Treating Heartburn And Gerd
Heartburn is a feeling of burning pain in your lower chest, behind the breastbone. It comes from acid backing up from your stomach to your throat. You may have seen ads for heartburn drugs, such as Nexium, Prilosec or Prevacid. These drugs are called PPIs . They keep the stomach from making too much acid. They have been shown to heal irritation of the tube between the throat and the stomach .
In most cases, you dont need a PPI for heartburn. You can get relief from a less powerful drug. And when you do need a PPI, you should take the lowest dose for as short a time as possible. Heres why:
Note The Time Your Heartburn Symptoms Occur
Think, too, about when the heartburn occurs. Galier says if it happens after a big meal, and it’s just the burning in the chest, with no other symptoms, itâs more than likely heartburn or indigestion. But if you have any doubt, it’s wise to ask your doctor for an evaluation.
“If you have chest pain after a meal, it’s more likely to be reflux,” agrees Glenn Eisen, MD, MPH, professor of medicine and director of endoscopy at the Oregon Health & Science University in Portland. But that’s not a perfect test, he says. “It could be cardiac.”
Phil Katz, MD, says that knowing what “classic” heartburn is like may help. Katz is president-elect of the American College of Gastroenterology and clinical professor of medicine at Jefferson Medical College in Philadelphia.
âThe classic heartburn symptom,â he tells WebMD, âis burning that starts at the upper stomach or lower breastbone and progresses upward and occurs after a meal or when bending over.” He adds, “It’s rapidly relieved by an antacid within a few minutes.â
Food And Lifestyle Habits Can Cause Stomach Acid To Flow Back Up
Heartburn occurs when the contents of your stomach flow up into your esophagus.
A ring of muscle at the end of your esophagus where it joins your stomach known as the lower esophageal sphincter normally prevents your stomach contents from flowing back up into your esophagus by tightening after you swallow food.
But sometimes this muscle doesn’t tighten completely, and the entrance to your stomach doesn’t fully close. When this happens, stomach acid can enter your esophagus and cause heartburn.
There is a wide range of potentially problematic foods and other factors that can contribute to heartburn.
Foods that can trigger heartburn for many people include:
- Tomatoes and tomato-based foods, including ketchup and sauces
- Coffee and other caffeinated beverages
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What Is Ranitidine And Which Products Are Affected
Ranitidine is available both over the counter and by prescription. It belongs to the class of drugs known as H2 blockers. OTC ranitidine is commonly used to relieve and prevent heartburn. Prescription strengths are also used to treat and prevent more serious ulcers in the stomach and intestines. Multiple companies sell generic versions of both the OTC and prescription products.
So far, only Novartis/Sandoz and Apotex have recalled products. Ranitidine distributed by other companies remains on store shelves.
Health Canada, a federal department within the Canadian government, has asked all companies to stop distributing ranitidine drugs there, indicating that current evidence suggests that NDMA may be present in ranitidine, regardless of the manufacturer. France has taken the step of recalling all ranitidine products.
How Is Gerd Treated
Treatment for GERD depends on how severe symptoms are. For some people, treatment may just include lifestyle changes, such as changing what they eat or drink. Others will need to take medicines. In very rare cases, when GERD is particularly severe, a doctor will recommend surgery.
These lifestyle changes can help ease the symptoms of GERD or even prevent the condition:
- quitting smoking
- losing weight if you are overweight
- eating small meals
- avoiding carbonated beverages
- avoiding foods that trigger reflux
It also can help to not lie down for 3 hours after a meal and to not eat 2 to 3 hours before going to bed. Doctors sometimes also recommend raising the head of the bed about 6 to 8 inches. Before you start a major bedroom makeover, though, talk to your doctor and your parents about the best sleeping position for you.
If symptoms continue, doctors might prescribe medicine, such as:
- H2 blockers, which can help block the production of stomach acid
- proton pump inhibitors, which reduce the amount of acid the stomach makes
- prokinetics, which help the esophageal sphincter work better and the stomach empty faster. This can prevent reflux episodes.
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Is There Anything Besides Eating That Leads To Heartburn
Besides eating a heavy meal, heavy lifting can cause heartburn, says Galier. So can exercise. And lying flat, especially after eating a big meal, can lead to heartburn, too.
People who are overweight or obese are more likely to suffer, Eisen says, noting that some people think only obesity raises heartburn risk. He also points out that pregnant women can suffer heartburn. He says thatâs probably because elevated levels of the hormone progesterone cause a temporary weakness in the LES.
Things Doctors Do When They Have Heartburn
Large meals. Acidic foods. Alcoholic drinks. What do these things have in common? They’re often found at holidays and celebrations â and they’re also common heartburn triggers.
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Of course, triggers are individual, gastroenterologist David Poppers, MD, PhD, clinical professor in the department of medicine at NYU Grossman School of Medicine, tells LIVESTRONG.com. Yours might be something totally different, like onions, garlic, caffeine, chocolate or eating close to bedtime.
Whatever the culprit, stomach acid bubbling back up into your esophagus leads to that burning sensation in your chest, and it’s mighty unpleasant.
