Heartburn: When to See a Doctor

According to a 2012 article published on Healthline, 60% of the adult population will experience some type of gastroesophageal reflux disease (GERD) within a 12-month period. Those suffering from weekly symptoms are estimated at 20% to 30%. Approximately seven million people in the U.S. have some symptoms of GERD, aka acid reflux or heartburn.

For many people suffering from heartburn, watching what they eat, o.t.c. medications and stress reduction can bring relief. But when symptoms don't improve and start to interfere with sleep or daily life, it is time to get your doctor's help.
 
Your doctor will ask detailed questions about the nature and pattern of your pain, including:

  • Is it worse after you eat a heavy meal or eat certain food, such as high-fat foods or dairy products?
  • Does bending over to tie your shoelaces or lying down aggravate the symptoms?
  • Does the pain seem linked to anxiety or stress?

If your symptoms are typical for GERD, the first step is usually to try a medication such as omeprazole (Prilosec) or lansoprazole (Prevacid). If symptoms improve, you can switch to a less powerful medication. That might be an H2-receptor antagonist (H2 blocker) such as cimetidine (Tagamet), ranitidine (Zantac), or famotidine (Pepcid), or an antacid like Tums.
 
If, however, medication doesn't seem to help, your doctor might suggest some tests to confirm reflux or rule out other possible causes for your symptoms.
 
Be aware that reflux symptoms can be similar to heart attack symptoms. If what you feel is more like a constriction or pressure rather than burning, call your doctor. Even if you know you have reflux, always seek medical attention if you experience chest discomfort brought on by exercise. Pay attention to the severity and length of your chest pain. Severe, pressing or squeezing discomfort, especially if it lasts a while, also warrants a call to your doctor.

7 ways to get heartburn relief
Indigestion comes in a variety of forms, but it is a real phenomenon. The medical term for persistent upper abdominal pain or discomfort without an identifiable medical cause is functional dyspepsia, meaning "bad digestion." Sometimes after a meal, your stomach just doesn't "feel right." Or you may feel bloated and uncomfortable. It can take on the classic burning sensation we refer to as heartburn. Some people feel queasy or become nauseated. You might say you have an "upset stomach." The symptoms can come and go at any time, but often eating is the trigger. Sometimes the discomfort begins during the meal; other times, about half an hour later.

Functional dyspepsia afflicts women and men about equally, and is responsible for a significant percentage of visits to primary care doctors, in part because many people worry they might have an ulcer. While it's frustrating that the cause of functional dyspepsia is unknown, it's even more frustrating that there is no surefire cure.
 
The good news is that there are simple things you can try to help get some heartburn relief:

  • Avoid foods that trigger your symptoms.
  • Eat small portions and don't overeat; try eating smaller, more frequent meals throughout the day, and be sure to chew food slowly and completely.
  • Avoid activities that result in swallowing excess air, such as smoking, eating quickly, chewing gum, and drinking carbonated beverages.
  • Reduce your stress. Try relaxation therapies, cognitive behavioral therapy or exercise. An aerobic workout 3 to 5 times per week can help, but don't exercise right after eating.
  • Get enough rest.
  • Don't lie down within two hours of eating.
  • Keep your weight under control.

Harvard Health Publications, The Sensitive Gut, 2016

Healthline, June 30, 2012, “Acid Reflux (GERD) Statistics and Facts,”
by Julie-Ann Amos, medically reviewed by George Krucik, MD, http://www.healthline.com/health/gerd/statistics

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