next person may eat yogurt and experience the worst heartburn ever," says O'Brien. "Experiment with foods to see if one thing aggravates it more than another." Good places to start? A banana, yogurt, small bowl of whole-grain cereal or toast.

3. Eat two to three hours before working out. Play with how long before you exercise to eat your light snack -- a half-hour, hour, 2 hours before -- and see which works best. Maybe you can eat a small snack an hour before exercise with no problem. Or you may need to eat two to three hours before working out to give your stomach time to empty.

4. Rethink your workout. Certain kinds of exercise may trigger heartburn for some people more than others. Experiment to see whether certain workouts trigger heartburn more or less for you. Maybe you can take a spinning class or go hiking if high-impact aerobics or running hurt. Crunches and core work on a full stomach may have to go. Headstands and Downward Dog in yoga, which reverse the natural gravity of digestion, can also trigger heartburn; ask your teacher how to modify these inverted poses.

5. Try baking soda. Taking something for symptoms wouldn't hurt, says O'Brien. Several natural remedies exist, although they only provide temporary relief. Baking soda added to water can help neutralize and wash away stomach acids. Because baking soda may add more salt to your diet, it's best to speak to your doctor first before trying this remedy.

6. Try over-the-counter relief. In your local pharmacy, look for an antacid with calcium -- that's the ingredient that neutralizes stomach acid. "Chewing a Tums or taking a calcium-based antacid is very safe, so it would be worth a try," says O'Brien. Although these are fast-acting, symptom-relief antacids, it can't hurt to try one as a preventive measure before exercise.

You exercise to feel the burn -- but not that kind of burn. Muscles, yes. Stomach, no. But when you go running, do aerobics, or go to a spinning class, there it is: heartburn. It's not just your legs that are churning, it's your last meal as well, churning right up into your throat. Your exercise heartburn has even made you hesitate to work out and made you wonder: What's going on here?
What Causes Exercise Heartburn?

Exercise can trigger heartburn if the LES muscle (the lower esophageal sphincter) is weak or too relaxed, and food or stomach acid "burps" back up from your stomach into your esophagus.

Exercise-induced heartburn can also be triggered by certain foods -- especially spicy foods like tomato sauce, acidic foods like orange juice, carbonated sodas, coffee, chocolate, and alcohol. These are the most common triggers for heartburn, according to the American Gastroenterological Association (AGA).
6 Tips When Exercise Triggers Heartburn

You don’t need to give up exercise to avoid heartburn. Instead, try these tips:

1. Problem-solve your diet. Do some simple problem-solving, says Tara O'Brien, PharmD, a pharmacy manager at Pharmaca in Seattle, a national, integrative pharmacy combining Western medicine with self-care. "Specifically, do you eat relatively quickly before going for a run? And what types of food?" Cut out the offending foods -- and hold the triple mochas before running.

2. Eat something soothing before exercise. "Some people eat a yogurt before a run and don't experience any problems, while the next person may eat yogurt and experience the worst heartburn ever," says O'Brien. "Experiment with foods to see if one thing aggravates it more than another." Good places to start? A banana, yogurt, small bowl of whole-grain cereal or toast.

3. Eat two to three hours before working out. Play with how long before you exercise to eat your light snack -- a half-hour, hour, 2 hours before -- and see which works best. Maybe you can eat a small snack an hour before exercise with no problem. Or you may need to eat two to three hours before working out to give your stomach time to empty.

4. Rethink your workout. Certain kinds of exercise may trigger heartburn for some people more than others. Experiment to see whether certain workouts trigger heartburn more or less for you. Maybe you can take a spinning class or go hiking if high-impact aerobics or running hurt. Crunches and core work on a full stomach may have to go. Headstands and Downward Dog in yoga, which reverse the natural gravity of digestion, can also trigger heartburn; ask your teacher how to modify these inverted poses.

5. Try baking soda. Taking something for symptoms wouldn't hurt, says O'Brien. Several natural remedies exist, although they only provide temporary relief. Baking soda added to water can help neutralize and wash away stomach acids. Because baking soda may add more salt to your diet, it's best to speak to your doctor first before trying this remedy.

6. Try over-the-counter relief. In your local pharmacy, look for an antacid with calcium -- that's the ingredient that neutralizes stomach acid. "Chewing a Tums or taking a calcium-based antacid is very safe, so it would be worth a try," says O'Brien. Although these are fast-acting, symptom-relief antacids, it can't hurt to try one as a preventive measure before exercise.

webmd

Labels: Heartburn

There are many good reasons to quit smoking. They range from curing your bad breath to reducing your risk of cancer, heart disease, and lung disease. But here's another reason to add to that long list: tobacco -- not just in cigarettes, but in cigars, pipes, chew, and snuff -- can cause heartburn.