The best remedy for heartburn is to practice moderation when eating, especially when it comes to your trigger foods. Maintaining a healthy weight, and particularly avoiding excess visceral fat , is also important, Dr. Poppers says.
Of course, we’re not all perfect â even gastroenterologists aren’t immune to heartburn. So, we asked them how they handle it, as well as the best advice they give patients. Here’s how to feel better fast :
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What Kinds Of Complications Are Caused By Frequent Heartburn
- Excess stomach acid in the esophagus can cause ulcers, damage to the inner layers of the esophageal wall, and narrowing .
- Very rarely, the esophagus may bleed or tear completely because it is so damaged. In severe cases, a person may vomit blood or have small amounts of blood in bowel movements, found only on testing the stool.
- Regurgitated stomach acid can damage the respiratory tract, causing asthma, hoarseness, chronic cough, sore throat, or tooth damage . A person may feel as if he or she has a lump in the throat.
- If the acid exposure continues for long periods of time, the esophagus becomes thick and damaged. A person may then have difficulty swallowing and food becomes stuck.
Six Signs Your Heartburn Could Be Something More Serious
That burning, uncomfortable sensation in your chest? Itâs probably heartburn. Heartburn is a very common ailment that affects many people for many reasons. It occurs when digestive acid escapes the stomach and irritates the delicate lining of the esophagus.
Usually, itâs the result of eating certain foods, or simply overeating, and can be treated with over-the-counter antacids. But sometimes, heartburn is a symptom of bigger problems, that require other solutions. Hereâs when to call a doctor:
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When To Connect With Health Care Provider
Dr. Graf said if these tips dont get your symptoms under control, or if youre experiencing regurgitation, you should talk to your primary care provider or a gastroenterologist. Its important to get treatment because GERD symptoms arent just uncomfortable. Acid can damage the lining of your esophagus. And over time that damage can lead to a condition called Barretts esophagus, which makes it more likely that you could develop esophageal cancer.
To put together a treatment plan, your doctor may start with an upper endoscopy. Thats a procedure where youre sedated, and a surgeon puts a scope through your mouth and into your esophagus and stomach to see if the acid has caused any damage. If theres no damage, you can likely have follow-up endoscopies when you have your colonoscopies. You can try prescription medications to control your GERD symptoms.
If your esophagus is damaged or inflamed, or if medication doesnt get your symptoms under control, your doctor may recommend surgery. Surgical treatments for GERD are very effective. They can give you significant relief and halt the progression of GERD, Dr. Graf said.
Whiskey And Acid Reflux
The whiskey family is an interesting case when it comes to alcoholic drinks for reflux sufferers.
In fact, they are all made from grains including wheat and can contain trace amounts of gluten.
Nowadays, theres a lot of buzz around gluten, and/or gluten-free foods/beverages.
So, whats the point?
Alcohol has to be consumed with moderation in all cases, both from reflux sufferers and healthy people.
However, its important to know that not all alcoholic drinks do the same when acid reflux is present.
Some drinks are more likely to determine heartburn episodes, while others behave differently.
Things are quite complex, thats wy informed decisions, and personal experience, are the key.
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Avoid Spicy Foods And Keep Some Dazzle In Your Diet With Low
The fiery feeling of heartburn is the last way you want to remember a great meal. But when your doctor says you have chronic heartburn caused by gastroesophageal reflux disease , you may worry that a bland and disappointing menu is in your future. “That may not be true,” says Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital. “The foods that trigger heartburn are different for everyone.” He suggests keeping a journal to determine which foods cause symptoms.
Some foods and ingredients may intensify heartburn, such as spicy foods, citrus, tomato sauces, and vinegar.
Fatty and fried foods linger longer in the stomach. That may increase stomach pressure and force open the muscles that keep stomach acid out of the esophagus.
Other common heartburn triggers include chocolate, caffeine, onions, peppermint, carbonated drinks, and alcohol.
Watch For These Signs Of Gerd
If you have GERD, along with heartburn you may also notice regurgitation at night. When you lay down after eating a heavier meal or drinking water before bed, you can wake up burping up acid, or feel acid in the back of your throat or mouth. These are classic symptoms of GERD, Dr. Graf said.
Less often, you might notice a chronic cough, hoarseness, a feeling that your voice gets tired quickly, or difficulty swallowing.
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What Are The Symptoms Of Acid Reflux And Oesophagitis
- Heartburn: this is the main symptom. This is a burning feeling which rises from the upper tummy or lower chest up towards the neck.
- Other common symptoms: these include pain in the upper abdomen and chest, feeling sick, an acid taste in the mouth, bloating, belching, indigestion and a burning pain when you swallow hot drinks. Like heartburn, these symptoms tend to come and go and tend to be worse after a meal.
- Some uncommon symptoms: these may occur and if they do, can make the diagnosis difficult, as these symptoms can mimic other conditions. For example:
- A persistent cough, particularly at night, sometimes occurs. This is due to the refluxed acid irritating the windpipe . Asthma symptoms of cough and wheeze can sometimes be due to acid leaking up .
- Other mouth and throat symptoms sometimes occur, such as gum problems, bad breath, sore throat, hoarseness and a feeling of a lump in the throat.
