Heartburn The Most Obvious But Not The Only Symptom
I see kids almost every week who are experiencing the symptoms of heartburn. This is not a harmless condition but a harbinger of illness yet to come. And kids with heartburn often experience other signs of carbohydrate neurotoxicity as well.
Many have to urinate frequently, a sign of poor neurological control of bladder emptying. They may experience headaches, poor concentration, and fatigue while sitting in class, a sign of poor blood flow regulation to the brain.
Parents are often surprised when I get their children to admit to a variety of other symptoms once I hear about their heartburn. Kids dont complain much and just seem to suffer through it.
What Are The Complications Associated With Heartburn
Occasional heartburn isnt typically a cause for concern. However, frequent heartburn may be a symptom of GERD. This condition may require treatment with prescription medication or surgery.
If left untreated, GERD may lead to additional health problems, such as an inflammation of the esophagus, which is called esophagitis, or Barretts esophagus, according to a 2018 review . Barretts esophagus causes changes in the lining of the esophagus that can increase your risk of esophageal cancer.
Long-term heartburn can also affect your quality of life. See your doctor to determine a course of treatment if you find it difficult to carry on your daily life or are severely limited in your activities due to heartburn.
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What Can Trigger Heartburn
Heartburn can be triggered by many different things that are a part of your daily life. For many people, heartburn can be caused by certain eating and lifestyle habits. These habits can involve things like eating large portions of food, eating too close to bedtime or even having high stress levels.
Certain foods and drinks can also trigger heartburn for some people. Some foods and drinks that could trigger your heartburn can include:
- Caffeinated beverages.
- Carbonated beverages.
Your lifestyle habits can also play a part in why you might experience heartburn. These everyday factors often contribute to medical conditions that cause heartburn, like GERD or hiatal hernia. Some lifestyle habits that can trigger your heartburn include:
- Being overweight.
- Having a high stress level.
- Wearing tight clothes and belts.
When Is Heartburn Considered Gastroesophageal Reflux Disease
Its that familiar burning or painful sensation in the chest that pretty much everyone has experienced often enough to immediately declare it a case of heartburn. However, some people arent sure if what the heartburn they feel is normal or a more serious, common condition known as gastroesophageal reflux disease .
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What Is Gastroesophageal Reflux
Gastroesophageal reflux , also called reflux, is when food and acid from the stomach go back up into the esophagus. This causes an uncomfortable feeling in the chest, often called heartburn.
With GER, reflux happens after nearly every meal and causes noticeable discomfort. After eating, people with GER feel a burning sensation in the chest, neck, and throat.
While it’s more common in adults, kids, teens, and even babies can have gastroesophageal reflux.
Stop Heartburn And Acid Reflux
Fortunately, you have several options for heartburn relief:
- Try eating smaller meals, and don’t eat two to three hours before bedtime.
- Avoid foods that may trigger heartburn, such as fried food, citrus, tomato, spices, peppermint, chocolate, and carbonated drinks.
- Cut back on alcohol and caffeine.
- Stop smoking if you smoke.
- Lose weight if your doctor says you’re overweight.
- Cut back on aspirin and pain relievers if you take them often.
Talk with your pharmacist about other self-care tips you can use. If changing your style of eating isn’t enough, consider trying one of these heartburn medications.
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Signs You Should See The Doctor For Your Heartburn
There’s nothing pleasant about heartburn, which manifests itself as burning pain in the chest. Even a written description of why heartburn occurs is unpleasant: It happens when stomach acid is regurgitated back up through the upper body thanks to an esophageal sphincter not closing at the right time. To many of us, heartburn seems like just another unpleasant thing to endure, much like taxes, rush hour traffic and the contents of a baby’s diaper. For this reason, heartburn is often considered the Rodney Dangerfield of conditions, because it gets no respect. Most people don’t take it seriously enough to put down the over-the-counter medications and speak to their doctor about it. So when should you bite the bullet and make an appointment with your doctor?
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Preparing For Your Appointment
To prepare for your appointment, see the topicMaking the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
- What are your main symptoms? Report any symptoms, such as abdominal pain, a change in bowel habits, or vomiting.