"Tobacco makes acid reflux worse," says David Carr-Locke, MD, director of endoscopy, Brigham and Women's Hospital, Boston. "It's definitely a risk factor."

And unlike a heightened risk of serious diseases -- which might seem rather abstract, especially when you're young -- heartburn is a consequence of tobacco use that you can feel right now. And chronic heartburn, due to gastroesophageal reflux disorder (GERD), can cause more than serious pain; it can disrupt your sleep and interfere with your life. Sleeping With Heartburn Carries Cancer Risks.
Healing the Heartburn

According to some experts, there's a simple solution to the heartburn/tobacco equation, although you've probably heard it before: quit.

"For some people, quitting tobacco use can be the difference between having GERD and not having it," says Lawrence J. Cheskin, MD, co-author of Healing Heartburn and associate professor at Johns Hopkins School of Medicine in Baltimore. "If you stop, your symptoms will probably get better quickly. It also really lowers the risks of having further complications down the road."

However, not everyone thinks that quitting tobacco use will necessarily have a dramatic effect on heartburn.

"I think that quitting only has a modest impact on GERD symptoms," says J. Patrick Waring, MD, a gastroenterologist at Piedmont Hospital in Atlanta. But he still strongly encourages anyone who uses tobacco to kick the habit.
How Does Tobacco Affect GERD?

When you eat, a muscular ring between the end of the esophagus and the entrance to the stomach -- called the lower esophageal sphincter (LES) -- relaxes to let food in. Once it has closed again, the stomach releases acids and enzymes to break down the food.

Usually, these acids stay put in the stomach. But in people with GERD, the sphincter may stay relaxed or relax at the wrong time. This allows stomach contents containing acids and enzymes to wash back up, irritating the tissue of the esophagus.

Experts believe tobacco might worsen heartburn in a number of ways, including:

* Impairing the function of the LES. "The nicotine in tobacco seems to lower the pressure in the lower esophageal sphincter," says Cheskin. The reduced pressure could allow stomach acids and enzymes to back into the esophagus.
* Increasing acidity. Nicotine increases the production of stomach acid, says Carr-Locke.
* Harming the esophagus. Tobacco smoke seems to directly irritate the esophagus lining, says Cheskin.
* Reducing saliva production. This causes two problems. When you swallow, saliva helps push acid down, out of the esophagus and into the stomach. Saliva also contains bicarbonate, which is a mild acid neutralizer, says Cheskin. So a reduction in saliva can make your acid reflux worse.

Only the effects of smoked tobacco have been seriously studied on GERD symptoms, say experts. But anything with nicotine is likely to worsen GERD. Waring says that chew might pose specific problems.

"Smoking a cigarette only takes a few minutes," he says. "But people use chewing tobacco all day. That could lead to more irritation."

By the same token, nicotine gum could also pose a risk, say experts. "I don't know of any studies on nicotine gum and GERD," says Cheskin. "But I would worry that anything with nicotine would increase the risk of acid reflux."

Tobacco use also increases the long-term risks of GERD. Acid reflux is more likely to damage the esophagus in people who use tobacco than in people who don't. The damage will heal more slowly too, Cheskin says. Over time, tobacco users are more likely to face complications of GERD. These include chronic inflammation of the esophagus and even esophageal cancer.
Quitting: Will It Help Your Heartburn?

Cheskin says that cutting out tobacco will almost certainly ease heartburn symptoms.

"I think most people would feel the benefit of quitting within a few days," says Cheskin. He says that it's possible that cutting down your tobacco use -- rather than stopping cold turkey -- might help. But he strongly encourages people to quit.

Yet not everyone is sure that quitting makes a big difference.

"It's true that people with GERD who smoke tend to have symptoms that are more pronounced than people who don't smoke," says Waring. But there isn't good evidence that symptoms improve when people quit using tobacco, he says.

"I think tobacco only plays a minor role in acid reflux," he tells WebMD.

The results of research have been mixed. One 2004 study published in the journal Gut found that smoking tobacco had a strong cumulative effect on GERD symptoms. For instance, the study found that people who smoked everyday for twenty years were 70% more likely to have GERD than those who smoked daily for less than a year.

But a 2006 analysis published in the Annals of Internal Medicine found that while there was a connection between smoking and GERD, quitting didn't necessarily help resolve the symptoms.

So cutting out tobacco use may not cure you. Even if you ditch the cigarettes or chew, you might still have heartburn symptoms. But these may be controlled by other lifestyle changes or medicine.
Getting Control of Your Heartburn

Obviously, quitting tobacco isn't easy. Talk to your doctor about different strategies. You'll certainly need the support of your family and loved ones. You might also consider joining a support group to help you cope.

