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Heartburn (GERD)

Heartburn (GERD): Frequently Asked Questions

Tuesday, April 10, 2012 - 10:20

Here are some frequently asked questions related to heartburn and hiatal hernia (GERD).

Q: The doctor thinks my acid indigestion actually is a different disease. She calls it GERD. Is this a new disease?

A: GERD is just a fairly new term for diseases that once were called heartburn, acid indigestion, and hiatal hernia. It stands for Gastro Esophageal Reflux Disease. Doctors use the term because it describes the problem - a back flow of acid from the stomach into the esophagus - that causes the symptoms of these diseases. A lot of patients and even some doctors are still not fully aware of GERD.

Q: What is heartburn, anyway? How does eating certain foods make the heart burn?

A: Heartburn has nothing to do with the heart. It's a popular term for the burning sensation that occurs behind the breastbone, right in the area where the heart is located. The esophagus also runs through the same region of the chest. It carries food from the mouth into the stomach, where a strong acid and enzymes help to digest it. When stomach contents back up into the esophagus, the acid and enzymes cause irritation and inflammation. That's the burning sensation in heartburn.

Q: My husband complains about bad heartburn after big meals. Sometimes he can barely breathe. My husband also is overweight and smokes a lot. He insists it's just indigestion. Shouldn't he see a doctor to be sure?

A: Absolutely. Doctors usually must do tests to be sure. A surprising number of people with heart attacks delay getting emergency medical help because they think the pain is just indigestion. It can be very difficult to decide when chest pain is indigestion and when it's something more serious. Your husband already is at high risk for a heart attack from smoking and being overweight. He should discuss the symptoms with a doctor.

Q: Will I need surgery for a hiatal hernia? The doctor thinks a hiatal hernia is causing my stomach problems, He wants me to have a series of upper GI x-rays to be sure. Now I'm worried that if the x-rays show a hernia, I'll have to undergo an operation.

A: Hiatal hernias are very common. In most people they don't even cause symptoms. A hiatal hernia, however, may cause heartburn and other symptoms of GERD. Those symptoms usually can be treated with lifestyle changes or medications. Relatively few people with hiatal hernias need surgery. Even then, new laparoscopic surgery is a lot easier on patients. They have less discomfort and recover quicker.

Q: One of my friends at work read that GERD can cause asthma, especially in adults. I started having asthma attacks at age 35. Asthma drugs don't work very well for me, either. How could a stomach problem like GERD cause a lung problem like asthma.?

A: Doctors have found a link between GERD and asthma. They think that people with GERD may inhale droplets of the acid material that backs up into the esophagus. That material may irritate the lungs, causing small airways to go into the spasm that occurs in an asthma attack. Another theory is that acid irritates nerve endings in the esophagus. The same nerve serves the esophagus, lungs, and other structures in the chest. Irritation of nerve endings in the esophagus may send a signal to the lungs, causing airways to go into spasm.

Q: I've tried lifestyle changes and drugs. But I'm still having indigestion and other GERD symptoms several times a week. The doctor is recommending surgery to keep acid from refluxing into my esophagus. I'd rather put up with the indigestion. Can untreated indigestion cause any serious health problems?

A: Left untreated for years, severe GERD can have potentially serious effects. It may damage the esophagus so much that scar tissue forms causing narrowed areas called strictures. Strictures can trap food and cause difficulty with swallowing. About 10 percent of people with severe GERD also develop Barrett esophagus. That's a condition in which stomach cells grow in the esophagus. Barrett esophagus may increase the risk of cancer of the esophagus.

Q: The doctor said lifestyle changes may cure my GERD. One suggestion was to elevate the head of my bed so that gravity helps to keep my stomach contents in my stomach. How can I elevate the bed?

A: One simple way is to use an extra pillow to raise the upper part of your body. Another is to place objects under the legs at the head of your bed. Try putting a couple of thick books, bricks, or blocks of wood under each leg. It takes a strong person to lift one side of the bed, while another person other places the objects. Once the bed is raised, make certain that the objects are stable and won't slip out.

Q: I've always used an antacid for heartburn. Is there anything more effective?

A: Antacids counteract, or neutralize, acid after the stomach produces it. They must be taken repeatedly as the stomach makes more acid. Several drugs do a much better job than antacids. Non-prescription strengths ofTagametZantac and Pepcid, for instance, block some acid production in the stomach. Several prescription drugs like Prilosec and Prevacidactually shut off almost all acid production. Other prescription drugs attack the real cause of GERD by making the valve between the stomach and the esophagus contract with greater force. Discuss this with your doctor.

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