DOCTOR'S VIEWS ARCHIVE
Topic: Irritable Bowel Syndrome (IBS), June 2000
Dr. Lee:
A viewer experiences heartburn and chest discomfort
after exercise. This viewer wants to know whether his symptoms could
be a warning for heart condition rather than GERD. What
is your opinion on that?
Dr. Marks:
Vigorous exercise can aggravate acid reflux.
However it is important to remember that exercise also causes heart pain
(angina). All too
often, pain in the chest following exertion is described as "heartburn"
when it is really angina. Anyone with chest discomfort
during or after exercising, even if it feels like heartburn, should be
evaluated for heart problems.
Dr. Lee:
Yes, I have to second that point. Every year I will have 2 or
3 patients coming into my office seeking relieve from heartburn.
I will refer them to a cardiologist first because I am concerned that their symptoms
could be angina (warning signals for impending heart attacks). Some of them actually did turn out to have diseases
in their coronary (heart) arteries, and their heartburn actually represented angina. It is
gratifying to have have them come back years later, thanking me for sending
them to the cardiologists rather than just treating them
for GERD.
Thus not all "heartburn" is due to GERD. Again, accurate diagnosis is the key.
Dr. Marks:
I am sure that your experience is very similar to other gastroenterologists.
Dr. Lee:
Especially if the symptoms are related to exertion or the symptoms do not seem to go
away with maximal acid suppressant therapy.
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