Six Signs Your Heartburn Could Be Something More Serious
That burning, uncomfortable sensation in your chest? Itâs probably heartburn. Heartburn is a very common ailment that affects many people for many reasons. It occurs when digestive acid escapes the stomach and irritates the delicate lining of the esophagus.
Usually, itâs the result of eating certain foods, or simply overeating, and can be treated with over-the-counter antacids. But sometimes, heartburn is a symptom of bigger problems, that require other solutions. Hereâs when to call a doctor:
What Do I Do If I Think I Have Gerd
With GERD when reflux and heartburn happen more than once in a while the tissue lining your esophagus is getting battered regularly with stomach acid. Eventually the tissue becomes damaged. If you have this chronic acid reflux and heartburn you can see its affecting your daily eating and sleeping habits.
When GERD makes your daily life uncomfortable in this way, call your healthcare provider. Although GERD isnt life-threatening in itself, its chronic inflammation of the esophagus can lead to something more serious. You may need stronger prescription medications or even surgery to ease your symptoms.
Heartburn Acid Reflux And Gerd
The terms heartburn, acid reflux, and GERD are often used interchangeably. They actually have very different meanings.
Acid reflux is a common medical condition that can range in severity from mild to serious. Gastroesophageal reflux disease is the chronic, more severe form of acid reflux. Heartburn is a symptom of acid reflux and GERD.
What To Drink For Acid Reflux
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If you have acid reflux or gastroesophageal reflux disease , you may spend mealtimes avoiding certain foods and drinks. These conditions cause stomach acid to leak back into the esophagus.
GERD symptoms are affected by what you . The symptoms can include coughing, nausea, and hoarseness. Burping, sore throat, and regurgitation are also commonly associated with GERD. What you decide to incorporate or avoid in your diet can help relieve some of your symptoms.
Beverages such as coffee, colas, and acidic juices often top the list of donts. These beverages may increase the risk of GERD symptoms. Instead, heres what you should drink to help reduce symptoms.
Herbal teas help improve digestion and soothe many stomach problems, such as and nausea. Try caffeine-free herbal tea for acid reflux, but avoid spearmint or peppermint teas. Mint triggers acid reflux for many.
Chamomile, licorice, slippery elm, and marshmallow may make better herbal remedies to soothe GERD symptoms.
Licorice helps increase the mucus coating of the esophageal lining, which helps calm the effects of stomach acid. However, theres insufficient evidence to confirm the effectiveness of fennel, marshmallow root, or papaya tea.
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Part 3 Of 4:knowing When To See The Doctor
Delaying Treatment May Lead To Complications
If GERD goes untreated, it can lead to more serious complications. One such issue is esophagitis, which is inflammation in the esophagus. Hagan says if thats not treated, you may develop strictures, which is a narrowing of the esophagus that can lead to esophageal pain and affect proper swallowing.
Another complication of GERD is a condition called Barretts Esophagus . Over time, the stomach acid causes cells in the lining of the esophagus to look more like the stomach lining, says Hagan. These changes, which happen on a cellular level, may in rare cases lead to a form of esophageal cancer called esophageal adenocarcinoma. BE is more common in:
- Caucasian males
This form of cancer appears to be on the rise, according to research published in March 2013 in the journal Cancer.
Meanwhile more recent research, published in May 2016 in the Journal of the American Medical Association, suggests that the chemical burn of stomach acid may not be the sole cause of changes to the esophageal lining. Instead, the study suggests that damage may be caused by an inflammatory response to proteins called cyotokines that are secreted in the intestinal lining of people with GERD.
If you have BE, says Hagan, your doctor may recommend surveillance endoscopy, which means he or she will perform an endoscopy periodically to see how well your esophagus is healing, secondary to drug therapy.
How To Minimize Heartburn In The Morning
Experiencing heartburn upon waking up may be very frustrating and uneasy. It may hinder your day to day activities. However, there are several techniques available that will help lessen the symptoms of acid reflux.
