Heartburn that is frequent or intense may be a sign of gastroesophageal reflux disease (GERD). Contact your doctor if your heartburn:
- Occurs more than twice a week
- Persists despite dietary and lifestyle changes
- Persists despite the use of over-the-counter medications
- Occurs even after taking proton pump inhibitors for more than 8 weeks and you are not currently seeing a gastroenterologist
GERD or esophagitis is a complicated condition with dangerous implications. Heartburn is the most common symptom of the disorder. If left untreated, GERD can cause bleeding and scarring in the esophagus and in some cases increase the risk of esophageal cancer.
What other conditions can cause heartburn?
A gastroenterologist can perform various examinations, including an upper endoscopy, to evaluate potential causes of GERD.
However, since there are other conditions that can mimic a heartburn, it is important to seek medical treatment if your symptoms are severe. These conditions include:
- Myocardial infarction (pain from the heart muscle radiates to the upper abdomen)
- Pancreatitis (severe crampy pain that aggravates with eating)
- Liver dysfunction (severe nausea and upper abdominal fullness may be related to the liver)
- Cholecystitis (gallbladder inflammation with or without gallstones can cause symptoms similar to heartburn)
- Ulcer (can cause similar symptoms, although pain is usually severe and there may be blood-stained vomiting)
What are signs and symptoms of GERD?
Gastroesophageal reflux disease (GERD) can manifest differently in each person. Although GERD can cause a wide range of symptoms, these symptoms can be classified as typical or atypical based on their severity.
Typical or common GERD symptoms include:
- Difficulty swallowing
- Excessive salivation
- Gas and bloating
- Pain or discomfort in the chest
- Intolerance of certain foods and liquids
- Bad breath or a sour taste in the mouth
Atypical GERD symptoms include:
- Hoarse voice
- Frequent swallowing
- Asthma or asthma-like symptoms
- Excessive clearing of the throat
- Chronic dry, irritated, or sore throat
- Persistent cough
- Burning in the mouth or throat (acid taste in the mouth)
- Dental erosions or therapy-resistant gum disease or inflammation
- Discomfort in the ears and nose
- Trouble sleeping
What causes GERD?
Gastroesophageal reflux disease (GERD) is characterized by regurgitation of stomach acid or digestive fluid into the esophagus, resulting in a burning feeling in the chest and frequent burping. Some people may experience cough or chest discomfort.
Causes of GERD may include:
- Irregularities affecting the lower esophageal sphincter: Because of esophageal muscle tone deterioration, it is more common among the elderly. This type of acid reflux can be caused by certain medications, alcohol, or smoking.
- Abnormalities affecting esophageal contractions: In some cases, the esophagus is unable to push the regurgitated acid back into the stomach. As a result, stomach acid remains in the esophagus for a longer period, leading to heartburn symptoms.
- Stomach contracting less frequently: All food that is digested is sent down into the intestines. Food left in the stomach for a lengthy amount of time produces pressure, which opens the esophageal sphincter and allows food and digestive fluids to flow up into the esophagus.
Risk factors for GERD include:
- Fatty, acidic, or spicy foods
- Caffeine, alcohol, and peppermint
- Certain medications
- Being overweight
How is GERD treated?
Treatment of gastroesophageal reflux disease (GERD) may include one or more of the following options, depending on the severity of the condition:
- Lifestyle changes:
- Typically, these are the first medicines advised to relieve heartburn and other minor GERD symptoms.
- Many products on the market combine various combinations of three basic salts—magnesium, calcium and aluminum—with hydroxide or bicarbonate ions to neutralize stomach acid.
- Antacids have side effects that may include diarrhea or constipation.
- Foaming agents:
- To avoid irritation of the inner lining of the stomach and esophagus, foaming agents cover the contents of your stomach with foam.
- These medications may be beneficial to people who do not suffer from esophageal injury.
- They can help reduce excessive belching.
- H2 blockers:
- These drugs provide temporary relief but should only be used for a few weeks at a time without medical supervision. They come in prescription and nonprescription strengths.
- They help in about 50% of cases.
- Proton pump inhibitors:
- Proton pump inhibitors are more effective than H2 blockers in treating GERD symptoms and can help practically everyone.
- These drugs should be taken 30 to 60 minutes before eating.
- Because persistent heartburn may indicate more serious illnesses, it is highly advised to consult with your doctor before using these drugs for an extended period of time.
- These help empty the stomach faster.
- Because various medications function in different ways, combining them may help reduce symptoms.
