THE INSIDE STORY ON HEARTBURN

Heartburn (AKA acid indigestion) is a hot or burning sensation felt at the base of the sternum or breastbone.

Heartburn may be mild and intermittent, but it may also be severe and be felt in other parts of the body. Fearing heart attack, sufferers often seek help in hospital emergency rooms. Daily heartburn is a common experience affecting about 7-10% of our population.

Heartburn, however, does not involve the heart at all. It is caused by a back flow of stomach contents into the esophagus. Swallowed food normally travels down the esophagus from the mouth to the stomach through a one-way valve called the esophageal sphincter. In certain situations, the valve may not function properly and the stomach contents may escape upward (acid reflux). A protective barrier of saliva, mucous and other fluids coats the esophagus and stomach. Heartburn occurs when this barrier fails.

Symptoms in addition to burning may be nausea, increased belching, feeling bloated, and persistent sore throat. These usually occur 1-2 hours after eating and may last several hours.

Risk factors:

• Some foods-chocolate, coffee, and onions, and tomato-based products such as spaghetti sauce and pizza
• Smoking
• Alcohol intake
• Some medications
• Overeating
• Tight restrictive clothing
• High-fat meals, overweight
• Pregnancy
• Exercising or lying down immediately after eating

Remedies:

• Eat smaller meals
• Decrease consumption of bothersome foods
• Avoid food and drink for 3-4 hours prior to lying down or exercising
• Lose weight if overweight
• Take necessary medications which cause symptoms with food
• Antacids and over-the-counter acid reducers such as Pepcid AC

If heartburn symptoms occur frequently, or if they become worse in spite of lifestyle changes, medical evaluation is advised. After an appropriate history and physical examination, a diagnosis is made, and your health care provider will suggest treatment. There are many prescription medications that can eradicate the symptoms. After a reasonable period of time (usually 2 to 6 weeks), if symptom control is not adequately achieved, further evaluation may be advised. This may include consultation with a specialist and/or additional tests such as Upper GI Series (X-ray) or esophagogastroscopy (a tube which allows direct visualization of the esophagus and stomach).

Heartburn or GERD (gastroesophageal reflux disorder) may be an intermittent or a chronic condition. The treatment goal is prevention of symptoms. Adequate treatment may also prevent progression to esophagitis or esophageal stricture and such complications as laryngitis, chronic cough and lung problems.

Questions regarding heartburn and other health problems may be addressed to Student Health Center personnel (775) 784-6598.

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