Ask a Doctor: Heartburn a real pain

Question: — I’m tormented frequently by heartburn. Why does this happen, and is there anything you can recommend? I really don’t want to take pills or drink anything for it. — Duke, Lima

Heartburn occurs when contents in the stomach, usually acid, migrate into the esophagus. It is a burning sensation felt behind the breast bone that occurs when the stomach contents cause irritation to the lining of the esophagus. Forty percent of Americans are impacted by GERD, which stands for Gastroesophageal Reflux Disease. Heartburn is one of the symptoms of GERD.

I would recommend first and foremost the following advice: Do not eat or drink for at least 2-3 hours before you go to sleep. Avoid carbonated beverages (pop). If you have symptoms at night, elevate the head of your bed by 6 inches. Bed risers can be purchased at the local drug stores and are inexpensive. It is a good idea to maintain a healthy body weight as obesity is a major cause of GERD.

In addition, other helpful advice would be to have smaller portions at meals and minimize fried foods and alcohol, especially before going to bed. Avoid juices including orange juice, grapefruit juice and other juices with citric acid. Tomato sauce and garlic also increase symptoms. Other foods include coffee, chocolate, spicy foods and peppermint. Tobacco products cause GERD as well.

You can also have anatomical causes such as a hiatal hernia or problems with your lower esophagus valve (sphincter) not closing properly.

So, to the heartburn sufferer, going out for a pizza and beer and having a chocolate mint for dessert will definitely cause significant symptoms.

Beware of taking antacids over the counter which are mint, spearmint or citrus fruit flavored. The antacid’s job is defeated by the flavoring, which can cause heartburn.

You should get an upper endoscopy or EGD if you have symptoms such as frequent heartburn, at least twice a week that interferes with your daily living, difficulty swallowing, upper abdominal pain, unexplained weight loss, GI bleeding, a family history of esophageal cancer or Barrett’s esophagus.

Males, especially white males, are at much higher risk of developing esophageal cancer and Barrett’s esophagus. Barrett’s esophagus is a precursor and the primary factor to the onset of esophageal cancer. Of those with chronic GERD, 26.5% may develop Barrett’s in their lifetime. Eighteen percent of people survive five years or more after being diagnosed with esophageal cancer.

Each year approximately 16,000 deaths will occur from esophageal cancer in the United States. Early detection of this condition can be performed by upper endoscopy by a gastroenterologist or some surgeons.

What can be done about these symptoms other than diet alone?

Assuming you don’t want to take any medications, there is a relatively new surgical procedure called the LINX which can prevent heartburn symptoms.

Dr. Jayde Kurland, Gastrointestinal Associates of Lima, Endoscopy Center West Central Ohio, 2793 Shawnee Road, Lima, OH 45805, 419-227-8209

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