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Why Wont My Heartburn Go Away

If Your Heartburn Lasts Longer Than Two Weeks

How do you treat heartburn that won’t go away?

Occasional heartburn may not require a visit to the doctor, but if you have heartburn that occurs several times a week, for more than two weeks, then it’s time to go to the doctor. For most people, the symptom can be controlled with either over-the-counter or prescription medications. However, in rare instances, that constant heartburn can indicate a far more serious condition. Because heartburn damages the esophagus tissue, you may be at risk for a precancerous condition known as Barrett’s esophagus. That, in turn, puts a person at risk for esophageal cancer, which is the fastest-growing cancer in the United States . To determine the extent of esophageal damage, a doctor will perform an endoscopy, in which a tube is slid down the throat to the esophagus. In some cases, surgery to reinforce the esophageal sphincter may be recommended, so if you suffer from heartburn very frequently, consult your doctor.

Find Out The Differences Between The Two

Acid Reflux and GERD are tied closely togetherbut most people arent aware of what differentiates them. Here’s an easy way to know the difference: Acid Reflux occurs when the acid in your stomach backs up, or refluxes, into your esophagus, causing heartburn. And Gastro-Esophageal Reflux Disease is chronic or recurring acid reflux.1

Many things can cause acid reflux, including foods like coffee and chocolate, being overweight or pregnant, or eating too much or too quickly.

But what’s actually happening inside you? At the entrance of your stomach is the lower esophageal sphincter, a ring of muscle that opens to let food in and closes tight to keep food and acid in the stomach. If this muscle doesn’t close all the way or opens too often, acid can flow back into your esophagus, causing heartburn.

Its Interfering With Your Life

For any symptom, its a good idea to get in touch with your doctor if its having a negative impact on your life. If your heartburn is persistent and isnt helped by medications, is causing you to modify your lifestyle to deal with the pain, or is keeping you from sleeping, working, or relaxing, its time to figure out whats really going on. Not only will it preserve your health in the long run, but youll feel better, too.

Read Also: How Do I Reduce Heartburn

Medicines That Can Help

We’ve come a long way in the treatment of indigestion, heartburn and peptic ulcers, and it’s all down to advances in medicines.

When I was a medical student, it was fairly common for people to need surgery to control their symptoms – these days tablets like PPIs keep acid under control much better.

Sometimes a germ calledHelicobacter pylori can make indigestion worse. Your doctor may perform a breath, stool or blood test for this and if necessary, give you a one-week course of treatment with three different tablets to get rid of it. This doesn’t always work and it involves taking several tablets a day and often having to avoid even a sip of alcohol for a week, but it can greatly reduce the chance of symptoms returning.

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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Learn About The Latest Treatments For Chronic Heartburn And Acid Reflux

Tasting your food once is great. Tasting it twice not so much.

If you have gastroesophageal reflux disease , this may be your reality at every meal. But eating doesnt have to become a constant game of trying to balance eating what you want with avoiding reflux symptoms. With a few changes to your lifestyle and access to the latest medical treatment methods, you can finally put your GERD symptoms to rest.

Its easy to brush off reflux symptoms, especially if theyre mild but excessive GERD symptoms are something that should be taken seriously, explains Dr. Robert Purcell, a gastroenterologist at Geisinger Gastroenterology/Endoscopy Montoursville.

If your GERD symptoms are interfering with your daily life or drastically restricting what you can eat, talk with your doctor about treatment options.

Taking H2 Blocker Or Antacids Only

Antacids such as Sucralfate, Magnesium hydroxide, or Aluminum hydroxide act locally by neutralizing The acid inside your stomach.

Heartburn wont go away if you are only taking antacids. This is because antacids are not the standard acid reflux treatment. They dont inhibit acid secretion and they are short-acting.

Also, The same goes for H2 blockers . H2 blockers are generally weak medications Compared to the standard GERD medications .

H2 blockers, when used long term, can develop a phenomenon called paraphylaxis. Paraphylaxis means decreased efficacy of the drug after a period of intake. with H2 blockers, paraplylaxis can develop within 10. days.

A refractory GERD is considered when you dont respond to the standard GERD medication which is a proton pump inhibitor such as Omeprazole .

But what if your heartburn is not going away with The standard PPI treatment? Keep reading the next section to figure out why This can occur.

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Antacids Or Otc Drugs Dont Help

If antacid medications stop working to soothe your heartburn, or if they never worked in the first place, your heartburn may have progressed to GERD, or gastroesophageal reflux disease. With GERD, the stomach acid washing up into your esophagus that causes the burning sensation essentially goes out of control, and untreated GERD can lead to further problems like dyspepsia and esophagitis.

Gerd: Relief From Gerd

Why won’t my back pain go away?

Topic: Irritable Bowel Syndrome , June 2000

Dr. Lee:A viewer suffers from nausea and stomach burning every night after supper. The only thing that relieves the symptoms is a medication called Gravol. He has tried Prilosec and Pepcid AC without symptom relief. What do you think?