1. Elevate head during sleep
Studies revealed that elevating the head during sleep is an effective way to reduce acid reflux. This is much more effective for those who are experiencing severe heartburn during the morning or at night. You can place a pillow underneath your head or keep blocks under the bed so that your head is much higher or elevated than your stomach. This will hinder the stomach acid from traveling to the esophagus during sleep.
2. Eat small quantity especially during dinner
Always keep an eye on the portion of food youve eaten for the day. Also, take note of the time you eat for dinner because this will affect the time that you will have to sleep. It is important to give at least three hours interval. This will allow the food to be fully digested before going to sleep. Never ever go to bed with a full stomach. This will lead to abnormalities in the esophagus which will worsen the condition.
Also, watch out for your sleeping position. The flat-lying position will cause the stomach acids to transport easily to the esophagus, leading to heartburn.
3. Drink lemon water upon waking up
Quite Often I Hear My Patients Say That They Dont Understand How I Can Tell Them They Have Acid Reflux Disease Because They Don’t Have A Complaint Of Heartburn In Fact Many Of My Patients Initially Simply Do Not Believe They Have Acid Reflux Disease At All The Symptoms They Do Have When They Come In To See Me Are Some Combination Of Cough Hoarseness Frequent Throat Clearing Excess Phlegm In Their Throat Post Nasal Drip And/or Difficulty Swallowing In Other Words Their Symptoms Are Not About Heartburn Rather They Are About Throat Burn
Quite often I hear my patients say that they dont understand how I can tell them they have acid reflux disease because they don’t have a complaint of heartburn. In fact, many of my patients initially simply do not believe they have acid reflux disease at all. The symptoms they do have when they come in to see me are some combination of cough , hoarseness , frequent throat clearing , excess phlegm in their throat , post nasal drip and/or difficulty swallowing . In other words, their symptoms are not about heartburn, rather they are about “throat burn.”
What is even more confusing to my patients is that these throat symptoms are usually treated with antacid medications that are the same as traditional heartburn medications like Nexium, Prilosec, Prevacid, Aciphex, Protonix, Kapidex or Zegerid. Or another class of antacid medications such as Zantac or Pepcid.
So what’s going on here? Whats going on is that there are 2 related diseases taking place here, GastroEsophageal Reflux Disease and LaryngoPharyngeal Reflux Disease . In both diseases, acid from the stomach is refluxing back up into either the esophagus, attached to the stomach from above, or all the way back into the throat, which sits on top of the esophagus.
How do we treat this acid induced swelling of the throat? The treatment consists of being careful with the intake of 4 of your favorite food groups: caffeine, chocolate, alcohol and mint. In addition, antacid medications are often used as well.
Heartburn Causes And Risk Factors
Heartburn symptoms can start up because of a problem with a muscular valve called the lower esophageal sphincter . It’s located where the esophagus meets the stomach — below the rib cage and slightly left of center.
Normally, with the help of gravity, the LES keeps stomach acid right where it should be — in your stomach. When it’s working right, the LES opens to allow food into your stomach or to let you belch, then closes again. But if the LES opens too often or doesn’t close tightly enough, stomach acid can seep into the esophagus and cause a burning sensation.
If your LES doesn’t tighten as it should, there are often two things that contribute to the problem. One is overeating, which puts too much food in your stomach. Another is too much pressure on your stomach, often due to obesity, pregnancy, or constipation.
Certain foods can relax your LES or increase stomach acid, including:
Meals high in fats and oils often lead to heartburn, as do certain medications. Stress and lack of sleep can raise how much acid your stomach makes and can cause heartburn.
If you’re pregnant, the hormone progesterone can relax your LES and lead to heartburn. Smoking also relaxes the LES and increases stomach acid.
