Is It Heartburn or Something More?
Many people reach for antacids after a meal. In fact, it is estimated that 60 million Americans experience heartburn once a month. But what is heartburn, and when is it more serious than “just heartburn?”
What is heartburn?
Heartburn is a painful, burning, achy, sensation that is usually centered in your chest behind the breastbone. It generally occurs after eating, and may be worsened with bending over and lying down. It occurs when stomach contents back up into your esophagus. It is one of the symptoms of gastroesophageal reflux disease (GERD).
What is GERD?
The esophagus is a tube that connects your mouth to your stomach. GERD is a digestive disorder where contents of the stomach flows back into esophagus causing irritation.
What is the difference?
Heartburn is a symptom of GERD. However, not all patients with GERD have heartburn as a symptom.
What are the signs?
Symptoms of GERD include:
- a burning sensation after eating, often worse at night
- chest pain
- shortness of breath
- dry cough
- difficulty swallowing
- sour or acid taste in the mouth
- regurgitation of food or liquid
What causes it?
There is a ring of muscle called the lower esophageal sphincter (LES) that sits between the esophagus and the stomach. When you swallow, this muscle normally relaxes to allow food to pass into the stomach. It then closes again between swallows. GERD occurs when there is weakening or abnormal relaxation of the sphincter to allow stomach contents to reflux upwards and irritate the lining, which can cause symptoms.
When should people see a doctor?
You should always call your doctor immediately if you have chest pain or shortness of breath as this may be a symptom of a heart attack. Otherwise, if you have frequent symptoms of GERD should talk to your doctor. Your doctor may refer to you a gastroenterologist, a doctor who specializes in digestive diseases.
How serious is GERD?
Over time, irritation to the lining of the esophagus can cause chronic inflammation. This may lead to the following serious conditions:
- Esophageal stricture is a narrowing of the lower esophagus caused by scar tissue due to chronic acid exposure. This can lead to difficulties swallowing your food.
- Esophagitis is an inflammation of the lining of the esophagus.
- Esophageal ulcers can be formed by the irritation caused by the constant exposure to acid. An esophageal ulcer can be painful and may also bleed.
- Barrett’s esophagus is a precancerous change in which the cells lining the esophagus can change into cells that are like those that line the intestine. These changes are associated with an increased risk for developing esophageal cancer.
What is the treatment for GERD?
There are both lifestyle and dietary changes that can help decrease symptoms. For some patients, medications may be prescribed.
Lifestyle changes include:
- weight loss
- avoiding overeating
- wait three hours after eating before going to bed
- smoking cessation
- loose fitting clothes
- elevating upper body in bed.
Dietary changes include avoiding the following:
- greasy foods
- spicy foods
- caffeinated drinks
- tomato products such as pasta sauce and ketchup
There are also number of medications that can be used to treat GERD. These include antacids, which neutralize the acid in the stomach. Other medications include H2 blockers and proton pump inhibitors, which decrease acid production. Surgery may be recommended for patients with symptoms that persist despite medications and lifestyle changes.
If you are experiencing heartburn often, or other symptoms of GERD, we can help. Learn more about our endoscopy services here.
About the Author:
Tian Gao, MD
Dr. Tian Gao is a gastroenterologist with Gastroenterology Associates, affiliated with The Miriam and Rhode Island hospitals, specializing in advanced endoscopy.
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