Latest posts by Dr. John Haydek (see all)
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Here comes the burn: You have just finished a great meal or you lay down to rest and you are hit with that uncomfortable, burning sensation in your chest. Although commonly called heartburn, it really doesn’t involve the heart.
Heartburn affects many of us. In fact the American Gastroenterological Association reports that more than 60 million Americans experience symptoms at least once each month.
The burning sensation you feel is actually stomach acid splashing up into your esophagus. A valve at the end of the esophagus, called the lower esophageal sphincter (LES), normally prevents this. But factors such as overeating, pregnancy or even stress can keep the valve from shutting properly. When that happens, stomach acid can be pushed back up into the esophagus, causing pain along with a sour or bitter taste in the mouth.
Occasional heartburn is normally nothing to worry about and can easily be treated with over-the-counter antacids. However, frequent heartburn may indicate a more serious problem. Over time, stomach acid can damage the wall of the esophagus and, if left untreated, can lead to narrowing of the esophagus, bleeding and trouble swallowing, a condition called Barrett’s esophagus, and even cancer of the esophagus. Prolonged heartburn may also indicate more serious problems such as acid reflux disease, gastroesophageal reflux disease (GERD), gastritis, hiatal hernia or peptic ulcer.
There are several lifestyle changes you can make to help avoid heartburn:
- Avoid trigger foods such as chocolate; coffee; peppermint; spicy or greasy foods; tomato products; and alcoholic beverages.
- Eat smaller , more frequent meals.
- Don’t go to bed with a full stomach. Give food 2-3 hours to digest before going to bed.
- Stop smoking or using tobacco in any form. Tobacco inhibits saliva, the natural protection for your esophagus and the nicotine in tobacco increases acid secretion and relaxes the LES.
- Shed some pounds. Losing weight can help relieve symptoms.
- Eat high-protein, low-fat meals.
- Drink plenty of water during exercise to keep from being dehydrated.
- Avoid tight clothes and belts.
If you still experience heartburn, antacids usually give fast, short-term relief. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide to reduce the chance of diarrhea or constipation. If your symptoms worsen when lying down, raising the head of your bed so that your head and chest are higher than you feet may help.
If symptoms persist or occur frequently, speak to your doctor. Continuous heartburn may indicate a serious problem, and sudden chest pain may be mistaken for heartburn when it is really a sign of heart disease. Your physician may suggest prescription medication or testing such as x-rays to check for ulcers, pH tests to check for acid in the esophagus, or endoscopy to look for other conditions. Seek medical attention when the following symptoms occur:
- Difficulty or pain when swallowing
- Vomiting blood
- Black or bloody stools
- Shortness of breath
- Lightheaded or dizziness
- Neck or shoulder pain
- Heartburn more than 2–3 times per week for more than 2 weeks.
If heartburn is becoming a more frequent problem, keep a heartburn record. Track how often you experience the symptoms, what time of day and what you are eating or doing when the symptoms occur. That will help you get a clearer picture of when it is time to seek medical care and help your doctor more effectively diagnose and treat your condition.