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Health Information Has Your Heartburn Gone on Too Long?

It's just heartburn, right? Take an antacid, hope it works and worry about it tomorrow. This is true for most heartburn, but when you have frequent or uncontrollable heartburn you should see your physician.

Heartburn or acid reflux (sometimes referred to as gastroesophageal reflux disease — GERD) occurs when acid from the stomach flows up or refluxes into the esophagus, the muscular tube that connects the throat with the stomach.

"When the lower part of the esophagus is continually exposed to acid from the stomach, the cells begin to adapt," says Michael D. Brown, MD, a specialist in digestive disorders at Rush University Medical Center in Chicago.

Over time, the cells of the esophagus that are repeatedly in contact with acid adjust to become more like cells found in the small intestines. This is referred to as Barrett's esophagus. While this change in the cells protects the esophagus from further damage caused by inflammation, abnormal cells can develop in the process.

"That's why if you have greater than three years of heartburn or acid reflux you should have an endoscopy," says Brown. "The endoscopy will look for any evidence of dysplasia or abnormal cell growth. We're hoping to catch any abnormal cells at the precancerous stage."

An endoscopy is a simple procedure where a specially designed scope is used to examine the esophagus and take tissue samples, when necessary. The tissue samples or biopsies are then examined to look for any abnormal cell growth.

"We also have the PillCam, which offers an alternative to an endoscopy," says Brown. "With the PillCam, one simply swallows a small camera that goes through the esophagus taking pictures at 14 frames per second. If there's no suspect tissue, which is true for about 80 percent of patients, you're done. If we do see tissue that we want to biopsy, we'll need to do an endoscopy."

Read more about the PillCam in the article "Camera-in-a-Pill Checks for Diseases of the Esophagus."

Keeping the Lines of Communication Open
It's important to communicate with your doctor if you've been experiencing recurring acid reflux or are treating yourself for heartburn with over-the-counter medications or with a prescription from another doctor.

You'll also want to visit your doctor if you:

  • Have trouble swallowing
  • Experience unexplainable weight loss
  • Have anemia
  • Have bleeding in the gastrointestinal tract, such as blood in the stool or vomit

"These are important symptoms to watch out for, because you can have Barrett's esophagus without experiencing heartburn," says Brown.

Avoiding Heartburn
If you experience heartburn on occasion, you may want to try to:

  • Avoid eating within three hours of the time you go to bed
  • Take any acid suppressant medication first thing in the morning
    • "Because of the way the body's rhythm affects your metabolism, it's not helpful to take these medications at night," says Brown.
  • Sleep on a slight incline
  • Avoid foods that may cause reflux, like peppermint, coffee and chocolate
    • "Interestingly, spicy foods haven't been shown to cause heartburn," says Brown. "And there's some evidence that spicy foods may protect the body from heartburn."
  • If you smoke or use other tobacco products, quit

"The most important thing is to be aware of what causes you personally to have heartburn," says Brown. "Everyone is different, so be aware of what triggers an attack for you and what food and remedies work best for you. But always work closely with your doctor and let him or her know when you are experiencing prolonged bouts of heartburn."

More Information at Your Fingertips:

  • For more information about gastroenterological care at Rush visit our Gastroenterology and Nutrition home page.
  • Looking for a doctor? Call toll free: 888 352-RUSH (7874)

Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.

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