But just remember that while quitting is tough, you will probably feel a lot better for it. While many people might think of heartburn as an occasional discomfort, people with GERD know how painful and debilitating it can be. Quitting tobacco use could be a first and important step in getting control of your condition.

"If there already weren't enough reasons for you to quit smoking," says Cheskin, "resolving your heartburn is one that you can really feel."

WebMd

Labels: Heartburn, Tabacco

For many people, Thanksgiving is about having family near and celebrating, sometimes in excess. That's because for some holiday revelers, perhaps the amount of time spent watching football on the tube is only surpassed by a second activity: eating. And with the turkey, sweet potatoes and pumpkin pie comes heartburn, but how do you know if you have a simple case of it, or something more serious? Simply put, if the heartburn you have affects your quality of life, you may have gastro-esophagael reflux disease, more commonly known as GERD.

"If a person has a burning feeling down in their gut that goes up into the chest, made worse by eating, or exercising or lying down, and this happens several times a week, then that's affecting their life and there's a good chance they have GERD,"said gastroenterologist Joel Richter, M.D., chair of the Department of Medicine at Temple University School of Medicine. "The next step is to see a doctor and have the condition evaluated because there is actually "good" and "bad" GERD."

And how doctors treat the two types are very different. Richter says "good" GERD is the most common; about 80 to 90 percent of patients have it. This group may have occasional to daily heartburn symptoms, but nothing more serious, such as esophageal damage by endoscopy or problems with swallowing.

"For this group, more medication may not be the answer. Rather," says Richter. "Those with intermittent symptoms need to modify their lifestyle by losing weight,reducing their fat intake and not eating late at night before going to bed."

And while they can take proton pump inhibitors, (PPI's) which ease heartburn by alleviating excess stomach acid that flows back into the esophagus, Richter recommends that many will only need to take these pills as needed when their symptoms are bothersome. But for the second group of sufferers who have "bad" or more serious GERD symptoms, a lifetime drug therapy regimen can not only improve their quality of life, but can be life-saving.

"About 10 to 15 percent of GERD patients suffer from a more severe form, in which they have scarring on the esophagus, problems swallowing, and may even have Barrett's Esophagus, in which the cells lining the esophagus can turn cancerous," said Richter. "So, even though PPI's pose the risk of side effects, they are very effective for this group and the benefits of using them far outweigh the risks."

Patients who rely on these drugs when they're not needed put themselves at unnecessary risk for side effects when used long-term, which include an increase in bacterial pneumonia, gastrointestinal infections, and hip fractures, especially in women. Richter warns that before a patient starts self-medicating with PPI's, it's crucial that they find out which type of GERD they're suffering from. The best way to do that is through a set of consults with a doctor. An initial visit will consist of an endoscopy and a review of the patient's medical history to determine what type of pill a patient should be on. A follow up visit to evaluate the patient's response to the drug determines which type of GERD they have.

"These visits are the two pieces to the puzzle when diagnosing someone with GERD," said Richter.

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Labels: GERD, Heartburn

You know it all too well. Heartburn. That fiery sensation that grabs hold of your lower chest after you eat something you know you shouldn't have. What often follows is that sour or bitter taste of acid reflux in your throat and mouth that can last minutes (if you are lucky) or hours (if you are not).

Yes, millions of us are familiar with the discomfort of heartburn, a condition in which stomach acids back up into the esophagus. The good news is that heartburn is largely avoidable if you steer clear of the top 10 heartburn foods. It also helps to avoid certain classic heartburn-inviting situations.

From coffee and liquor to tomatoes and grapefruit, experts tell WebMD that certain foods are known heartburn triggers.

Here's what you need to know about the top 10 heartburn foods.

Heartburn and Tangy Citrus Fruits

Oranges, grapefruits and orange juice are classic heartburn foods. "These are very acidic," says Robynne Chutkan, MD. Chutkan is the founder of the Digestive Center for Women in Chevy Chase, Md. and a gastroenterologist at Georgetown Hospital in Washington, D.C. "As a result of being so acidic," she says, "they are likely to cause heartburn, especially when consumed on an otherwise empty stomach."

Heartburn and Tomatoes

While they might be chockfull of healthy nutrients like lycopene, Chutkan tells WebMD that tomatoes are also highly acidic and likely to cause heartburn in those who are prone to it.

The acid antidote may be a sour ball, according to Daniel Mausner, MD. Mausner is the section head of gastroenterology at Mercy Medical Center in Rockville Center, N.Y. "Things that promote saliva -- like sour balls -- are good for acid reflux," he says, "because saliva neutralizes the acid that comes up from your stomach."