- Severe chest pain develops in some cases .
Why Do I Keep Getting Heartburn Every Day
The actual reason behind getting heartburn regularly and a few simple remedies
As the name suggests, many of us may think that heartburn is related to the heart. When we notice irritation in your esophagus, then we call it heartburn. The esophagus is the tube that forms a connection between our throat and stomach. The stomach acid formed can create a feeling of discomfort around the area of our upper belly.
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If You’ve Been Taking Medications For A Long Time
Occasional heartburn is often relieved with a simple antacid. However, if you’ve been devouring antacids for weeks and not seeing results, then see a doctor. You may require a stronger prescription medication.
Prescription medications for heartburn aren’t meant to be lifetime drugs, but many people treat them as such. Obviously, it’s difficult to stop taking something that relieves possible pain. While heartburn medications are generally safe, doctors do warn that there are some long-term side effects that are cause for concern. Because the drugs decrease your gastric acid, your body absorbs far less calcium from your diet than normal. As a result, you could be at a higher risk for experiencing a bone fracture or osteoporosis. While the benefits of staying on the drugs outweigh the risks for frequent heartburn sufferers, those who suffer from heartburn only infrequently should eventually taper off their use.
If severe heartburn occurs in a relatively young person, who faces a lifetime of taking prescription medications, doctors may consider surgery in which the upper part of the stomach is wrapped around the esophageal sphincter to strengthen it. Surgery is not recommended for everyone due to its invasive nature and due to studies that show that it might not be a permanent fix .
A Digestive Problem That Affects Roughly 18 Percent Of The Us Population
More than 60 million people in the United States experience heartburn at least once a month, according to the American College of Gastroenterology .
The group also notes that according to some studies, over 15 million Americans have heartburn symptoms every single day.
Heartburn is more common in older people and pregnant women.
In fact, between 17 and 45 percent of pregnant women report episodes of heartburn, according to a study published in September 2015 in the journal BMJ Clinical Evidence.
Harvard Medical School notes that according to one survey, 65 percent of people with heartburn experience symptoms both during the day and at night.
Among those who report nighttime symptoms, 75 percent experience trouble sleeping as a result, and 40 percent say that it affects their job performance the next day.
While both occasional and frequent heartburn commonly cause discomfort, only about 6 percent of the population has heartburn that causes ongoing functional problems, according to the ACG.
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Heres How To Control Your Symptoms
When your symptoms flare up, there are a few things you can try:
- Avoid foods that trigger your heartburn, especially in the afternoon or evening
- Elevate the head of your bed to enlist gravity to help fight regurgitation
- Take over-the-counter antacids like Tums or Rolaids, or acid suppressors such as Prilosec, Nexium, or Pepcid
What Causes Acid Reflux And Whom Does It Affect
The circular band of muscle at the bottom of the gullet normally prevents acid leaking up . Problems occur if the sphincter does not work very well. This is common but in most cases it is not known why it does not work so well. In some cases the pressure in the stomach rises higher than the sphincter can withstand for example, during pregnancy, after a large meal, or when bending forward. If you have a hiatus hernia , you have an increased chance of developing reflux. See the separate leaflet called Hiatus Hernia for more details.
Most people have heartburn at some time, perhaps after a large meal. However, about 1 adult in 3 has some heartburn every few days, and nearly 1 adult in 10 has heartburn at least once a day. In many cases it is mild and soon passes. However, it is quite common for symptoms to be frequent or severe enough to affect quality of life. Regular heartburn is more common in smokers, pregnant women, heavy drinkers, those who are overweight and those aged between 35 and 64 years.
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Opt For Losing Weight
Studies have shown that obese patients have gotten relief from heartburn symptoms after they lost weight. This is because the extra weight on your body puts a lot of strain on your stomach, which is not able to keep the acid down. This is why the acid starts to head up towards your esophagus. By getting into shape and losing some weight, you will not only get rid of heartburn without medications, but you will also start feeling healthier also.
How Long Heartburn Lasts
Heartburn can last anywhere from several minutes to a few hours, depending on the underlying cause.
For example, after eating a spicy meal, mild heartburn can last for as long as it takes to digest the food but the symptoms may reoccur a few hours after youve eaten, when you lie down in bed at night or when bending over.
Bending over allows gravity to help pull the acid from the stomach, potentiating the severity of heartburn symptoms. The symptoms often awaken a person during the night, while sleeping.
Occasional heartburn goes away on its own and can often be prevented by avoiding certain foods . But when heartburn is severe, it usually requires medical treatment.
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How Gastroenterologists Help With Gerd
The key to treating your GERD: a board-certified gastroenterologist
If you are suffering from chronic acid reflux, a specialist can help. GERD is a potentially serious condition, and it will not go away on its own. Untreated GERD can lead to inflammation of the esophagus and cause complications like ulcers, strictures and increased risk of Barretts esophagus, which is a precursor to esophageal cancer.
A gastroenterologist is a physician with specialized training in managing diseases of the gastrointestinal tract . Our gastroenterologists are fellowship-trained and qualified to diagnose GERD and help develop a meet your treatment plan.
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