How Should I Change My Diet
If you don’t eat certain foods, your throat problems may get better. Here’s a list of foods you should try not to eat :
Tomato-based foods, like spaghetti sauce, chili and pizza
Mint flavoring, like peppermint and spearmint
Citrus fruits, like oranges and grapefruit
Drinks with caffeine, like coffee, tea and cola
Fatty foods, like french fries and donuts
Acid Reflux During Pregnancy
Some women who have never had acid reflux before develop acid reflux or heartburn symptoms for the duration of their pregnancy. This is normal, and many women have decreased or no symptoms after the pregnancy is over.
In addition to following the guidelines discussed above, try sipping liquids instead of drinking them quickly to help prevent acid reflux symptoms. Keeping a food diary to help track what aggravates your symptoms can help you prevent symptoms throughout your pregnancy.
If your GERD or acid reflux hasnt responded to purely dietary changes, other remedies and medications may offer relief.
Over-the-counter treatments include:
What Are The Main Symptoms Of Gerd
The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.
How Is Gerd Treated
Treatment for GERD depends on how severe symptoms are. For some people, treatment may just include lifestyle changes, such as changing what they eat or drink. Others will need to take medicines. In very rare cases, when GERD is particularly severe, a doctor will recommend surgery.
These lifestyle changes can help ease the symptoms of GERD or even prevent the condition:
- quitting smoking
- losing weight if you are overweight
- eating small meals
- avoiding carbonated beverages
- avoiding foods that trigger reflux
It also can help to not lie down for 3 hours after a meal and to not eat 2 to 3 hours before going to bed. Doctors sometimes also recommend raising the head of the bed about 6 to 8 inches. Before you start a major bedroom makeover, though, talk to your doctor and your parents about the best sleeping position for you.
If symptoms continue, doctors might prescribe medicine, such as:
- H2 blockers, which can help block the production of stomach acid
- proton pump inhibitors, which reduce the amount of acid the stomach makes
- prokinetics, which help the esophageal sphincter work better and the stomach empty faster. This can prevent reflux episodes.
Why Do I Get Heartburn When I Havent Eaten
If you visit a doctor to talk about your heartburn, one of the first things they will ask is your diet.
As most people know and what we constantly mention, heartburn is often caused by what you eat and what you drink, so your doctor wants to be sure you are eating a diet that wont provoke any additional symptoms before moving into treatment options.
If youre getting heartburn without eating anything, here are some of the reasons:
The Difference In Their Symptoms
Both acid reflux and gastroesophageal reflux disease have many similar symptoms. You say heartburn, we say acid reflux.
Its pretty clear when you have simple heartburn. Theres a burning in your chest that might have been caused by poor digestion since you sat in your lazy boy chair right after dinner.
With acid reflux and GERD there are additional and very uncomfortable symptoms. Pain and pressure in your chest especially when lying down is one obvious symptom. Add in that bitter and sour taste in your mouth because the food you ate is regurgitating back into your throat.
This keeps occurring because the esophagus and stomach are connected by the LES, better known as the lower esophageal sphincter. It should close once the food reaches the stomach, but sometimes it is weakened or just does not close securely to keep the food down. When someone occasionally experiences these symptoms, they are suffering from acid reflux.
What Is Heartburn And Acid Reflux
Heartburn can last from a few minutes to several hours. It often feels worse after you eat or when you lay down too quickly after eating. So what, exactly, is happening in the body?
As Qin explains it, when you eat, the food passes down a long tube that connects your mouth and stomach. At the bottom of the esophagus is a valve called the lower esophageal sphincter. This valve opens to let food through and then closes to keep your stomach contents down.
Related: Foods That Cause Heartburn
Inside your stomach is a strong acidic mixture that starts the process of breaking down your food . Sometimes the valve that separates your stomach and esophagus relaxes momentarily and some of the acidic mixture from your stomach goes back up the esophagus. This is called acid reflux. When you have acid reflux, youll often feel the burning sensation thats heartburn, and you may feel the reflux of stomach contents coming up into your chest.
