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Heartburn and GERD - RCJ
Did you know that nearly 20% of adults will experience
heartburn at least once a month? And up to fifteen percent
of adults will have such severe heartburn that they will
seek medical advice in order to feel better. Heartburn
occurs when there is an abnormal backflow (reflux) of food
and stomach acids into the tube that leads from the throat
to the stomach called the esophagus.
Most people with heartburn will feel a burning sensation
that often starts in the upper part of the abdomen,
spreading in waves upward into the throat. It is not
uncommon to have a sour taste in the mouth as well as some
nausea or difficulty swallowing. The pain of heartburn can
last up to two hours and is often worse after eating. Lying
down or bending over seem to make it worse and these
symptoms may cause sleep difficulties, choking spells or a
chronic cough.
You may be able to control your symptoms of heartburn by
making a few changes in your lifestyle.
If you smoke or chew tobacco----stop. Nicotine from tobacco
relaxes the valve or sphincter between the esophagus and
stomach, allowing the acids to back up into the esophagus.
Change your eating habits by avoiding
foods that aggravate your heartburn. For example, some
people suffer heartburn after eating onions, peppermint,
chocolate, caffeine, citrus fruits, tomatoes, or high-fat
foods. Others suffer heartburn if they lie down after a
large meal.
If you are overweight, try to take off
a few pounds. Being overweight can put additional pressure
on your stomach causing the acids to reflux back up the
esophagus.
You can reduce your heartburn at night
by raising the head of your bed at least six inches with
blocks underneath your bed frame. This will help keep
stomach acid from flowing into the esophagus while you are
sleeping. Try to eat meals at least two to three hours
before lying down. This will give the acid levels a chance
to decrease before you go to bed and heartburn is less
likely to occur.
Along with making a few lifestyle
changes, drugs such as antacids (Tums, Rolaids) or other
non-prescription acid reducers such as Pepcid AC and Zantac,
may be needed in order to control mild heartburn symptoms.
Mild to moderate heartburn usually is
not a concern. However, if the heartburn becomes severe, it
can be a sign of a more serious problem such as
gastroesophageal reflux disease or GERD. If left untreated,
too much stomach acid in the esophagus can cause damage to
the lining of the esophagus. The normal cells that line the
esophagus become irritated and turn into an abnormal cell,
which can lead to cancer.
Occasionally, the damaged lining of the
esophagus becomes scarred, causing a narrowing of the
esophagus. This narrowing or stricture can interfere with
eating and drinking by preventing food and liquid from
reaching the stomach.
You should see your primary care
physician if your heartburn occurs more frequently and home
treatment does not relieve your discomfort.
Often, your physician will refer you onto a specialist
(gastroenterologist) for an upper Endoscopy if the symptoms
of GERD are not clear-cut. The specialist will use a thin,
flexible instrument with a camera at the end of it in order
to directly see the stomach and the esophagus. He or she
will be able to determine whether there is inflammation or
erosions (ulcer) or irritation of the lining of the
esophagus.
Sometimes a piece of the esophagus is removed (biopsy) and
sent to another specialist (pathologist) in order to see if
the cells have changed or if there are any other problems
related with the acid irritation.
Once the diagnosis of GERD is made and other causes of your
heartburn have been ruled out, your doctor will often
prescribe acid blockers such as Zantac, Pepcid or Axid. At
high doses, these drugs can be very effective in relieving
heartburn symptoms and treat GERD.
Depending on the source of your problem, your doctor can
prescribe stronger acid blockers called proton pump
inhibitors, or PPIs for short. They include drugs such as
Prilosec, Prevacid, Aciphex, Protonix and Nexium.
Occasionally, the symptoms of heartburn occur as a result of
a hiatal hernia. A hiatal hernia occurs when part of the
stomach moves up through the opening in the diaphragm where
the esophagus goes through. Some patients may choose surgery
to correct this condition if medications do not relieve
their symptoms.
Don’t be concerned if you have heartburn on occasion. Though
uncomfortable, heartburn does not usually cause serious
health problems. Most people who suffer heartburn find
relief from symptoms by making a few changes in their diet
and lifestyle. If your symptoms continue, see your primary
care physician in order to find the cause of your heartburn.
He or she may prescribe medications or do further testing in
order to make the diagnosis.
Content
of articles can only be used with writer attribution to Dr.
Kevin Weiland.
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