Heartburn and Garlic and Onion

Bonnie Taub-Dix, MA, RD, says, "Some people with heartburn do not do well with either garlic or onion." Taub-Dix, a spokeswoman for the American Dietetic Association, is a nutritionist in private practice in New York City and Woodmere, N.Y. "It's all very individual," she says. For avoiding heartburn, she offers the following suggestion: "Keep a food log to help you track the foods that are your heartburn offenders, and try to develop a list of safe foods." Foods like broiled chicken, baked sweet potatoes, toast, or cottage cheese, she says, are on the safe side of the heartburn food list.

Heartburn and Spicy Foods

Pepper, Mexican food, chili, and any other food that is loaded with pepper or other spices can trigger heartburn, says Deepa A. Vasudevan, MD. Vasudevan is an assistant professor of family medicine at The University of Texas Medical School at Houston. He tells WebMD that avoiding heartburn isn't necessarily a matter of all or nothing. "If spicy food triggers your heartburn, avoid it. Then slowly reintroduce milder versions of whatever you like."

Heartburn and Peppermint

Chutkan says that while many people think peppermint is soothing for the tummy, it is actually a heartburn trigger food. Her advice? Skip the after-dinner mints -- especially after a rich meal. "They may be good for your breath on a date," she says, "but they are not so good if you are prone to heartburn."

Peppermint may increase your chances of heartburn because it relaxes the sphincter muscle that lay between the stomach and esophagus. This allows stomach acids to flow back into the esophagus.

Heartburn and Cheese, Nuts, Avocadoes, and a Juicy Rib Eye

What do these foods have in common? They are all high in fat, according to Chutkan. "These foods may not get as much press as acidic foods when it comes to heartburn," she says, "but they can be major triggers." Here's why: Fat slows down the emptying of the stomach, so there is more opportunity for a big distended stomach -- which increases pressure on the esophageal sphincter -- to make heartburn more likely.

Chutkan says that doesn't mean you can never have those foods again. "Don't have a cheese plate at the end of a meal," she suggests. "Instead, eat it early in the day when you are not already full." Remember, a serving of cheese is roughly the size of two dice.

Heartburn and Alcohol

Wine, beer, or your favorite cocktail can all trigger heartburn, says Chutkan, especially when they are imbibed with a large meal. "If you have a meal of steak, creamed spinach, and lobster bisque and then alcohol on top of that," she says, "you may be in for it."

Taub-Dix agrees. "A glass of red wine may not be a big deal on its own," she points out. "But if you also have tomato sauce on your pasta and a glass of orange juice in the morning on an empty stomach, it could be a problem." Like peppermint, alcohol opens the sphincter, allowing the acid free range.

Heartburn and Caffeine

Coffee, soda, tea, iced tea, and any other food or beverages that contain caffeine are big offenders. But java junkies don't have to give up their Joe forever, Chutkan tells WebMD. "It's not 'no coffee ever' if you have heartburn. It's about cutting down and paying attention to portion sizes. A Starbucks tall," she explains, "which is their version of a small, is like three cups of coffee. Some people tell me they drink two cups of coffee a day and that they get it at Starbucks. That's like six cups a day."

If you have heartburn, you can likely consume a 3- or 4-ounce cup of coffee each morning with no problem. But if you guzzle coffee all day long, then, yes, heartburn is a consequence

Heartburn and Chocolate

Sure, it can be loaded with caffeine, but chocolate can also be a heartburn food in and of itself. "Pack up all of your chocolate and give it to your gastroenterologist for safekeeping if you have heartburn," Chutkan says. Chocolate relaxes the sphincter, allowing stomach acids to flow back into the esophagus, she says.

Heartburn and Carbonated Beverages

"Carbonated beverages cause gastric distension," Mausner says. And if your stomach is distended, this increases pressure on the esophageal sphincter, promoting reflux." He tells WebMD that people with heartburn may be wise to steer clear of pop and other carbonated beverages.

Heartburn Foods: Find Your Triggers

Taub-Dix's advice is to use the above list as a guide to help you figure out your heartburn foods and heartburn trigger situations. And remember, she cautions, even if your favorites are not on this list, you don't necessarily have a free pass. "Too much of any food can trigger heartburn," she says. It's not just what you eat; it's how much you eat and when you eat it. "Consuming a large meal right before you lie down," she says, "will likely cause heartburn even if it doesn't include any of these heartburn foods."

source: WebMd

Labels: Heartburn

Labels: acid reflux, Food Safety, Heartburn, stomach acid, Video