Acid Reflux & Heartburn Treatment
Heartburn
Acid Reflux & Heartburn
People who experience heartburn at least two to three times a week may have gastroesophageal reflux disease or GERD. The most common symptom of GERD is heartburn, which is estimated to affect 10 million adults in the United States on a daily basis. Patients experience heartburn as a burning sensation in the center of the chest, which sometimes spreads to the throat with an acidic taste. Less common symptoms include:
● Stomach pain (pain in the upper abdomen).
● Non-burning chest pain.
● Difficulty swallowing (called dysphagia), or food getting stuck.
● Painful swallowing (called odynophagia).
● Persistent sore throat.
● Persistent laryngitis/hoarseness.
● Chronic cough, new onset asthma, or asthma only at night.
● Regurgitation of foods/fluids; a taste of acid in the throat.
● Sense of a lump in the throat.
● Worsening dental disease.
● Chronic sinusitis.
● Recurrent lung infections (called pneumonia).
● Waking up with a choking sensation.
When to Seek Help
If you have difficulty or pain when swallowing, such as feeling that the food gets “stuck,” you may need to see a healthcare provider. Other signs and symptoms that should send you to a doctor include unexplained weight loss, chest pain, choking, dark-colored stools, or vomiting blood.
Acid Reflux Diagnosis
Acid reflux is usually diagnosed based upon symptoms and the response to treatment. In people who have symptoms of acid reflux but no evidence of complications, a trial of treatment with lifestyle changes and, in some cases, medication is often recommended without testing. Specific testing is required when the diagnosis is unclear or if there are more serious signs or symptoms as described above.
It is important to rule out potentially life-threatening problems that can cause symptoms similar to those of gastroesophageal reflux disease. This is particularly true with chest pain since it can also be a symptom of heart disease. When the symptoms are not life-threatening, and the diagnosis of gastroesophageal reflux disease is not clear, one or more of the following tests may be recommended:
● Endoscopy to evaluate the esophagus.
● 24-hour esophageal pH study.
● Esophageal manometry to measure muscle contractions of the esophagus.
Acid Reflux Complications
The vast majority of patients with GERD will not experience serious complications. A number of complications can arise, however, such as:
● Ulcers in the esophagus from stomach acid.
● Severe inflammation of the esophagus, called esophagitis.
● Stricture from acid damage, resulting in scarring and narrowing of the esophagus.
● Lung and throat problems.
● Barrett’s esophagus.
● Esophageal cancer.
Reflux Treatment
For mild cases, dietary changes can be effective, as can antacids or histamine antagonists. Lifestyle changes can also be effective, such as weight loss, and raising the head of the person’s bed 6 to 8 inches. Those suffering from acid reflux or heartburn should quit smoking, avoid large and late meals, and avoid tight-fitting clothing.
For moderate to severe cases where lifestyle changes have not been effective, prescription medication is given. Most patients are given proton pump inhibitors (PPIs), which are medicines that work by reducing the amount of stomach acid made by glands in the lining of your stomach.
Surgical treatment is sometimes the best option for severe cases. The most common surgical treatment for acid reflux is laparoscopic Nissen fundoplication, which helps strengthen the lower esophageal sphincter.
Reflux Treatment
Heartburn
Heartburn—for many, an annoyance after big meals and greasy American staples like burgers and fries. But often, heartburn is a more serious matter, disrupting sleep, affecting eating patterns, and even causing frequent and intense pain. Chronic heartburn can actually cause ulcers and even cancer if it goes unchecked. You may be among the 20 percent of Americans who suffer from heartburn at least once a week, but you need not be, in light of widely available treatments. With an understanding of what causes the condition and how to combat those causes, you can reduce your heartburn and prevent serious consequences.
Heartburn is all a matter of acid and valves. Your body relies on powerful acid in your stomach to break down food into the nutrients it needs. The stomach is equipped with a strong lining to prevent the acid from harming it and valves meant to keep that acid away from more fragile organs. One of these organs, the esophagus, is the tube that brings chewed food from your throat to your stomach and it has one of these valves that connects it to the stomach. Normally the valve allows food to go into the stomach, and then closes so the stomach acid doesn’t get into your esophagus. However, for people who suffer from heartburn, this valve muscle becomes weakened, making the valve lax and allowing acid into the esophagus, causing the painful burning sensation known as heartburn.
Foods and circumstances that temporarily weaken the valve are chocolate, peppermint, and citrus fruit. High-fat foods, heavy meat, slow emptying of the stomach, large meals, eating close to bedtime, and carbonated beverages. Obesity causes extra pressure against the valve and can make heartburn worse. Smoking also plays a damaging role.
Frequent heartburn may mean you have acid reflux or gastroesophageal reflux disease, also known as GERD.
GERD can also be treated with simple lifestyle changes, such as in diet, the timing of food consumption, and other behavioral changes. When these changes, along with medication, do not work, surgery is an option.
Heartburn Surgery
This acid reflux can cause severe inflammation of the esophagus, called esophagitis. The esophagus can also become strictured or have other physical changes, such as with a disease called Barrett’s esophagus. These are other factors that might make surgery the right option.
Heartburn surgery involves either open surgery or laparoscopic surgery, which is less invasive and usually the better option. A common technique that has been successful for patients is to wrap the top part of the stomach around the lower part of the esophagus, sewing it into place. This procedure tightens the lower part of the esophagus, which helps prevent the movement of acid from the stomach into the esophagus.
Sometimes patients experience side effects from this surgery, but it has a high success rate.
Additionally, modern medical science is consistently making improvements. A new procedure recently approved by the FDA involves inserting a magnetic bracelet-like device to control acid flow and has shown promising clinical results.
If lifestyle changes haven’t resulted in sufficient improvements to heartburn, ask your doctor about heartburn surgery.