A few times a week, I have heartburn after eating. I can manage it fairly well by eating a restricted diet (no onions, spicy foods, beef, etc.), but I wasn't sure if I should be concerned. I've heard that sometimes heartburn can lead to more serious conditions.
Heartburn is a common condition, with around 20 percent of adults experiencing it from time to time. About 6 percent have symptoms two times a week or more. A common cause of heartburn is gastroesophageal reflux disease, or "GERD." The "reflux" in GERD refers to the reverse flow of acid from the stomach up into the esophagus, the tube that goes from the throat to the stomach. Muscles at the connection of the stomach and esophagus form a valve to reduce this backflow. However, this valve is weak and sometimes ineffective.
Everyone has some reflux on occasion. It usually is minor and causes no symptoms or disease. However, some people experience discomfort, heartburn, or even regurgitation.
Just like you, doctors are concerned that heartburn is either a sign that a more serious condition exists, or will lead to a serious condition. Fortunately, that is rarely the case. Still, heartburn can cause problems, such as an ulcer or bleeding in the esophagus, a scar that constricts the esophagus, or changes in the cells lining the esophagus that can lead to cancer. Doctors also want to rule out other serious possibilities, like a heart condition. (If the "heartburn" occurs only with exertion and goes away with rest after a few minutes, it could point to a cardiac problem.)
Most heartburn patients require only lifestyle changes and/or medication to see improvement. Staying away from certain foods, alcohol, or caffeine, or avoiding late-night meals can help. Antacids also work for some. Drugs commonly used to treat heartburn include H2 (histamine) blockers like ranitidine or famotidine (Zantac® or Pepcid®). Powerful acid blockers called proton pump inhibitors (or PPIs) are also sometimes used. One example of a PPI is omeprazole (Prilosec®).
Persons experiencing persistent pain when swallowing, a feeling that food is sticking in the chest, weight loss, vomiting of blood, or black or very dark bowel movements will usually require an evaluation with a scope that can look at the esophagus. Some doctors may also recommend this for persons who need continuous treatment for more than a year (though the benefit is unproven) or for those who fail to respond to repeated trials of treatment.
If you have ongoing concerns about your heartburn, talk to your doctor. He or she can provide you with the best course of action.
