Have you ever eaten a big meal and felt a burning or tightening pain in your chest several hours later? Is the pain difficult to relieve even when repositioning your body?
You may be experiencing symptoms of heartburn—a common condition that affects more than 60 million Americans at least once a month. The name “heartburn” is a bit misleading, though, as this condition doesn’t relate to the heart. Heartburn, in fact, doesn’t occur in the heart at all. Heartburn starts in the esophagus, and is actually a symptom of other medical conditions called acid reflux and GERD. What are these conditions, how do they cause heartburn, and what are their effects? Here’s a look.
Acid Reflux and GERD
Acid reflux disease is a condition in which acid from the stomach moves up into the esophagus when a particular esophageal muscle (called the lower esophageal sphincter, or LES) stays open for too long or doesn’t close completely. The chronic form of acid reflux disease is called gastroesophageal reflux disease, abbreviated GERD. GERD is usually diagnosed if a person experiences symptoms of acid reflux twice a week or more.
There are several potential causes and risk factors for acid reflux disease and GERD:
- • Hiatal hernia: This occurs when the diaphragm, which helps keep acid in the stomach, loosens and allows acid into the esophagus
- • Obesity
- • Meals near bedtime, particularly large meals, followed by lying down or bending over
- • Foods: Spicy, fatty, citrus, minty, garlic-heavy, tomatoes, onions
- • Beverages: Coffee, alcohol, carbonation, some teas
- • Smoking
- • Pregnancy
- • Certain medications: Painkillers, muscle relaxers or blood pressure medicines (only cause symptoms rarely)
The most common symptom of acid reflux disease is heartburn—a burning pain that can be present anywhere from your lower stomach all the way up to your throat. Heartburn is tied to factors like weight, diet and certain lifestyle habits, such as smoking. Isolated cases are usually treated with antacid medications.
Other Acid Reflux Symptoms
There are several other common symptoms of acid reflux disease and GERD:
- • Regurgitation: A bitter, acidic taste in your mouth or throat
- • Burping and bloating
- • Nausea or bloody vomiting
- • Unexpected weight loss
- • Coughing or chronic throat issues
- • Bloody stools
- • Dysphagia: Painful or difficult swallowing
- • Chronic hiccups
Treatments and Preventive Measures
Acid reflux disease is usually easy to identify, and if you experience acid reflux more than twice a week, or if antacids don’t relieve your symptoms, it’s time to see a doctor. Your doctor will perform one of several tests to check your esophagus, stomach or acid levels.
In many cases, acid reflux and GERD can be relieved with certain preventive measures and lifestyle changes. Talk with your doctor to find a plan that works for you.
More often than not, basic lifestyle changes can effectively alleviate or even eliminate acid reflux issues. A few suggestions include:
- • Avoid foods and beverages that trigger acid reflux
- • Stop smoking
- • Maintain a healthy weight, and avoid wearing tight clothing or belts
- • Change positions: Take naps in a chair to remain upright, and try to raise your bed a few inches if • possible to re-position your chest
- • Don’t eat for three to four hours before lying down
- • Eat smaller meals more often throughout the day rather than two or three large meals
- • Check with your doctor to see if medications might be causing the problem
In some severe cases, medications are needed. These can include basic antacids like Rolaids, but they can’t be overused as they can cause diarrhea or constipation.
Other medications your doctor might recommend include:
- • H2 blockers: Slows down acid production in the stomach
- • Proton pump inhibitors: Also slows acid production
- • Foaming agents: Coats the stomach with a protective layer
- • Prokinetics: Strengthens the stomach to remove acid more quickly
In extreme cases, surgery might be necessary as treatment. Surgery can be effective if other methods of treating GERD are ineffective. Two common methods are:
- • LINX device: A ring that is placed around the esophagus, and prevents stomach acid from reaching it
- • Fundoplication: Creates a new, artificial valve at the end of the esophagus to strengthen the esophagus and repair hiatal hernias
If you are experiencing symptoms of acid reflux or GERD, schedule an appointment with your gastroenterologist. He or she will work with you to create a treatment and prevention plan that works for you.
Casey Owens, MD
I grew up in Utah County and graduated from Brigham Young University. I received my medical degree from the University of Virginia, and I finished my residency in internal medicine at the University of Utah where I also served as chief medical resident. As a doctor, I recognize the tremendous trust my patients place in me, and I do my best to help them understand not only their medical issues but also the plan—the how and why—behind helping them feel better. I love the challenge posed by all gastrointestinal disorders but especially enjoy the challenges and intricacies of Crohn’s disease and Ulcerative Colitis.
- “What Is Acid Reflux Disease?” WebMD. http://www.webmd.com/heartburn-gerd/guide/what-is-acid-reflux-disease
- “Heartburn vs. Acid Reflux.” Healthline.com. http://www.healthline.com/health/gerd/heartburn-vs-acid-reflux#Overview1