Occasional heartburn is common, but frequent heartburn can indicate a bigger problem. Heartburn on a regular basis is typically a symptom gastroesophageal reflux disease . If youre experiencing regular heartburn, you should speak with your healthcare provider. If left untreated, it can cause severe damage to your esophagus.
Related: Is Pickle Juice a Home Remedy for Acid Reflux?
Is Gerd Dangerous Or Life
GERD isnt life-threatening or dangerous in itself. But long-term GERD can lead to more serious health problems:
- Esophagitis: Esophagitis is the irritation and inflammation the stomach acid causes in the lining of the esophagus. Esophagitis can cause ulcers in your esophagus, heartburn, chest pain, bleeding and trouble swallowing.
- Barrett’s esophagus: Barrett’s esophagus is a condition that develops in some people who have long-term GERD. The damage acid reflux can cause over years can change the cells in the lining of the esophagus. Barretts esophagus is a risk factor for cancer of the esophagus.
- Esophageal cancer: Cancer that begins in the esophagus is divided into two major types. Adenocarcinoma usually develops in the lower part of the esophagus. This type can develop from Barretts esophagus. Squamous cell carcinoma begins in the cells that line the esophagus. This cancer usually affects the upper and middle part of the esophagus.
- Strictures: Sometimes the damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus. These strictures can interfere with eating and drinking by preventing food and liquid from reaching the stomach.
What Happens When You Dont Have A Gallbladder
Your liver continues to manufacture bile, but there is no longer a place to store it or concentrate it. Therefore bile continually slowly trickles into the intestines. If you eat a fatty meal, you will not be able to secrete a large enough amount of bile into your intestines, therefore the fat will be poorly digested. This means many people experience diarrhea, bloating, nausea or indigestion.
Not digesting fat well means you will not be able to digest essential fatty acids, including omega 3 and omega 6 fats. It also means youll have a hard time absorbing fat soluble vitamins such as vitamins D, E, A and K. A lot of the antioxidants in vegetables are fat soluble: lycopene, lutein and carotenoids are all fat soluble. If you dont produce adequate bile, you will not be adequately absorbing these life saving compounds from foods. If you take any of the above mentioned nutrients in supplement form, without sufficient bile you will sadly not absorb them well.
Some common symptoms of poor fat digestion are dry, brittle hair; dry skin and premature aging of the skin; weak nails and painful joints. Essential fatty acids are important for optimal brain health, therefore low mood, anxiety, depression and impaired cognitive function are all possible manifestations of poor fat digestion.
What Medications Do I Take To Manage The Symptoms Of Gerd
Many over-the-counter and prescription medications relieve GERD. Most of OTC drugs come in prescription strength too. Your provider will give you a prescription for these stronger drugs if youre not getting relief from the OTC formulas.
The most common GERD medications:
- Antacids include Tums®, Rolaids®, Mylanta®, Riopan® and Maalox®.
- H-2 receptor blockers include Tagamet®, Pepcid AC®, Axid AR® and Zantac®.
- Proton pump inhibitors include Prevacid®, Prilosec®, Zegerid®, Nexium®, Protonix®, AcipHex® and Dexilant®.
- Baclofen is a prescription drug used to reduce the relaxation of the lower esophageal sphincter which allows acid backwash.
Why Do I Get Heartburn And Indigestion
When you swallow, the food is supposed to follow a certain path down your esophagus and into your stomach. A valve opens to allow the food to pass into your stomach. This valve should close once the food has passed. If this valve does not work properly, it may allow some stomach acid to enter your esophagus. This is called acid reflux, which can be painful. Acid reflux is synonymous with heartburn.
Indigestion is often a sign of an underlying problem, such as gastro-esophageal reflux disease , ulcers, or gallbladder disease, rather than a condition of its own.
Also called dyspepsia, indigestion is a term used to describe a feeling of fullness or discomfort during or after a meal. It can be accompanied by burning or pain in the upper stomach and any or all of these sensations:
- Burning in the stomach or upper abdomen
- Abdominal pain
These symptoms may increase in times of stress.
