Reflux/GERD

Reflux/GERD

Heartburn—Overview

(Gastroesophageal Reflux Disease; Gastro-oesophageal Reflux Disease [GORD]; GERD; Reflux, Heartburn)

by Swedish Staff and Contributors

See also:

• Heartburn—Adolescent

• Heartburn—Child

• Heartburn—Infant

• Heartburn—Children With Disabilities

Symptoms of Heartburn
When Should I Call My Doctor?
When Should I Call for Medical Help Immediately?
Heartburn Defined
What Causes Heartburn
Diagnosis
Treatment
Risk Factors
Prevention

Symptoms of Heartburn

Heartburn is a symptom of acid reflux – a condition in which stomach acid rises up into your esophagus (throat). Symptoms of heartburn may last a few hours or just a few minutes, and usually occur after overeating or lying down after eating a big meal. Common symptoms include:

  • A burning feeling that begins in your lower chest and moves up your throat
  • Bitter or sour taste in your throat
  • Food feels like it’s coming back up

Other symptoms and complications of reflux include:

  • Sore throat
  • Chronic cough
  • Hoarseness
  • Feeling of a lump in your throat
  • A sensation of choking when waking up
  • Asthma
  • Difficulty swallowing

Acid reflux can damage your esophagus if it persists. Symptoms of esophageal damage include:

  • Bleeding and ulcers in your esophagus
  • Vomiting blood
  • Black or tarry stools
  • Inflammation and scarring of your esophagus
  • Barrett's esophagus —a change in cells that line your esophagus and can lead to esophageal cancer
  • Dental problems—can occur as stomach acid wears down tooth enamel

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When Should I Call My Doctor?

Occasional heartburn is common, but if you experience heartburn two times or more a week or if you have symptoms of heartburn complications, make an appointment to see your doctor.

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When Should I Call for Medical Help Immediately?

Heartburn and chest pain caused by a heart attack can feel similar. Seek medical help immediately if you have:

  • Pressure or squeezing in your chest
  • Pain in your left shoulder, left arm, or jaw
  • Difficulty breathing
  • Clammy, sweaty skin
  • Weakness
  • Nausea
  • Lightheadedness
  • Pain that starts when you’re feeling stressed or during activity

Call for emergency help if you’re not sure what’s causing pain in your chest.

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Heartburn Defined

Heartburn, a burning sensation in your lower chest, is most often related to gastroesophageal reflux disease (GERD), but it can be caused by a number of medical conditions.

The cause of your heartburn will determine your treatment. In most cases, heartburn can be treated with lifestyle changes, medications or surgery.

Heartburn


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What Causes Heartburn

Heartburn is caused by stomach acid that rises up into your esophagus. A muscle at the top of your stomach allows food to enter the stomach. It also prevents food and acid from moving back up into the esophagus. Certain conditions can keep this muscle from closing completely, allowing acid to flow out. This causes heartburn.

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Diagnosis    

A physical exam is needed to diagnose heartburn. Your doctor will ask about your medical history and any symptoms you may be experiencing. Images of your esophagus or stomach may be taken with an upper GI series. A sample of your esophagus may be taken and sent for examination. This is often done during a procedure called an endoscopy.

Other tests may include:

  • 24-hour pH (acid) monitoring
  • Manometry to test muscle strength in your lower esophagus

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Treatment 

Treatment will depend on what’s causing your heartburn. It may focus on repairing damage that’s causing the heartburn or preventing heartburn from occurring. Talk to your doctor about the best treatment options for you.

Lifestyle Changes

To help reduce your incidence of heartburn:

  • Eat smaller portions.
  • Allow at least 2-3 hours between meals and exercising or lying down.
  • Keep a food diary – a record of what you eat and how your body reacts. Make gradual changes to your diet and record the results of those changes.
  • Avoid foods that trigger heartburn symptoms.
  • Lose weight.
  • Don’t smoke.
  • Avoid wearing belts and clothing that fit too tight and can increase pressure on your abdomen.
  • Elevate the head of your bed 6-8 inches.

Medication

Many heartburn medications are available over-the-counter that can help relieve heartburn symptoms and repair damage to your esophagus. Medications your doctor may recommend include:

  • Proton-pump inhibitors which block acid production in your stomach
  • H-2 blockers which decrease the amount of acid secreted by your stomach
  • Antacids which can neutralize stomach acid

Procedures

Surgery may be an option for you if heartburn symptoms are severe and you cannot tolerate medication.
A fundoplication is the most common surgery for heartburn. This procedure involves your doctor wrapping your stomach around your esophagus to create pressure on the muscle at the opening to the stomach.

Endoscopic Procedures

During an endoscopic procedure, your doctor will insert a lighted device called an endoscope through your mouth and down your esophagus. The doctor can perform one of a variety of procedures with this scope to decrease the backward flow of stomach acid into your esophagus. An advantage of endoscopic techniques is that they do not involve incisions in your skin.

If endoscopy or surgery is successful, you may no longer need heartburn medication.

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Risk Factors    

Risk factors that can increase your chance of developing heartburn include:

  • Exercising or strenuous activity immediately after eating
  • Lying down, bending over, or straining after eating
  • Obesity
  • Smoking
  • Pregnancy
  • Diabetes

• Prior surgery for heartburn such as vagotomy

  • Scleroderma
  • Certain nervous system disorders
  • In-dwelling nasogastric tube
  • Drinking alcohol, caffeinated beverages or carbonated soft drinks
  • Eating chocolate, citrus fruits, foods made with tomatoes and fried or spicy foods

Supplements and medications associated with heartburn include:

  • Anticholinergics
  • Nitrates
  • Theophylline, bronchial inhalers, and other asthma medications
  • Calcium channel blockers
  • Bisphosphonates
  • Sildenafil

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Prevention   

Currently, there are no guidelines for the prevention of heartburn.


This content was created using EBSCO’s Health Library. Edits to original content made by Swedish.

Diagnosis and Treatment

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