- How long have you had heartburn?
- Have you had this problem before? If so, do you know what caused the problem at that time? How was it treated? How did you respond to that treatment?
- Have you had any signs of bleeding from your digestive system?
- Have you had any difficulty swallowing when you eat or drink?
- How much tobacco do you use? How much alcohol do you drink? How much caffeine do you drink?
- Has your weight increased or decreased more than 5 lb recently?
- Have there been any changes in your diet? Are you eating certain foods more often?
- Have there been changes in your daily schedule, such as when you eat and when you go to bed?
- Are you taking any nonprescription or prescription medicines? Bring a list of all the medicines you are taking to your appointment.
- What home treatment measures have you tried? Did they help? Be sure to include lifestyle changes you have made.
- What nonprescription medicines have you taken or used to treat your heartburn? Did they help?
- Do you have any health risks?
Remember to take your heartburn symptom record to your doctor visit. Be sure to note any lifestyle changes you have made or nonprescription medicines you use.
When To See A Healthcare Provider
You should see a healthcare provider to determine the underlying cause and for proper treatment if:
- You have constant heartburn that won’t subside
- Your symptoms of heartburn are becoming more severe or frequent
- You have taken an over-the-counter PPI for the recommended two weeks and your symptoms return
- You experience vomiting or difficulty swallowing with your heartburn
- You have hoarseness or wheezing
- You experience unexpected weight loss
You should seek care immediately if you vomit blood or material that looks like coffee grounds . You should also seek care immediately if you notice blood in your stools or have black or tar-like stools .
If your vomiting is large, green, yellow, or forceful, you should seek care urgently by going to an emergency room.
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Barretts Esophagus Risk Factors
Based on these risk factors and your medical/family history, your doctor may recommend screening for Barrettâs esophagus.
- Chronic Heartburn/Acid Reflux/GERD: Those who have chronic symptoms are more likely to develop Barrettâs esophagus.
- Age: Barrettâs esophagus is more common in middle-aged and older adults. 55 is the average age of diagnosis.
- Gender: Men are more likely to develop Barrettâs esophagus
- Ethnic Background: White and Hispanic populations are at higher risk than other populations. Black and Asian populations have a lower risk of developing Barrettâs esophagus.
- Smoking: Current and past smokers are more likely to develop Barrettâs esophagus.
Possible Remedies For Heartburn In A Woman
One of the most trusted treatments for heartburn is to control the unwanted production of stomach acids. Several lifestyle remedies can assist you to prevent heartburn such as:
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How Is Gerd Diagnosed
Often, your doctor can tell you have GERD by carefully evaluating your symptoms. It also helps the doctor if you keep a food journal and write down when you have your heartburn problems.
Sometimes, the diagnosis must be confirmed by doing an upper endoscopy, a pH probe test or a test using a Bravo capsule. The pH balances tell your doctor the level of acid in your throat.
What Happens During an Upper Endoscopy?
During this procedure, an endoscopea thin tube with a light and cameradown your throat to detect any inflammation of your throat. Dont worry: While you may feel some pressure as it passes down your throat, you should not feel any pain.
What Happens During a pH Probe Test?
A pH probe test measures the amount of stomach acid that comes up into your throat. This information is then relayed to a small computer that is typically worn around your waist.
What is the Bravo Capsule?
This is a wonder of medicine that sounds like something out of a science fiction movie. During an endoscopy, a small capsule, about the size of a gel cap is placed on the wall of your esophagus. It uses radio frequencies to send pH measurements to a receiver. The receiver is the size of a pager.
This information is then analyzed by your health care team. Youll also be asked to keep a daily journal of what you eat and when.
Progression To Esophageal Cancer
A small percentage of people with Barretts esophagus will develop cancer, and the number of cases in North America is rising.
Identifying cancer early really improves patient care and outcomes, says surgeon Richard Battafarano, M.D., Ph.D.
Cancer that has not spread to lymph nodes can be removed using minimally invasive endoscopic techniques. When the cancer is more advanced, surgical removal is required. In advanced cases, often when patients hadnt shown symptoms or been treated before the cancers discovery, chemotherapy or radiation treatments may be required before surgery.
