What can affect the LES or cause heartburn?

• Foods and beverages such as chocolate, peppermint, fried or fatty foods, coffee, or alcoholic beverages
• Hiatal hernia - a common physical condition where part of the stomach protrudes through the diaphragm
• Lying down
• Cigarette smoking
• Certain medications - make sure your doctor knows all the medications and supplements you are taking

Heartburn can also be caused by other medical conditions, including if your stomach produces too much acid, if you digest food too slowly, or if your body´s natural defense mechanisms, like productions of saliva, are not working.

How common is heartburn?

As many as 33% to 44% of Americans Experience heartburn at least once a month and up to 13% of Americans have heartburn each day. The likelihood of having heartburn increases with age and among women who are pregnant.

How can my doctor find out what´s causing my heartburn?

Upper GI series is a common test that x-rays the esophagus, the first part of the small intestine, and the stomach. The patient swallows a harmless liquid mixture, allowing the doctor to locate strictures or scar tissue in the esophagus and rule out other diagnoses, such as peptic ulcers.

Can the foods I eat cause heartburn?

Although some foods can affect people in different ways, all foods cause the stomach to produce acid. Here is a list of foods and beverages that may aggravate your symptoms, and probably should be avoided:

• Fried or fatty foods
• Heavy seasonings and spicy foods
• Onions
• Orange juice, grapefruit juice, and tomato juice
• Alcoholic beverages
• Coffee
• Chocolate
• Peppermint and spearmint

Are there lifestyle changes I can make to reduce heartburn?

• Stop smoking
• Lose weight - If you´re overweight
• Eat small, well-balanced meals
• Reduce abdominal pressure - don´t wear tight belts or tight clothing
• Avoid eating less than 2 hours before bedtime
• Don´t stack pillows or use foam wedges which cause bending at the waist because they can increase abdominal pressure and actually increase reflux.
• To help reduce acid reflux at night, elevate your bed so the head of the bed is 6 to 8 inches higher than the foot of the bed

Can certain medicines cause heartburn?

Yes, certain drugs can contribute to your heartburn. Be sure your doctors knows about all of the drugs and supplements you are taking.

What are the medical treatments to relieve heartburn?

Although there are several possible causes of heartburn associated with GERD, they all involve stomach acid, so no matter what the cause may be, reducing stomach acid lead to heartburn is divided into 3 different classes of drugs: antacids, H2 blockers, and proton pump inhibitors. Your doctor knows which drug is most appropriate for your situation.

Over-the-counter (OTC) antacids, which about 27% of adult Americans take more than twice a month, are used primarily for heartburn. Unfortunately, they can provide only limited, short-term relief. If you´re using an OTC antacid more than twice a week, it may be a sign of a more serious problem, and you should see your doctor.

H ₂ blockers, which are available OTC and by prescription, get their name from the way they block one stimulus of acid production. H ₂ blockers reduce the amount of acid that is produced in the stomach, but not as much as proton pump inhibitors. If you continue to suffer frequent and severe heartburn while taking an H ₂ blockers, you should see your doctor. Your doctor may develop a different treatment plan.

Proton pump inhibitors are the most effective medicine available for decreasing stomach acid production. That´s because protons pump or proton pumps inhibitors effectively block the final stage of acid production regardless of stimuli. This relieves the burning feeling caused by an acid-related disorder and results in healing of the affected area. Taken only once a day, proton pump inhibitors work to effectively relieve heartburn associated with GERD for 24 hours.

How long will I need to take my medicine?

The length of your treatment depends on how often you get heartburn, how serious your acid reflux is, and how your body responds to the medicine. Some people feel better very soon after they start taking their medicine. Other need to take all of your medicine as directed. Only your doctor can know for sure how long you will need to take your medicine.

Can heartburn require surgery?

A small number of people with heartburn may need surgery because of complications and poor response to medical treatment. The surgical procedure, called fundoplication, improves the natural barrier between the stomach and the esophagus, which prevents acid backup. Surgery should be relied on only after all other treatment options have proved to be unsuccessful.

What are the complications of long-term heartburn and reflux?

Left untreated, stomach acid can repeatedly reflux into the esophagus, resulting any of the following serious complications:

• Esophagitis, an irritation or inflammation of the esophagus, can occur as a result of the constant presence of stomach acid in the esophagus. Long-term esophagitis can result in esophageal bleeding or ulcers.
• An esophageal stricture is a narrowing or closure of the esophagus. A stricture can make swallowing difficult and painful. It can also cause food to get trapped in part of the esophagus or the stomach. A stricture can sometimes become so severe that it may require surgery.
• Barrett´s esophagus is the most serious complication of long-term acid reflux disease. In this complication, the internal surface of the esophagus changes to resemble the surface of the intestine or stomach. This is one way the body tries to protect itself from further injury from stomach acid. When this happens, the risk of developing esophageal cancer increases.

What other conditions may be associated with acid reflux disease?

• A sore throat, chronic hoarseness and cough, or laryngitis can develop from the irritation of refluxed stomach acid.
• Recent studies suggest that the majority of asthmatic have acid reflux.

Can heartburn affect my quality of life?

All of the complications caused by heartburn can significantly impact your quality of life and require you to make long-term dietary and lifestyle changes. In some cases, heartburn sufferers may have a lower quality of life than people with congestive heart failure, coronary artery disease, or diabetes.