The aftereffects of a big meal can leave some people feeling satisfied and others with the uncomfortable feeling of heartburn. While heartburn is not uncommon, frequent heartburn might be a symptom of an underlying condition known as gastroesophageal reflux, or GERD. But how do you decide when it’s time to stop munching antacids and see a physician? And does heartburn really have anything to do with your heart?

Heartburn or GERD: What’s the difference?
Most people know the burning sensation that comes with heartburn. It is estimated that approximately one in 10 adults has heartburn at least once a week and that more than 60 million Americans experience heartburn monthly. Symptoms of heartburn may include burning in the throat, difficulty swallowing or the feeling of food sticking in the chest or throat.
“Despite its name, heartburn has nothing to do with your heart,” says Alice Friedman, M.D., a gastroenterologist with The Austin Diagnostic Clinic. “Also referred to as acid indigestion, heartburn is an irritation of the esophagus caused by acid that flows up, or refluxes, from the stomach.”

The burning sensation, which is often accompanied by a bitter taste in the mouth, can occur after you eat or exercise or at night when lying down. Heartburn alone can usually be treated by lifestyle changes and with over-the-counter medications, such as antacids and acid blockers.
GERD is a disease in which a weakened muscle between the esophagus and stomach allows food and stomach acid to reflux into the esophagus. “When you swallow, food travels down the throat and through the esophagus into the stomach,” explains Dr. Friedman. “The lower esophageal sphincter controls the opening between the esophagus and the stomach and remains tightly closed except when swallowing food. If this muscle fails to close, stomach contents will reflux into the esophagus. The more this occurs, the more irritated the esophagus becomes.”

Causes of GERD and Heartburn
“There is no definite cause for GERD,” says Dr. Friedman, “but certain trigger factors can contribute to both GERD and heartburn.”
• Foods such as fatty foods, spicy foods, chocolate, caffeine, onions, tomato sauce, carbonated beverages and mint
• Alcohol
• Large meals
• Lying down too soon after eating
• Certain medications, including sedatives and blood pressure medication
• Smoking
• Being overweight

When to Seek Help
Heartburn is the most common symptom associated with GERD. Anyone experiencing severe heartburn more than twice a week or not finding relief from antacids should consult a physician. “There are also other symptoms that can indicate a problem with GERD, such as excessive clearing of the throat, problems swallowing, regurgitated blood, burning in the mouth, or weight loss. Should any of these occur, prompt medical care is imperative,” says Dr. Friedman.

Which Treatment is Right for You?
In order for a physician to determine whether or not GERD is the cause of heartburn, a few medical tests are needed. Keeping a heartburn diary to track the frequency and severity of heartburn can also be beneficial.
“Once a diagnosis has been made, there are a number of treatment options that are available,” says Dr. Friedman. “Heartburn can normally be treated by dietary and lifestyle changes in addition to over-the-counter medicines.”
These changes can also decrease the severity of GERD symptoms, but in most cases, prescription medication is also required to help heal the esophagus.
“For those who don’t respond to these treatments or who have additional complications, such as a hiatal hernia, surgery may be needed,” cautions Dr. Friedman. “If self-treatment is not working, consult a physician immediately to reduce the risk of further complications.”

SIDEBAR:

How bad is your heartburn? If you answer “yes” to any of these questions, it’s time see your physician.
• Is your heartburn occurring more than twice a week?
• Has the pattern of your heartburn changed? Is it worse than it used to be?
• Do you wake up at night with heartburn?
• Have you been having occasional heartburn that is associated with difficulty with swallowing?
• Do you continue to have heartburn symptoms even after taking non-prescription medication for heartburn?
• Are you experiencing asthma symptoms that worsen after meals, when you exercise or when you lie down? Are asthma symptoms worse at night?
• Are you experiencing unexplained weight loss or loss of appetite?
• Do your heartburn symptoms interfere with your lifestyle or daily activities?

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The Austin Diagnostic Clinic (ADC) is a multi-specialty clinic with physicians representing 24 medical specialties at more than 10 locations. Dr. Jere practices at the ADC Main Clinic at 12221 N. MoPac. To schedule an appointment, call 901-4026.