What is Heartburn?
Heartburn is one of the most common medical complaints facing Americans. Almost everyone experiences heartburn at some point following a meal. Frequent episodes or persistent heartburn can be a symptom of acid reflux or the more serious medical condition called gastroesophageal reflux disease or GERD.
Heartburn is the painful feeling, or “burning”, radiating from your chest and acid taste in the back of your mouth that is the result of the mixture of stomach acid and partially digested food moving up into your esophagus. Persistent heartburn can affect your quality of life, your sleep and your health. It can be associated with breathing problems like asthma, chronic sore throats or a hoarse voice, as well as dental problems and gum disease. It can often be controlled through simple measures, such as behavior and diet modifications and may require the occasional use of over the counter medications for relief. More serious conditions, such as GERD and Barrett’s Esophagus (pre-cancerous changes in the cells lining the esophagus resulting from chronic acid reflux), often require additional testing and treatments, administered by gastroenterologists.
What are the Symptoms of Frequent Persistent Heartburn and GERD?
Heartburn and acid indigestion can be an occasional event for most. But if you experience symptoms, such as a burning pain in your mid-to-lower chest and your upper abdomen more than twice a week, this is considered GERD or gastroesophageal reflux disease. These symptoms may be worse when you are lying down or bending over. It is more common following a meal. For children under 12, this condition can be indicated by a dry cough, asthma symptoms or trouble swallowing. GERD and its persistent symptoms can lead to more serious health problems.
What Causes Heartburn and GERD?
Heartburn is caused by stomach acid backing up into your esophagus. The reasons why the acid and stomach contents are allowed to move back into the esophagus can differ. For many, it happens because the lower esophageal sphincter (LES) or muscle controlling the opening of your esophagus into your stomach functions abnormally. Instead of remaining closed, it can relax, allowing stomach contents to move back up into your esophagus and mouth. Another cause for GERD in some people is the presence of a hiatal hernia. This is an anatomic finding in 30% of people in which the stomach can slide up and down through a hole in your diaphragm. Many people with a hiatal hernia do not experience heartburn or GERD. Other factors that have been determined to contribute to heartburn and GERD are being overweight or obese, smoking and being pregnant. Certain foods can cause heartburn symptoms to be worse, these include citrus fruits or juices, spicy foods, garlic, tomato products, mint, chocolate, fatty or fried food, and drinks with caffeine and alcohol. Certain medications may also contribute to GERD by loosening the sphincter muscle in the bottom of your esophagus (LES).
How is Heartburn Treated?
Many people initially treat heartburn with antacids and over-the-counter medications. If symptoms persist for more than two weeks, you should see your doctor or make an appointment with a gastroenterologist. Treatments for severe and persistent heartburn and GERD can include lifestyle changes, prescription medications and surgery. Simple lifestyle changes, such as modifying your diet, losing weight and raising the head of your bed a few inches can often be effective in treating symptoms. Medications prescribed by your physician can include antacids, foaming agents (Gaviscon), H2 blockers (Zantac, Pepcid), proton pump inhibitors (Prilosec, Aciphex, Nexium, Kapidex, Zegrid, etc.), or prokinetics (Reglan). You may be prescribed a combination of lifestyle changes and medications to treat your heartburn. You may be referred to the Ambulatory Center for Endoscopy and Colonoscopy (ACE.) to have an upper gastrointestinal endoscopy (EGD) procedure, which involves a thin flexible tube with a light and camera being inserted through your mouth into your esophagus and stomach to evaluate your condition. This will lead to the proper diagnosis of the condition causing your heartburn and a treatment plan that best fits your needs.
What Does Frequent Heartburn Mean to My Health?
Frequent, persistent heartburn and GERD can have serious consequences for your health. Inflammation of the lining of your esophagus and stomach can lead to ulcers, scar tissue being formed or a narrowing of the esophagus that can restrict swallowing. Heartburn can also be a precursor to Barrett’s Esophagus, where the normal cells in your esophageal lining change to a different type of cell as a result of recurrent injury from stomach acid. Barrett’s Esophagus has been proven to be a risk factor for developing cancer of the esophagus later in life. This form of esophageal cancer (Adenocarcinoma) is one type of cancer that is increasing in incidence. Its diagnosis may be delayed if the symptoms may be hidden through the prolonged use of over the counter heartburn medications without the supervision of a physician. Patients with persistent heartburn must be evaluated for Barrett’s Esophagus to formulate a treatment strategy that will relieve the heartburn but also reduce the risk of cancer. GERD has also been proven to contribute to or make asthma symptoms worse and harder to control. The back flow of acid into the throat and mouth can cause chronic sore throats, and problems with your vocal chords. Chronic irritation from acid reflux can cause premature tooth decay and other dental problems as well