Is it Heartburn, or Something Worse?
That fire in your chest could be gastrointestinal reflux (GERD), which can lead to other health problems
Heartburn, a.k.a. acid reflux, is no picnic. The stomach juices that wash up through the esophagus can be as strong as battery acid, which accounts for the telltale burning sensation in the chest and sour taste in the back of the throat. Still, occasional heartburn is nothing to worry about. Chronic acid reflux, on the other hand, can point to gastroesophageal reflux disease, or GERD, which may be cause for concern.
GERD can be tough to diagnose. Not everyone who develops it has or notices frequent heartburn. But GERD can cause or worsen other health problems, so if you develop any of the following symptoms, see your doctor:
Coughing, wheezing and hoarseness. If stomach acid gets into the lungs, it can lead to a chronic dry cough, wheezing, hoarseness or voice loss. GERD also can worsen asthma by irritating airways or increasing sensitivity to tobacco smoke or cold air, according to the American Academy of Allergy, Asthma & Immunology. (Asthma flare-ups and some asthma drugs, such as theophylline, can make reflux worse, too, meaning it’s not always clear which came first.) Breathing stomach acid into the lungs can even lead to “aspiration pneumonia.”
Trouble swallowing. GERD can cause ulcers to develop on the esophagus, leaving scars that make it tough to swallow. Worse, it can increase the risk of esophageal cancer by bringing about precancerous changes in the cells that line the esophagus.
Sleep troubles. Researchers at Thomas Jefferson University in Bethesda estimate that 15 to 30 percent of people who have trouble staying asleep may have GERD. In one study they found that taking sleeping pills made GERD worse, since they allowed people to sleep through symptoms instead of sitting up and letting digestive acids flow back into the stomach.
Nausea, pain, enamel erosion and more. Other possible signs of GERD include nausea, vomiting, chest or upper belly pain, bad breath, frequent sinus infections and erosion of teeth enamel.
Rx for reflux
Straightforward lifestyle changes can go a long way toward easing heartburn caused by GERD. For example, dropping excess pounds if you’re overweight may reduce pressure on the lower esophageal sphincter (LES), the muscular valve that separates the esophagus from the stomach. Quitting smoking helps, too. Smoking decreases acid-neutralizing saliva and also weakens the LES.
You also may get relief by eating smaller meals, having your last one at least two or three hours before bedtime and steering clear of foods that seem to trigger your heartburn. Although studies have yet to find a strong connection between specific foods and heartburn, according to the American Gastroenterological Society, some possible culprits are fried and fatty foods, chocolate, peppermint, alcohol, coffee, carbonated drinks, catsup and mustard, vinegar, tomato sauce and citrus fruits and juices.
Your doctor may recommend antacids and/or over-the-counter drugs that reduce acid production and help your esophagus heal. These include H2 blockers such as cimetidine (Tagamet HB) and famotidine (Pepcid ACT) as well as stronger proton-pump inhibitors such as omeprazole (Prilosec) and lansoprazole (Prevacid). Learn about the potential side effects of these drugs before you take one. Some cases of GERD may require surgery.