Dr. Marks: Gravol is an antihistamine, diphenhydramine, to be exact, and I don’t know why it would be effective in acid reflux orGERD. It is not one of the mainstays of treatment.

The symptoms of GERD usually respond to optimal treatment with medications such as Prilosec and Pepcid. In fact doctors sometimes use acid-suppressing medications as a diagnostic test. If the symptoms go away the problem is likely have been due to acid reflux.

If symptoms do not go away with acid suppressing medications such as Prilosec or other PPI drugs, there are two possible explanations. First, the symptoms may be due to something else other than GERD. Second, the medications are not adequately shutting off the production of stomach acid. This can occur in as many as 1 out of every 5 or 10 patients.

Esophageal pH monitoring can be used to determine why acid suppressing medications are not working. If the pH monitoring study performed while the patient takes his or her medication for reflux shows abnormal amounts of reflux, then treatment is inadequate and needs to be changed .

Dr. Marks: That is certainly true. For detailed discussion of the diagnostic tests for GERD, please refer to our GERD article.

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Theres More To Heartburn Than You Think

  • Theres More To Heartburn Than You Think

Heartburn very common, and the discomfort that most people feel is not something to be worried about. But what if it wont go away? At what point does heartburn become a cause for concern? Do you find yourself reaching for over the counter antacids regularly? Do you experience discomfort after having a large meal? Do you find yourself reacting poorly and being uncomfortable after eating certain foods? You might be experiencing a number of GI issues involving some combination of the esophagus and stomach acid, all of which have similar symptoms but varying causes and treatment paths. These disorders include acid reflux, heartburn, and GERD.

How To Identify Heartburn

Heartburn has nothing to do with your heart. Its a condition that occurs in the esophagus when a small amount of stomach acid escapes your stomach and sits in your lower esophagus. The acids create an uncomfortable burning sensation that, because of its location near the heart, has been given the name heartburn.

Mild heartburn can pop up on occasion for a variety of reasons, but sometimes it can hinder your regular daily activity. If it gets that intense, or it seems like it wont go away or is consistent over many days, it is important to have it checked.

Read Also: What To Take To Prevent Heartburn

How A Doctor Can Help

If you have heartburn two or more times a week and changes to your diet or eating pattern haven’t helped, consult a doctor. A gastroenterologist can perform tests to measure the acidity in your stomach and see if frequent acid reflux has damaged your esophagus.

GERD is often treatable through a combination of lifestyle changes and medication. But persistent symptoms of reflux need thorough evaluation by a gastroenterologist who can find the underlying cause and discuss available treatment options.

The Johns Hopkins Heartburn Center

GERD is an ongoing condition that often requires more attention than over-the-counter treatments can offer. The Heartburn Center at Johns Hopkins Medicine provides personalized care to help patients find relief.

Serious Conditions That Mimic Heartburn

Heartburn-like pain is a common symptom of gastroesophageal reflux disease . But several other conditions can cause a burning feeling in your chest.

Most of the time, your doctor will be able to identify whether you have heartburn or GERD by doing tests.

Here are nine other conditions that can cause heartburn-like pain.

1. AnginaAngina, or chest pain caused by lack of blood flow to the heart, can feel a lot like heartburn.”The major key is if you’re getting heartburn when you’re doing strenuous or moderate activity,” says Dr. Ryan Madanick, a gastroenterologist and assistant professor of medicine at the University of North Carolina School of Medicine, in Chapel Hill.

If you’re 50 or older and getting heartburnespecially if you haven’t had this kind of pain beforeit can raise suspicion of angina. Suspicions can also be raised if you’re younger but have heart risk factors such as hypertension, diabetes, or a family history of heart disease.

2. GallstonesAlthough gallstones don’t always cause symptoms, a stone blocking your bile duct can hurt, usually in the middle or upper-right side of the abdomen.

Pain may be cramping, dull, or sharp, and often strikes minutes after you eat.

3. Stomach UlcerUlcers can cause a gnawing, burning sensation, usually felt in the upper abdomen. The pain can find its way up to the chest, Madanick says.

Certain anti-inflammatory drugs , and osteoporosis drugs called bisphosphonates, can also cause stomach ulcers.

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What Are Prescription Medications For Heartburn

If over-the-counter antacids and acid blockers do not relieve your heartburn, your healthcare provider may give you a prescription for other medicines, such as:

  • Prescription-strength acid blockers: In prescription-strength , Zantac®, Tagamet®, Pepcid® and Axid® can generally relieve heartburn and treat GERD.
  • Proton pump inhibitors: These are drugs that block acid production more effectively. Proton pump inhibitors include Aciphex®, Nexium®, Prevacid®, Prilosec® and Protonix®.

There are some proton pump inhibitors that can be purchased over-the-counter. Talk to your healthcare provider about these medications and what is best for you.

What Else Should I Know

Early diagnosis and treatment can help reduce or even stop uncomfortable GERD symptoms. Untreated GERD can cause permanent damage to the esophagus.

You’ll probably find that one of the simplest ways to make living with GERD easier is to avoid the things that trigger your symptoms. Some people will have to limit certain foods others may have to give them up entirely. It all depends on your symptoms.

