Heartburn And Reflux
Heartburn And Reflux
Siamak Tabib (Gastroenterologist, Cedars-Sinai Medical Center, Los Angeles, CA) gives expert video advice on: What can I do to treat symptoms of heartburn?; What if antacids and prescription drugs don't relieve my heartburn?; What are the most effective prescription drugs for treating acid reflux? and more...
What is "heartburn"?
Heartburn is a very common condition that affects millions of Americans and also people worldwide. It is a symptom that we generally feel as indigestion or burning; either in our chest area or in the upper abdominal area. It can be caused by an increase in acid in the stomach. It can be caused from irritation in the lining of the food pipe of the stomach. It can also have a lot of symptoms that we usually don't think of as being related to our stomach. It can cause a cough. It can cause shortness of breath. It can cause hoarseness. It can sometimes cause difficulty swallowing and it can cause severe pain that sometimes can be mistaken with pain coming from the heart.
What causes heartburn?
Heartburn is usually related to a condition we call Gastro Oesophageal Reflux Disorder (GORD for short) or generally what we call Acid Reflux. Acid Reflux is when excess acid generally produced in the stomach moves up from the stomach into the oesophagus or the food pipe. The stomach usually has a protective barrier, a protective layer, that doesn't cause it to feel discomfort from acid that is already being produced there, but the oesophagus doesn't have the protective layer that the stomach has. As acid refluxes or moves back up into the oesophagus, it can cause burning, irritation, and inflammation in the lining of the oesophagus which generally we perceive as heartburn.
What can I do to treat symptoms of heartburn?
In the treatment of heartburn, when dietary modification alone is not enough, there are antacids which you can get over the counter, as well as very good acid reducing agents that are also available now over the counter. These can decrease the amount of acid that is produced in the stomach in order to not only alleviate some of the symptoms that people with heartburn experience, but also to protect the oesophagus and the stomach for future problems that can occur, such as ulcers or even cancer that can occur with chronic untreated acid reflux. There are, of course, prescription medicines that work very, very effectively if given to the appropriate person with the appropriate condition.
What if antacids and prescription drugs don't relieve my heartburn?
One of the procedures that we can do in order to further investigate what is going on in the lining of the oesophagus, what is going on in the lining of the stomach, and why these people are experiencing the symptoms that they are, is to do a procedure called an endoscopy or an upper endoscopy, and this is a procedure that takes about five to ten minutes to do. It's generally done under sedation, so people are comfortable when it's done. We take a very small, flexible camera, and we pass it from the mouth into the food pipe, or the oesophagus, farther down into the stomach, and all the way into the beginning of the small intestine to take a better look at the general anatomy of what the stomach looks like, what the oesophagus looks like, and how much inflammation is going on. Are there ulcers taking place, or is there a hiatal hernia that can promote this type of acid reflux?
What is "reflux"?
Reflux is when liquid or in our stomach, namely acid alone or acid mixed with food contents, doesn't flow directly into the small intestine as it should but comes back up into the oesophagus, (what we call reflux back up into the oesophageal area) and as a result causes irritation and potentially damage to the lining of the oesophagus.
What are the symptoms of reflux?
The symptoms of reflux that one can notice can include any of the following: heartburn, indigestion, abdominal pain, chest pain, shortness of breath, nausea, difficulty swallowing, coughing and a dry or a bitter taste in your mouth, especially when you wake up in the morning.
What are the most effective prescription drugs for treating acid reflux?
The classes of medicine that we use for acid reflux, which are available both by prescription and over the counter, include H2 blockers: which are anti histaminic agents that work on the areas that produce acid and are responsible for secretion of acid in the stomach. There is other classes of agents known as proton pump inhibitors, which actually work at the cells which are responsible for the production of acid and the production of namely hydrochloric acid, through hydrogen and chloride mechanism .Now these proton pump inhibitors are highly effective at reducing the amount of acid ,that is produced and is available at any time in the stomach cavity and as such will help decrease the amount of reflux that can take place .
How does a doctor diagnose indigestion?
Indigestion is usually diagnosed by a doctor taking medical history. Taking a good history from our patients, listening to them and figuring out what kind of symptoms they have is the best way to diagnose indigestion, think about how their symptoms relate to certain types of food that they may eat, how they relate to certain times of the day, whether they're worse during the day or night and whether they're relieved by certain types of medications or not.