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Excess acid collects in the stomach, not because of excess acid production but because the stomach isnt emptying as well as it should. Couple this with poor closure of the valve between the stomach and the esophagus and you end up with stomach acid splashing up into the esophagus. Its this combination of neurological problems that leads to heartburn or GERD .
Both of these problems are controlled by the autonomic nervous system . The ANS is a primitive part of the brain that controls all bodily organ function. It controls peristalsis that pushes food through the intestinal tract. It coordinates the muscles and valves of the bladder so we can empty the bladder efficiently. It even controls blood pressure regulation, sweating, pupil dilation and constriction, saliva production and erections.
A growing body of scientific evidence suggests that carbohydrates are having a toxic effect on the ANS and is the cause of such common problems as heartburn, constipation, frequent urination, chronic fatigue and lightheadedness.
When To See A Gastroenterologist
Sometimes its difficult to know when your symptoms are severe enough that you need to make an appointment with a gastroenterologist, and we understand that. Here are some indications that its time to call a gastroenterologist:
- Symptoms that continue for more than two weeks
- Heartburn that persists after taking over-the-counter medications
- Heartburn episodes that change in frequency or intensity
- Nighttime symptoms that affect your sleep quality
- Acid reflux that interferes with your daily activities or affects your quality of life
- Unexplained weight loss or decreased appetite
- Pain or difficulty swallowing
- Heartburn accompanied by nausea or vomiting
- Unexplained weight loss
- Chronic hoarseness or wheezing
If you experience any of the symptoms above, its time to see one of our gastroenterologists. After performing a complete medical exam, your gastroenterologist may recommend that you undergo an upper endoscopy to evaluate your symptoms and see if you have suffered any damage to your esophagus, or provide you with the peace of mind that everything is all right. During your visit, the doctor will examine the lining of your esophagus, stomach and duodenum to determine the cause of your digestive symptoms and the appropriate treatment.
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Are There Any Tests For Heartburn
If it is obvious from the symptoms that a person has heartburn, no tests or exams may be necessary. Advice in regard to lifestyle modifications, diet, or medications may begin immediately.
If your health care professional is not sure about the diagnosis, or if he or she is concerned about damage done by chronic heartburn, tests may be ordered. This is true especially if the patient has already been prescribed medications that are not relieving the heartburn.
There is no simple blood test for heartburn. The tests used to diagnose heartburn include the following:
How Do Antacids Work To Treat Heartburn
Antacids reduce the amount of stomach acid, relieving your heartburn. These medications can also be used to soothe stomach upset, indigestion and other pains in your stomach. Some antacids contain simethicone, which reduces gas. Antacids that you can get without a prescription include:
Make sure you always follow the instructions on the package or talk to your doctor about the right way to use an antacid. If you use tablets, chew them well before swallowing for faster relief.
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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.
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Tips To Keep Heartburn On The Backburner
To prevent occasional bouts of heartburn, try taking the following five steps:
1. Avoid eating within three hours of the time you go to bed.
2. Take any acid suppressant medication, such as a proton pump inhibitor, first thing in the morning. Because of the way proton pump inhibitor-type medications activate, its not helpful to take these medications at night on an empty stomach, says Brown.
3. Sleep on a slight incline, with your head elevated, and/or sleep on your left side. If you have chronic heartburn, falling asleep in the wrong position enables acid to sneak into the esophagus. Keeping your head raised slightly keeps that from happening. Studies have also found that while sleeping on the right side actually aggravates heartburn, flipping over to your left side is likely to calm it, although the reason why is unknown.
4. Avoid foods that may cause acid reflux, such as peppermint, coffee and chocolate. Interestingly, spicy foods havent been shown to cause heartburn, says Brown. And theres some evidence that spicy foods may actually protect the body from ulcers.
5. If you smoke or use other tobacco products, quit. Not only does smoking relax the lower esophageal sphincter, allowing stomach acid to move up into the esophagus where it doesnt belong, but it also can slow the production of saliva, which protects against acid in the esophagus.
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