When Heartburn Gets Out of Hand

We may call it “heartburn,” but it has absolutely nothing to do with the heart (thankfully).  It is perhaps more accurately termed “acid (or gastroesophageal) reflux,” and it describes the backward flow of stomach acid into the esophagus — the tube that connects the throat and stomach. It feels like a burning pain in your chest, just behind your breastbone. The pain is often worse when lying down or bending over.

Periodic or occasional heartburn is common, and should cause you no alarm. Over-the-counter antacids, H-2-receptor blockers, and proton pump inhibitors will give you all the relief you should require. If your heartburn is a bit “too periodic” for your liking, eat smaller meals, and avoid fried foods, fatty foods, tomato products, citrus products, chocolate, peppermint, alcohol and nicotine. 

If, however, your heartburn is near-constant, you may have gastroesophageal reflux disease (GERD), and no amount of TUMS is going to banish that. You should see a your doctor about your condition if:

·         Your heartburn occurs more than twice a week

·         Your symptoms persist despite use of over-the-counter medications

·         You have difficulty swallowing

·         You have persistent nausea or vomiting

·         You have weight loss because of poor appetite or difficulty eating

Note that you should get immediate help if you experience severe chest pain or pressure, especially when combined with other signs and symptoms such as pain in the arm or jaw or difficulty breathing. Chest pain may be a symptom of a heart attack.

To properly diagnose GERD, your doctor will likely prescribe an X-ray, which he will scan to determine the condition of esophagus and stomach. After this, he may schedule an endoscopy, to check for abnormalities in your esophagus, as well as take a tissue sample from your esophagus for analysis. To get a more granular read of when and for how long acid is building up in your body, your doctor may fit you for ambulatory acid probe tests, during which an acid monitor is placed in your esophagus and is connected to a small computer that you wear around your waist or on a strap over your shoulder.

Your doctor can treat GERD with higher-strength prescription version of the OTC H-2-receptor blockers and proton pump inhibitors you may already have been taking. Although these meds can conquer GERD in most every case, there is occasionally the need for surgery. During this procedure, your surgeon will tighten your lower esophagus. Thereby preventing acid from moving from the stomach into the esophagus.