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Heartburn (GERD)

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What is heartburn?

Heartburn is described as a burning-type pain in the lower part of the mid-chest, behind the breast bone, and in the mid-abdomen. Other conditions related to heartburn are acid reflux, acid indigestion, and Gastroesophageal reflux disease (GERD). The main symptom of GERD in adults is frequent heartburn. When acid reflux occurs, food or fluid can be tasted in the back of the mouth. When refluxed stomach acid touches the lining of the esophagus it may cause a burning sensation in the chest or throat called heartburn or acid indigestion.

What causes heartburn?

Many factors can contribute to heartburn including obesity, pregnancy, smoking, and anatomical abnormalities. Certain foods can make heartburn worse, such as:

  • citrus fruits

  • chocolate

  • drinks with caffeine or alcohol

  • fatty and fried foods

  • garlic and onions

  • mint flavorings

  • spicy foods

  • tomato-based foods, like spaghetti sauce, salsa, chili, and pizza

How is heartburn treated?

Both lifestyle changes and medications can provide relief from heartburn and prevent reoccurrence.

Lifestyle changes

  • If you smoke, stop.

  • Avoid foods and beverages that worsen symptoms.

  • Lose weight if needed.

  • Eat small, frequent meals.

  • Wear loose-fitting clothes.

  • Avoid lying down for 3 hours after a meal.

  • Raise the head of your bed 6 to 8 inches by securing wood blocks under the bedposts. Just using extra pillows will not help.

Medications

Your health care provider may recommend over-the-counter antacids or medications that stop acid production or help the muscles that empty your stomach. You can buy many of these medications without a prescription. Check with your provider before starting or adding a medication.

Antacids (Alka-Seltzer, Maalox, Mylanta, Rolaids, Riopan, Tums) are usually the first drugs recommended to relieve heartburn and other mild GERD symptoms. Antacids can have side effects including diarrhea or constipation.

Foaming agents (Gaviscon) work by covering your stomach contents with foam to prevent reflux.

H2 blockers (Tagamet HB, Pepcid AC, Zantac 75) decrease acid production. They are available in prescription strength and over-the-counter strength. These drugs provide short-term relief and are effective for about half of those who have GERD symptoms.

Proton pump inhibitors (Prilosec, Zegerid, Prevacid, Protonix, Aciphex, Nexium) are available by prescription. Prilosec is also available in over-the-counter strength. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms and heal the esophageal lining in almost everyone who has GERD.

Points to Remember

  • Frequent heartburn, also called acid indigestion, is the most common symptom of GERD in adults. Anyone experiencing heartburn twice a week or more may have GERD.

  • You can have GERD without having heartburn. Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing.

  • If you have been using antacids for more than 2 weeks, it is time to see your health care provider. Most doctors can treat GERD. Your health care provider may refer you to a gastroenterologist, a doctor who treats diseases of the stomach and intestines.

  • Health care providers usually recommend lifestyle and dietary changes to relieve symptoms of GERD. Many people with GERD also need medication. Surgery may be considered as a treatment option.

References: Adapted from: The National Digestive Diseases Information Clearinghouse (NDDIC), NIH Publication No. 07–0882, on 5/8/2012