It can be hard to give up sodas or favorite foods at first. But after a while, lots of people discover that they feel so much better that they don’t miss the problem foods as much as they thought they would.

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Medications To Treat Gerd

Antacidsconstipation

Antacids are often the first type of drug doctors recommend to relieve heartburn and other less-severe symptoms of GERD.

Widely used antacids include Mylanta , Rolaids , and Tums .

H2 blockers These drugs work by reducing acid production. They dont offer relief from symptoms as quickly as antacids, but they can work for up to 12 hours. They may also help heal your esophagus, although not as well as other options.

Your doctor may recommend both an antacid and an H2 blocker to treat heartburn after meals.

OTC options in this category include Tagamet and Pepcid . A stronger version of Pepcid is available with a prescription.

Proton pump inhibitors These drugs greatly reduce acid production, offering relief from symptoms and helping your esophagus heal.

Clostridioides difficileC. diff

OTC options in this category include Prilosec , Prevacid , and Nexium , and may be used for short-term treatment. Longer-term use should be guided by your doctor given the risks noted above. Prescription-strength versions of Prilosec , Prevacid , and Nexium , as well as Protonix , Aciphex , and Dexilant are available with a prescription.

Avoid Food Before Bedtime

Breathe Away Occasional Heartburn Ayurvedically

Late-night snacking is never a good idea if you have GERD. When you lie flat after eating, gravity forces the contents of your stomach closer toward the LES . If you eat a lot of food, the pressure against the LES increases even further.

To avoid this, avoid eating or drinking at least two hours before bedtime. If you have severe GERD symptoms, you may want to stop four hours beforehand.

Eating earlier meals not only ensures that the stomach is empty while sleeping but also reduces the level of nocturnal stomach acids, according to a 2011 study in the Journal of Neurogastroenterology and Motility.

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Gerd Diet: Foods That Help With Acid Reflux

Getting a case of acid reflux once in a while isn’t unusual, but some people suffer from burning discomfort, bloating and belching almost every time they eat. About 20% of the population has gastroesophageal reflux disease , a chronic acid reflux condition that’s diagnosed by a doctor.

Normally, the esophageal sphincter protects the esophagus from stomach acid. However, if the sphincter relaxes, food can push upward through the loosened opening and cause acid reflux.

“Diet plays a major role in controlling acid reflux symptoms and is the first line of therapy used for people with GERD,” says Ekta Gupta, M.B.B.S., M.D., gastroenterologist with Johns Hopkins Medicine.

How Is Gerd Diagnosed

Tell your parents and visit your doctor if you’ve had heartburn that doesn’t seem to go away or any other symptoms of GERD for a while.

The doctor will do an exam and ask about your symptoms. If the doctor suspects GERD, you might go see a pediatric gastroenterologist. This is a doctor who treats kids and teens who have problems of the gastrointestinal system.

Doctors sometimes order these tests to diagnose GERD or rule out other possible problems:

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Watch What You Eat Drink And Do

Making some changes to your lifestyle can go a long way toward easing the pain of heartburn.

Say goodbye to cigarettes. Smoking causes your body to make less saliva, a liquid that helps stamp out stomach acid. That can lead to burning in your esophagus. Tobacco may also cause your stomach to make more acid and relax the muscles at the lower end of your esophagus that can shut down the opening between the stomach and the esophagus. Chewing gum and sucking on lozenges can help you make more saliva.

Avoid trigger foods. For many people, these are spicy and high-fat foods, chocolate, peppermint and other mints, coffee, citrus fruits or juices, tomato products, carbonated drinks, and onions.

Donât lie down after you eat. If you need an afternoon siesta, snooze upright in a chair. Eat dinner at least 2-3 hours before you go to bed, and donât make the last meal of the day your biggest one.

Raise the head of your bed. If the top of your bed is higher than the bottom, itâs harder for the acid to travel up. You can do this with a block of wood under the bed or a foam wedge under the mattress.

Be careful what medications you use. Aspirin, ibuprofen, and other medications, such as some sedatives and blood pressure drugs, can trigger heartburn. Ask your doctor if any of your medications might be causing your symptoms. There may be something else you can take.

Wear loose clothing. Tight clothing, including belts, can cause stomach contents to push upward.

When Should I Call My Doctor About My Heartburn

Even though heartburn is common, it can sometimes lead to more serious health problems. Severe, chronic heartburn has been linked to inflammation and narrowing of the esophagus, respiratory problems, chronic cough, GERD, and Barretts esophagus, which may lead to esophageal cancer.

You should contact your doctor if:

  • Your heartburn wont go away.
  • Your heartburn symptoms become more severe or frequent.
  • Its hard or hurts to swallow.
  • Your heartburn causes you to vomit.
  • You have had substantial, unexpected weight loss.
  • You take over-the-counter antacids for more than two weeks and you still have heartburn symptoms.
  • You have heartburn symptoms even after taking prescription medicines.
  • You have serious hoarseness or wheezing.
  • Your discomfort interferes with your lifestyle or daily activities.

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