Beyond Heart Burn: Knowing when to seek treatment

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Heart burn, indigestion, and acid reflux are all pretty common health complaints. The wide selection of over-the-counter medications and problem-solved television commercials might lead you to believe that the conditions are easily treated without seeing a health provider. While a bout or two of heart burn a month should not raise any alarm, ongoing digestive discomfort should not be ignored or treated on one's own. Here's a quick guide about how you can improve your heartburn symptoms and how to decide when to make an appointment with an office that treats digestive disorders.

If you have heart burn or acid indigestion once a week or less, you may want to limit some of the common causes. If you can tell what foods trigger the irritation for you, simply avoid them. Some common heartburn-causing foods include alcohol especially red wine, spicy foods like those containing black pepper, raw onions, and tomatoes, chocolate, citrus fruits, coffee and caffeinated drinks like tea and soda, and even mint.

Certain behaviors are also related to heartburn and acid indigestion. You might avoid eating within three hours of bedtime and try reducing the fat in your diet to no more than 30 percent of calories from fat. In addition to their immediate effect to reduce heartburn, these new behaviors may also help you lose weight. Like many other health issues, being overweight and smoking are both common causes of heartburn and acid indigestion.

Other recommendations include avoiding tight-fitting clothes, which can put pressure on your waist. And if you experience symptoms most often at night, you might also try using a wedge, available in medical supply stores and some drugstores, to elevate the head of your bed by six to nine inches. Using pillows to elevate your head does not provide a benefit.

If you have heartburn or indigestion symptoms that occur twice a week or more, you should see a health care provider. Frequent heartburn is a primary symptom of gastroesphageal reflux disease or GERD. Other symptoms include trouble swallowing, dry cough, and asthma-like symptoms.

GERD happens when the entry to your stomach doesn't close properly. This allows stomach contents such food and stomach acid to leak back, or reflux, into the esophagus and irritate it.

While GERD is uncomfortable, it is not a major health threat on its own. Many people find that they can withstand symptoms, especially with the help of over-the-counter medications. But it is very important to see a doctor for a confirmed diagnosis and treatment. If left untreated, GERD can lead to more serious conditions such as Barrett's Esophagus or cancer.

If you are found to have GERD, there are many treatment options available. Your health provider may recommend that you use an over-the-counter remedy to neutralize stomach acid or to reduce acid production. If your case is more severe, your provider might prescribe a stronger version of a medication that reduces acid production or a medication that both reduces acid production and allows the esophagus to heal. Sometimes, the medications are used in combination with one another to increase their effectiveness.

Most GERD cases can be controlled with medications. If medications do not work for you, there are surgical options to repair or strengthen the muscle between the esophagus and the stomach and keep food and acid in.

Whether your case is mild or severe, there is no reason to suffer with potentially harmful heartburn symptoms. Instead, do what you can to alleviate your symptoms at home, and consult your health provider if your symptoms don't improve.

— Stephanie Sauer, FNP-BC, is a family nurse practitioner with Southwestern Vermont Medical Center's gastroenterology office, which is now a part of the SVMC Multispecialty Practice. Health Matters is a column meant to educate readers about their personal health, public health matters, and public policy as it affects health care. For more articles like this one, visit svhealthcare.org/wellnessconnection.




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