Living With Acid Reflux

What is heartburn?
Heartburn doesn’t actually affect the heart as the name would imply. Instead, heartburn is a burning feeling in the lower chest that is often accompanied with a sour or bitter taste in the mouth and throat. It typically occurs after eating a large meal or when lying down. The painful sensation can last for a few minutes or a several hours.

What are the causes of heartburn?
When eaten, food passes from the mouth down a tube (that is about 10 inches long) called the esophagus. On this trip, the food must pass through an opening between the esophagus and stomach. This opening acts like a valve that allows food to pass into the stomach.

Usually, this opening closes after food passes through. However, if it doesn’t close completely, the acid from your stomach can backup into the esophagus. This is called acid reflux. The stomach acid can irritate the esophagus and cause the burning.

What is a hiatal hernia?
Hiatal hernia is an abnormal condition in which part of the stomach is pushed up through the diaphragm (the muscle wall between the stomach and chest) and into the chest. Sometimes this condition causes heartburn.

What factors worsen heartburn?
Many factors can make heartburn worse. Heartburn is common after overeating food, when bending over or when lying down on a flat surface. Other factors include pregnancy, clothing that’s so tight it puts pressure on your stomach, stress and certain foods. The list below shows other things that can aggravate heartburn symptoms.

Things that worsen heartburn

• Cigarette smoking

• Coffee (regular or decaf) and other drinks that contain caffeine

• Alcohol

• Citrus fruits

• Tomato products

• Chocolate, mints or peppermints

• Fatty foods or spicy foods (pizza, chili, curry)

• Onions

• Excess weight

• Aspirin or ibuprofen

• Some other medicines (check with your doctor)

Is heartburn serious?
If someone has heartburn now and then, it is probably not serious. However, if heartburn is frequent, it can lead to esophagitis (inflamed lining of the esophagus). When esophagitis becomes severe, the esophagus can narrow and might bleed or cause difficulty with swallowing.

More than occasional heartburn is often a symptom of acid reflux disease, gastroesophageal reflux disease (GERD), an inflamed stomach lining (gastritis), hiatal hernia or peptic ulcer.

What to do to feel better?
The first step to avoid heartburn is to make some lifestyle changes. The list below shows several tips on how to prevent heartburn.

Tips on preventing heartburn

• Place 4- to 6-inch blocks under the legs at the head of your bed.

• Try to eat at least 2 to 3 hours before lying down.

• Lose weight if overweight.

• Don’t overeat.

• Eat high-protein, low-fat meals.

• Avoid very tight clothes and tight belts.

• Avoid foods and liquids that give you heartburn.

Will antacids resolve heartburn?
Antacids neutralize acid that is in the stomach. For most people, antacids that are available without a prescription (over-the-counter) give quick, short-term relief.

However, antacids can sometimes cause diarrhea or constipation. For best results, look for antacids that contain both magnesium hydroxide and aluminum hydroxide. Some brands of antacids include Maalox, Mylanta and Riopan. Follow the directions printed on the package.

What to do if my symptoms get worse?
If lifestyle changes and antacids don’t resolve your symptoms, talk with your doctor. Your doctor may want you to take perscription medicine or schedule you for some specific tests.

Tests might include an abdominal x-rays to check for ulcers, a pH test to check for acid in the esophagus, or an endoscopy to check for other conditions. During an endoscopy, a specially trained doctor can look into your stomach and through a long, thin tube which is inserted down your esophagus. Another test may check for H. pylori, a bacteria in the stomach that can cause ulcers.

What about medicines for heartburn?
Several families of medicine can be used to treat heartburn. H2 blockers reduce the amount of acid your stomach makes. Several are available without a prescription.

Other medicines called Proton Pump Inhibitors, such as omeprazole (brand name: Prilosec) and lansoprazole (brand name: Prevacid), also reduce how much acid the stomach makes.

Is heartburn associated with a heart attacks?
No. However, some pain in the chest may be mistaken for heartburn symptoms when it is really a sign of heart disease.

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