Occasional bouts of heartburn are common and rarely serious. But if they happen two or three times a week for months, you should get in to see S. Radi Shamsi, MD, at Los Angeles Gastroenterology Clinic in Santa Monica, California. Your symptoms may be caused by gastroesophageal reflux disease (GERD). Your stomach has a lining that protects it against strong digestive acid, but your esophagus doesn’t. When acid backs up into your esophagus, you’ll feel heartburn. Plus if the valve that separates your stomach from your esophagus doesn't close properly, this keeps happening, damaging your esophagus. GERD is a chronic condition that may lead to more serious medical conditions, although it can usually be treated if caught in time. Dr. Shamsi gladly accepts new patients who suffer from GERD.
Between your esophagus and your stomach, you have a sphincter muscle that is normally closed. It opens to allow the passage of food into your stomach, but shuts at all other times to keep acid in your stomach.
If your sphincter — called the lower esophageal sphincter, or LES — opens at the wrong time or doesn't close properly, acid can regularly back up into the esophagus. This condition is called GERD.
While your stomach has a protective lining of mucous, your esophagus doesn’t. Your stomach's acid can damage your esophagus or make it raw. If left untreated, GERD can result in ulcers, bleeding, and scarring.
Heartburn that continues more than once a week for two or three months is the most common symptom of GERD. Regurgitation or retching is another symptom, as is having a sour, bitter taste in your mouth.
It’s possible to have GERD without these symptoms though, since everyone’s bodies react to the esophageal acid differently. GERD may also produce symptoms outside of your intestinal tract. These can include chronic coughing, damage to your dental enamel, a change in your voice, sinusitis, and others.
Your gastroenterologist, Dr. Shamsi, can determine if you have GERD, right in his office. Your medical history will be taken into account. You should provide him with information about how severe your symptoms are, when they occur, how long they last, and how often they show up. Let him know about your lifestyle and eating habits, as well as any over-the-counter medications you have used and what effect they've had.
It might be necessary for Dr. Shamsi to perform an endoscopy to see if your LES is performing properly, or to examine any damage to your esophagus. You may also be asked to drink a liquid that can be seen on an X-ray, or need to do other tests to determine the acid levels in your esophagus. Sometimes a tiny capsule is placed in your esophagus that transmits this information to a receptor you wear around your waist —like a beeper — before it harmlessly passes from your body.
The goal of any treatment is a threefold. Dr. Shamsi will first try to manage your symptoms, then heal any damage to your esophagus. Finally, treatment will focus on preventing any further damage.
Treating the symptoms is sometimes as easy as making some simple lifestyle changes. These changes can include modifying your diet, changing your resting habits, or even altering your wardrobe to avoid wearing tight garments.
Over-the-counter antacids can be helpful to neutralize stomach acid. Or Dr. Shamsi can prescribe other medications that protect your esophagus, limit the amount of stomach acid you produce, or cause your stomach to empty more quickly.