- Surgery: When lifestyle modifications and medications fail, surgery may be a viable option. Surgical options include:
- Fundoplication: To tighten the sphincter, prevent acid reflux and repair a hiatal hernia, the top section of the stomach is wrapped around the lower esophageal sphincter (LES). This technique may be performed with a laparoscope and only requires small incisions in the abdomen. Laparoscopic fundoplication has been used safely and efficiently on people of all ages, including infants. Patients can leave the hospital in 1-3 days and return to work in 2-3 weeks.
- Endoscopic devices: The FDA has authorized numerous endoscopic devices to treat persistent heartburn. The Bard EndoCinch technique uses application of sutures to produce small pleats in the LES, which helps strengthen the muscle. Electrodes are used in the Stretta system to make microscopic incisions on the LES. Scar tissue helps toughen the muscle once the wounds heal. The long-term implication of these are unknown. Endoscopic devices are rarely used to treat GERD.
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Heartburn and Acid Reflux: What You Need to Know: https://www.cedars-sinai.org/blog/what-causes-heartburn-and-acid-reflux.html
IS HEARTBURN A SIGN OF SOMETHING MORE SERIOUS? https://www.rmhp.org/blog/2012/july/is-heartburn-a-sign-of-something-more-serious
When is heartburn considered gastroesophageal reflux disease? https://healthcare.utah.edu/healthfeed/postings/2019/06/heartburn.php
Top How Do You Know When Heartburn Is Serious Related Articles
aluminum hydroxide/magnesium trisilicateAluminum hydroxide/magnesium trisilicate is a combination medication used to relieve symptoms of acid indigestion and heartburn due to acid reflux. Common side effects of aluminum hydroxide include stomach cramps, constipation, fecal impaction, hemorrhoids, nausea, vomiting, chalky taste, rebound hyperacidity, softening of bones (osteomalacia), and others. Common side effects of magnesium trisilicate include nausea, vomiting, diarrhea, headache, dizziness, lethargy, drowsiness, lightheadedness, and high magnesium levels in blood (hypermagnesemia).
aluminum hydroxide, magnesium hydroxide, simethicone antacidsaluminum hydroxide, magnesium hydroxide, simethicone antacids (Mylanta, Mylanta Maximum Strength, Mylanta Ultimate Strength, Maalox, Maalox Advanced, Gelusil) are over-the-counter (OTC) medications that provide relief from gas and bloating. Side effects, drug interactions, dosing, and pregnancy safety information should be reviewed prior to taking this product.
cimetidine, Tagamet HBCimetidine (Tagamet) is a drug prescribed for the treatment of GERD, duodenal ulcers, active gastric ulcers, Zollinger Ellison syndrome, heartburn, indigestion; and the prevention of gastrointestinal bleeding. Minor side effects include constipation, diarrhea, fatigue, headache, insomnia, muscle pain, nausea, and vomiting. Consult your doctor before taking if pregnant or breastfeeding.
citric acid/sodium citrateCitric acid/sodium bicarbonate is a combination antacid medication used for the temporary relief of upset stomach, including sour stomach, heartburn, and acid indigestion. Use with caution if you are on a sodium-restricted diet. Side effects of citric acid/sodium bicarbonate include gas (flatulence), abdominal bloating, nausea, vomiting, diarrhea, fluid retention, and excessive alkalinity of body fluids (alkalosis). Consult your doctor if pregnant or breastfeeding.
famotidineFamotidine is a drug prescribed for the treatment of stomach and duodenal ulcers, heartburn, esophagitis, GERD, and Zollinger-Ellison syndrome. The most commonly reported minor side effects of famotidine are constipation, diarrhea, fatigue, headache, insomnia, muscle pain, nausea, and vomiting. Other important side effects include anemia, confusion, easy bruising or bleeding, hair loss, and rash. Consult with your doctor if pregnant or breastfeeding.
GERD PictureThe stomach contents regurgitate and back up (reflux) into the esophagus The food in the stomach is partially digested by stomach acid and enzymes. See a picture of Gastroesophageal Reflux (GERD) and learn more about the health topic.
GERD (Acid Reflux, Heartburn)Gastroesophageal reflux disease (GERD), also called acid reflux, can cause symptoms like heartburn, chest pain, regurgitation, and nausea. Learn about causes, diagnosis, treatment and prevention.
GERD QuizWho is at risk for developing GERD? Are you? Take this quiz to learn what GERD is, if you're at risk, and what you can do about it.
