When heartburn is more than just heartburn

By Injil Abu Bakar

DENPASAR, Bali (JP): Just about everyone has occasional mild heartburn or acid indigestion.

This may be caused by eating certain spicy foods, such as pepperoni pizza, very hot peppers or chili. These foods can irritate the esophagus (the tube that carries food from your mouth to your stomach).

This sort of discomfort or burning feeling in the chest and throat may not last long. And antacids or acid reducers that you can buy without prescription often bring quick relief. Over time, some people learn what foods cause problems for them and take acid reducers before eating those foods to help prevent symptoms.

But what if you follow all of the dosage recommendations of such medications (including the length of time you should continue to take them), and they still don't relieve your symptoms? Or what if you start having heartburn more often, and your symptoms are worse than when you had acid indigestion only once in a while?

Then the chances are very good that your heartburn is more than just heartburn!

When heartburn is ... gastroesophageal reflux disease

Where the esophagus joins the stomach, there is a muscular ring called the lower esophageal sphincter (LES). Normally, the LES acts like a door that opens to let food enter the stomach and closes to keep stomach acids (which process the food in the stomach) from flowing backward into the esophagus.

When the LES muscles are weakened by such things as spicy foods, smoking or pressure on the stomach, acid from the stomach may flow back or reflux into the esophagus. This can cause the esophagus to become irritated and inflamed (a condition called esophagitis, or GERD), producing a burning pain and discomfort.

If left untreated, GERD can cause ulcers to form in the esophagus, swallowing difficulties and, rarely, even more serious complications. So if you think you have GERD, consult your physician.

Recognizing the symptoms of GERD

If you answer "Yes" to one or more of the questions below, you may be suffering from GERD or another, more serious condition. Do you have:

- Frequent heartburn?

- Regurgitation? Does food or sour liquid come back up into your mouth?

- Frequent belching or burping?

- Difficult or painful swallowing?

- Chest pain/discomfort?

- Symptoms at night or when sleeping?

- More discomfort after you eat, bend over or lie down?

If you answered "Yes" to one or more of the questions above, it is important to consult your physician.

It's important for your physician to make a diagnosis so that treatment for your condition can be started. The more you can tell your physician about your present symptoms and your health in general, the better the chances are that your condition can be properly diagnosed and treated.

Knowing the type of symptoms you are having and their severity, your eating and sleeping habits and your general lifestyle will help your physician design a treatment program that is right for you.

To determine if you have GERD, your physician will begin by taking a complete medical history and performing a physical examination. Sometimes additional information will be needed to be certain of the diagnosis. In this case, your physician may ask you to have certain tests performed.

The treatment program your physician recommends may include dietary and lifestyle changes, as well as prescription medications.

Lifestyle changes may include:

* Watching what you eat and drink to avoid foods and beverages that can increase stomach acid and weaken your LES

- Acidic or high-fat foods (hamburgers, citrus fruits, tomatoes, etc.)

- Coffee, tea, alcohol, carbonated beverages (with or without caffeine)

- Chocolate

- Mints

* Watching when you eat and drink

- Divide your daily food intake into smaller quantities eaten more often

- Don't eat late at night or lie down right after eating

* Watching your weight and your smoking habit

- Lose weight if you are obese (obesity puts pressure on your LES)

- If you smoke, quit! (tobacco increases stomach acid and weakens your LES)

Other helpful hints to reduce symptoms

- Avoid bending over unless you have to (bending over increases the pressure on your LES)

- Don't wear tight belts or tight-fitting clothes

- Raise the head of your bed six to 10 inches by placing blocks or books under the legs (lying flat lets acid reflux back into the esophagus)

- Take any medication your physician has prescribed for your condition as directed (don't stop taking your medication without consulting with your physician)

- Check with your physician before taking aspirin or anti- inflammatory medications such as ibuprofen, which can aggravate GERD and its symptoms

- Make sure your physician knows about all the medications you are taking.