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Heartburn, Acid Reflux and GERD: When Should You Worry?

It happens to almost all of us at some point—we feel that burning sensation in the chest after a glass of wine, a dinner of spaghetti and meatballs, or that late-night bowl of potato chips. It’s heartburn, and you feel it when acid from the stomach spills into the esophagus, which is called acid reflux. It can be quite painful.

“Heartburn can be severe enough to be mistaken for chest pain or a heart attack,” said Emil Graf, MD, a general and bariatric surgery specialist at Banner Health in Arizona.

Heartburn and acid reflux are also both symptoms of gastroesophageal reflux disease (GERD). “It’s the same disease process,” Dr. Graf said.

According to the National Institutes of Health, certain foods often trigger common symptoms:

  • High-acid foods like citrus fruits and tomatoes
  • Alcohol
  • Chocolate
  • Coffee/caffeine
  • Fatty foods
  • Spicy foods
  • Mint
  • Fried foods

Watch for these signs of GERD

Along with heartburn, people with GERD may also notice regurgitation of stomach contents at night. “When you lay down after eating a heavier meal or drinking water before bed, you can wake up with a sour taste, burping up acid, or feel acid in the back of your throat or mouth. These are classic symptoms of GERD,” Dr. Graf said.

Less often, symptoms of GERD include a chronic cough, hoarseness, a feeling that your voice gets tired quickly, or difficulty swallowing.

Here’s how to control your symptoms

When your symptoms flare up, there are a few things you can try:

  • Avoid foods that trigger your heartburn, especially in the afternoon or evening.
  • Elevate the head of your bed to enlist gravity to help fight regurgitation.
  • Take over-the-counter antacids like Tums or Rolaids, or acid suppressors/proton pump inhibitors such as Prilosec, Nexium, or Pepcid.

When to connect with health care provider

Dr. Graf said if these tips don’t get your symptoms under control, or if you’re experiencing regurgitation, you should talk to your primary care provider or a gastroenterologist. It’s important to get treatment because GERD symptoms aren’t just uncomfortable. Acid can damage the lining of your esophagus. And over time that damage can lead to a condition called Barrett’s esophagus, which makes it more likely that you could develop esophageal cancer.

To put together a treatment plan, your doctor may start with an upper endoscopy. That’s a procedure where you’re sedated, and a surgeon puts a scope through your mouth and into your esophagus and stomach to see if the acid has caused any damage. If there’s no damage, you can likely have follow-up endoscopies when you have your colonoscopies. You can try prescription medications to control your GERD symptoms.

If your esophagus is damaged or inflamed, or if medication doesn’t get your symptoms under control, your doctor may recommend surgery. “Surgical treatments for GERD are very effective. They can give you significant relief and halt the progression of GERD,” Dr. Graf said.

The bottom line

If you experience heartburn once in a while, you can control it with over-the-counter medications and try to figure out which foods to avoid that trigger your flare-ups. But if medication isn’t working or you’re regurgitating acid, talk to your doctor. Prescription medications, like H2 blockers, or surgery can keep GERD from getting more serious.

A doctor can help with diagnosing GERD, troubleshoot your heartburn triggers and walk through your options for treating GERD. To find a gastroenterologist, visit bannerhealth.com.

For a deeper dive into GERD, check out: