Q: Is heartburn considered to be an uncomfortable inconvenience or a symptom of a more serious problem?
A: It's estimated that more than 40 million Americans experience heartburn at least once a week, with around 25 million folks who suffer from it daily. If you're plagued by heartburn two or more times a week, and it's not responding well to over-the-counter antacids, you need to see your doctor. Frequent bouts might mean you have gastroesophageal reflux disease (GERD), which can severely irritate and damage the lining of the esophagus.
Depending on the frequency and severity of your heartburn, there are a number of lifestyle adjustments you can make that can help you get relief and avoid a more serious problem.
Adjust your diet: Certain foods can trigger heartburn symptoms such as citrus fruits, tomatoes, fatty foods, chocolate, garlic, onions, spicy foods, mints, alcohol, coffee and sodas. Keep a food diary to track which foods cause you the most problems.
Eat less: Take smaller portions and eat slower. Having a full stomach can cause acid reflux. Also avoid exercising, bending or lying down for two hours after eating. And don't eat at least two to three hours before bedtime.
Monitor your meds: Drugs used to treat arthritis pain, asthma, osteoporosis, depression, insomnia, high blood pressure and more can cause heartburn.
Lose weight: Being overweight is a big contributor to heartburn because the excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.
Stop smoking: Smoking can increase stomach acid and weaken the valve that prevents stomach acid from entering the esophagus.
Loosen up: Clothes that fit tightly around your waist puts pressure on your abdomen and can cause heartburn.
Relax: More than 50 percent of heartburn sufferers say stress increases their heartburn.
Sleep better: To help keep the acid down in your stomach while you sleep, elevate the head of your bed 6 to 8 inches. Sleeping on your left side may also help keep the acid down.
If the lifestyle adjustments don't solve the problem, or if antacids aren't doing the trick, there are a variety of over-the-counter and prescription medications that can help along with a surgical option. Your doctor can help you determine which one is best for you. Treatment options include:
- H-2 blockers. Available as both over-the-counter and prescription strength, these drugs (Pepcid, Tagamet, Axid and Zantac) reduce how much acid your stomach makes but may not be strong enough for serious symptoms.
- Proton-pump inhibitors. If you have frequent and severe heartburn symptoms, PPIs are long-acting medications that block acid production and allow time for damaged esophageal tissue to heal. They include Nexium, Prevacid, Prilosec, Protonix, Aciphex and Zegerid. But be aware that long-term use of PPIs can reduce the amount of calcium your body absorbs and increase your risk for osteoporosis.
- Surgery. An alternative to drug treatments is anti-reflux surgery, a procedure that tightens the leaky valve so gastric fluids can't wash back up into the esophagus.
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