Heartburn Foods SlidesLearn the symptoms of heartburn and which foods cause heartburn or GERD. Discover home remedies and which foods may provide treatment for heartburn relief.
Acid Reflux (Heartburn, GERD): Symptoms & RemediesHeartburn is a symptom of acid reflux that causes chest pain when stomach acid backs up into the esophagus. Heartburn symptoms may mimic chest pain that occurs during a heart attack. Gastroesophageal reflux disease (GERD) may produce other symptoms.
Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name because it feels like a burning sensation around the heart. Another symptom that occurs with heartburn is a bitter or sour taste in the mouth, usually when you eat or lye down. Heartburn affects more than 60 million people in the US at least once a month. Acid reflux, or GERD, occurs when stomach acid backs up into the esophagus, which irritates it. Heartburn is just one symptom of acid reflux. Other symptoms of acid reflux include:
- Nausea after eating
- A feeling of fullness during or after eating
- Abdominal bloating
- Upset stomach
- Reflux laryngitis
- A tightness in the throat
- Problems swallowing
- In some people, vomiting
Causes of acid reflux and heartburn include:
- Being obese
- Slouching (poor posture)
- Medications like calcium channel blockers, theophylline, nitrates, and antihistamines
- Foods and drinks like caffeine, citrus fruits and vegetables, alcohol, and chocolate
- Increase in stomach acid
- Eating a heavy meal
- Eating before bed
The treatment for heartburn and acid reflux is to treat the underlying cause, for example, GERD, with over-the-counter (OTC) medicine, prescription medicine, natural remedies, and lifestyle changes like a eating a healthy, less fatty, spicy diet, not eating big meals, not eating before bed, and getting regular exercise to improve your posture.
Sometimes a heart attack can mimic heartburn and acid reflux because they feel very similar. If you have symptoms of chest pain, tightness in the chest, heartburn, acid reflux, jaw, tooth, or head pain; shortness of breath, nausea, vomiting, sweating, discomfort in the upper middle of the abdomen, arm or upper back pain, or the general feeling of being ill, go to the nearest Emergency Department immediately because these are the symptoms of a heart attack.
American College of Gastroenterology. "Acid Reflux." 2017.
familydoctor.org. "Heartburn." Updated: Mar 2014.
National Library of Medicine; PubMed Health. "Heartburn and GERD: Treatment options for GERD." Updated: Nov 18, 2015.
lansoprazole (Heartburn Relief 24 Hour, Heartburn Treatment 24 Hour, Prevacid 24)
Lansoprazole (Heartburn Relief 24 Hour, Heartburn Treatment 24 Hour, Prevacid 24HR, Prevacid, Prevacid SoluTab) is in a class of drugs called PPIs (proton pump inhibitors). Prevacid capsules are available over-the-counter. Other forms of lansoprazole are by prescription only. Lansoprazole is for the treatment of GERD, treating ulcers of the stomach and duodenum, and Zollinger-Ellison syndrome. Side effects, safety information, warnings and precautions and drug interactions should be reviewed prior to taking this medication.
magnesium hydroxideMagnesium hydroxide, also known as milk of magnesia, is used to relieve occasional constipation and to treat heartburn and acid indigestion. Common side effects of magnesium hydroxide include diarrhea, abdominal pain, bloody stools, rectal bleeding, dehydration symptoms (dry mouth, extreme thirst, reduced urination, dizziness, electrolyte imbalance), and high magnesium in blood (hypermagnesemia). Occasional use of magnesium hydroxide in recommended doses during pregnancy and breastfeeding is generally considered safe.
omeprazoleOmeprazole, omeprazole/sodium bicarbonate is a proton pump inhibitor drug (PPI) prescribed for the treatment of ulcers, gastroesophageal reflux disease (GERD), Zollinger-Ellison syndrome, duodenitis, erosive esophagitis, heartburn, and H. pylori infection. Side effects, drug interactions, warnings and precautions, and patient information should always be reviewed prior to taking any medication.
Proton Pump Inhibitors (PPIs)Proton pump inhibitors (PPIs) reduce the production of acid in the wall of the stomach (that produces acid) thereby preventing ulcers and assists in the healing of ulcers that exist on the esophagus, stomach, or duodenum. PPIs are prescribed for the prevention and treatment for acid-related conditions such as GERD (gastroesophageal reflux disease), ulcers, and Zollinger-Ellison syndrome. PPIs may also be used in combination with antibiotics for the treatment of Helicobacter pylori.
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