Heartburn!

Heartburn, or acid indigestion, is a burning sensation mid chest that worsens when you bend over or lay day. It usually occurs after eating and at night.  It is caused by reflux. Reflux occurs when the acid in your stomach backs up into your food pipe (esophagus), resulting in inflammation.  It is considered a disease when you have symptoms more than 2 times a week.

Gastroesophageal Reflux Disease (GERD) is a condition of digestion that allows stomach acid to go up the esophagus due to a weakening of the muscle at the point where the esophagus ends and your stomach begins. GERD often interferes with routine daily activities, and result in damage to your esophagus.

Symptoms- heartburn, vomiting or spitting up blood, bitter taste in mouth, burning chest pain, dry cough, painful throat, painful swallowing, and hoarse voice.

Complications- scarring of esophagus, bleeding in stomach or esophagus, ulcer formation in esophagus or stomach

Risk Factors

Spicy or hot foods

Alcohol, soda, caffeine

Fatty foods

Gassy foods (certain vegetables)

Pregnant

Obese

Smokers

Abdominal hernias

Treatment for GERD

Antacids– help to neutralize the acids in your stomach, but will not treat the inflammation of the esophagus. Over use can cause constipation and diarrhea.

Gaviscon

Tums

Maalox

Mylanta

Rolaids

Histamine-2 (H2) Blockers -Reduce production of acid in stomach. May not be as good for treating esophagitis (inflammation that occurs in the esophagus). Histamine stimulates acid production, especially after meals, so H2 blockers are best taken 30 minutes before meals. They can also be taken at bedtime to suppress nighttime production of acid. Examples of prescription H2 blockers:

Nizatidine (Axid)

Famotidine (Pepcid)

Cimetidine (Tagamet)

Ranitidine (Zantac)

 

These drugs are useful at relieving heartburn, but may not be as good for treating esophagitis (inflammation that occurs in the esophagus).

Side effects can include headache, abdominal pain, diarrhea, nausea, gas, sore throat, runny nose, and dizziness.

Proton Pump Inhibitors (PPIs)

Drugs that block acid production more effectively and for a longer period of time than the H2 blockers, PPIs are best taken an hour before meals. They include:

  • Rabeprazole (Aciphex)
  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec, Zegerid)
  • Pantoprazole (Protonix)
  • Dexlansoprazole (Dexilant)

Many doctors do not believe that one drug is more effective than the others in treating GERD. These medications are also good for protecting the esophagus from acid so that esophageal inflammation can heal.

Side effects can include headache, diarrhea, abdominal pain, bloating, constipation, nausea, and gas.

Home Care

Avoid eating foods and drinks that trigger heartburn. fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, citrus fruits (Pineapple, strawberries), vinegar, foods that can cause gas (peppers, cabbage,) and caffeine may make heartburn worse.

Do not over eat.  Try eating smaller frequent meals.

Do not lie down after a meal, and wait 2- three hours after eating before lying  down or bending over

Elevate the head of your bed

Do not smoke.

Avoid medications that can irritate your stomach, like NSAID’s (Aspirin, Aleve, Ibuprofen)

Weight loss may help to reduce abdominal pressure pushing acid into the esophagus

Avoid wearing tight clothes

Seek medical attention if symptoms occur for more than 2 times a week, and over the counter medications do not help, if you have difficulty swallowing, nausea, vomiting, or weight loss.

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