Heartburn often happens after overeating, when bending over, or while lying down. Nearly everyone has occasional bouts of heartburn, that burning sensation in your chest or throat. But if you experience it often — a couple times a week or more — it may be a symptom of a serious condition. Before heartburn causes permanent damage, get in to see top gastroenterologist S. Radi Shamsi, MD, at Los Angeles Gastroenterology Clinic in Santa Monica, California. Dr. Shamsi uses only the latest diagnostic and treatment measure to help resolve your uncomfortable heartburn issues.
Heartburn happens when the acid in your stomach backs up into your esophagus, the muscular tube that runs from your mouth to your stomach. At the entrance to the stomach is a tight muscle that acts like a one-way gate when you swallow food. Sometimes this gate lets stomach acid pass back up. This is called acid reflux. Stomach acids can irritate your esophagus and give you heartburn, plus cause a bitter or sour taste in the mouth.
In some cases, yes. Your stomach has a special layer of mucus that protects it from the harsh acids it contains. The rest of your body does not. If heartburn is frequent or chronic, the tissues of your esophagus can be damaged.
Medical care is especially urgent in some cases of heartburn. Contact Dr. Shamsi immediately if your heartburn causes:
These can all be symptoms of serious conditions that require prompt medical care.
You already know if you're suffering from heartburn, so there's usually no need for any test to determine that. Most often, you’ll be advised to make some changes in your diet, modify your lifestyle, or sample some over-the-counter medications, to see if any of these can eliminate the problem.
If these options don't offer relief, you may need an upper GI endoscopy, which lets Dr. Shamsi examine your esophagus, stomach, and even the top of your lower intestine. You might also undergo an upper GI series, where you’ll drink a liquid that can be seen by X-rays. The muscle between your esophagus and stomach can be tested for strength, too.
Dr. Shamsi might use a capsule the size of a small bean, to measure the amount of acid in your system. This device transmits your information to a beeper sized receiver you wear on your belt. Then it passes harmlessly from your system in about 48 hours or so. Dr. Shamsi then studies the details on that receiver to get a diagnosis.
Heartburn can often be relieved through medications such as antacids and acid blockers, as well as changes in diet or lifestyle. In severe cases, surgery might be necessary as a last resort.
If heartburn is continuous, it may be a symptom of a more serious disease, such as gastroesophageal reflux disease (or GERD) or Barrett’s esophagus. Some stomach hernias can create heartburn, as can gastritis, and other gastrointestinal conditions.
Peptic ulcers, or those caused by the H. pylori bacteria, often produce heartburn as a symptom, too. To properly diagnose and treat any of these conditions, Dr. Shamsi will go perform a thorough medical exam.
Mild cases of heartburn, or occasional ones, can often be relieved by such simple means as avoiding large meals, caffeine, and fatty or fried foods. These foods lower pressure on the muscle between your stomach and esophagus. To avoid damaging that muscle, stop eating — or limit — spicy foods, citrus fruits, and tomato products. Any tight clothing, or activities such as lifting or straining, especially after eating, may prevent heartburn.
A high-protein, low-fat diet often helps, and if you are overweight, losing some of that extra weight can improve heartburn. Quitting smoking and limiting your use of alcohol are beneficial, too. Try not to lie down for three hours after eating, or if you need to, use blocks or wedges to raise the head of your bed a few inches.
Antacids can reduce the amount of acid your stomach makes and they can produce fast, temporary relief from heartburn. Unfortunately, depending on their makeup, they can also cause diarrhea or constipation. This can worsen whatever is causing your heartburn.
It’s better to choose an antacid that contains both magnesium hydroxide and aluminum hydroxide, instead of one or the other. Those containing calcium carbonate neutralize stomach acid better than most.
If antacids and changes to your lifestyle are unsuccessful in treating your heartburn, and it’s not a symptom of another treatable disease or condition, Dr. Shamsi may prescribe more powerful medications.
Some of these, like histamine-2 blockers, decrease the amount of acid your stomach makes. Others empty your stomach of food and acid more quickly, so less can back up into your esophagus. Some types of medication prevent your stomach from secreting very much acid at all.