People often have heartburn along with indigestion, but heartburn is caused by stomach acids rising into the esophagus while indigestion may be caused by one or many things.
You’ll talk with your doctor about how to solve these issues. In the meantime, here’s a list of some common and unexpected foods that may be triggering the symptoms.
Symptoms Of Acid Reflux
If you have acid reflux, you might experience the following:
- Burning sensation or discomfort in your chest
- Burning sensation or discomfort in the back of your throat
- Unpleasant taste in the back of your throat
- Unpleasant hiccups that seem to carry acid up your throat
- Stay upright for three hours after a meal
- Over-the-counter antacids to neutralize the acid in your stomach
- Prescription antacids
- H2 blockers that reduce the amount of acid your stomach makes
- Proton-pump inhibitors that further reduce the amount of acid your stomach produces and are available both over the counter and by prescription
- Prokinetics that help clear stomach contents and strengthen the LES
- Upper endoscopy, in addition to helping diagnose GERD, can be used to tighten the LES or fix a hiatal hernia
- Fundoplication is a surgical procedure in which the upper part of the stomach is wrapped around the lower part of the esophagus to strengthen the LES
If youre suffering from acid reflux, talk to your doctor about your options or find a doctor near you.
Diagnosis Of Silent Reflux
At UT Southwestern, our skilled laryngologists conduct a thorough evaluation, which includes a:
- Physical exam
- Review of personal medical history
- Discussion of symptoms
In some cases, we can confirm a diagnosis of LPR based on our evaluation, without any additional testing. Depending on each patients specific needs, we sometimes work with gastroenterologists , who can help to diagnose reflux with pH, impedance, and motility testing.
When needed, additional tests might include:
- Acid reflux test: Test to measure the amount of acid in the fluid inside the esophagus
- Endoscopy: Test to view inside the throat and esophagus using a long, thin tube with a lighted camera at its tip
- Swallowing study: Test to evaluate how food moves from the mouth through the esophagus, using a special liquid called barium that shows up on X-rays
What Are The Common Signs Of Gerd
The most common sign is heartburn. Heartburn is a pain in the middle of your chest. The pain from heartburn can be very strong. Sometimes the pain can be so strong that you think you’re having a heart attack.
GERD can cause other signs, too. You can even have GERD without having heartburn.
Sometimes GERD can cause problems in your throat. It can make you feel like you have a lump in your throat or like you always have to clear your throat. It can also cause hoarseness. You might be more hoarse when you first get up in the morning.
GERD can give you a burning feeling in your mouth. It can cause you to have a sore throat or to have trouble swallowing. You may feel like food is sticking in your throat. GERD may also make you feel like you’re choking or that your throat is tight. A dry cough is another sign. GERD can also cause bad breath. It can even cause pain in your ears.
If you have any of these signs, you may have GERD. Be sure to tell your doctor about any of these signs.
Can You Have Gerd Without Heartburn
While nearly half of American adults have occasional heartburn, only about one in five develops persistent heartburn, regurgitation or other symptoms associated with gastroesophageal reflux disease. Still, GERD is the most common upper gastrointestinal disease in the Western world, according to a 2012 review in the World Journal of Gastroenterology. Although heartburn and regurgitation are the most common symptoms of GERD, a significant number of people with GERD do not experience such symptoms.
Is It Possible To Get Heartburn When You Havent Eaten
As noted earlier, yes, it is possible to get heartburn when you havent eaten.
While eating food is often a triggering factor for heartburn symptoms to begin manifesting, it is not always that direct of a relationship.
Remember that the systems in our body are always working even when we arent actively moving or eating something.
Since these systems are always in motion, the potential for negative symptoms, like heartburn, is possible at any time.
Still, there are some specific reasons why you might be experiencing heartburn even when you didnt just eat a meal or drank a certain beverage, and were going to go into some of them and how to address them in more detail.