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Heartburn/GERD Health Center

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No More Heartburn


WebMD Feature from "Good Housekeeping" Magazine

By Lisa Collier

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New Treatments, from Easy At-Home Tricks to an Amazing 20-Minute Hospital Fix

 

Yesterday, 15 million Americans were miserable. That's how many women and men get heartburn every single day. Over the past month, some 60 million people experienced either the main symptom — a severe burning sensation in the chest — or another one, such as discomfort in the back of the throat. In some cases, food comes back up, along with a sour taste. If you're one of those millions, the good news is that simple, new treatments can help you feel better fast.

Heartburn is primarily a mechanical problem. When you swallow food, it travels down the esophagus and enters the stomach via a small, muscular valve.

Normally, the valve then closes and stays shut. But sometimes it becomes weak and floppy and doesn't close properly. That's when trouble begins: Food and stomach acids gurgle back up into the esophagus — a condition known as acid reflux. If this happens to you frequently (twice a week or more) and if your symptoms are severe, the condition is called gastroesophageal reflux disease, or GERD.

Heartburn can strike anyone, but women suffer more often than men, and pregnant women are especially susceptible. Weight is another key risk factor, and it doesn't have to be extreme. If your weight is normal, but at the upper end of the healthy range, your chances of having frequent heartburn are higher, reported the Harvard Nurses' Health Study last June. For example, if you're a five-foot-four-inch woman weighing 128 pounds, gaining as few as six pounds can up your risk of GERD 38 percent.

As for your diet, it may not be as important as doctors once thought. For years, the forbidden list for heartburn sufferers included spicy or salty dishes, high-acid foods (like oranges), caffeine, carbonated drinks, alcoholic beverages, even chocolate. But a recent review of research at Stanford University questions whether restricting these foods and drinks really helps. "There's currently not enough evidence that they make heartburn worse or that cutting them out will make it go away," says gastroenterologist Lauren Gerson, M.D., lead researcher on the study and director of the university's Esophageal and Small Bowel Disorder Center. Of course, if a certain kind of food seems to aggravate your symptoms, do try dropping it from your menu. And if your diet, whatever type, is causing you to put on pounds, losing weight should improve symptoms, says Dr. Gerson.

Recent studies have also shown that the following measures help:

  • Raising the head of your bed. If your heartburn kicks in during the night, put gravity to work by keeping your esophagus higher than your stomach so stomach acid can't flow up. Place blocks under the bed legs to elevate your head six inches or lie on a special slanted cushion. The Stanford review also found that sleeping on your left side may diminish reflux.
  • Chewing gum after meals. Chewing increases saliva flow, which helps wash stomach acid out of your esophagus, explains Ryan Madanick, M.D., a gastroenterologist at the University of North Carolina at Chapel Hill. For even more help, try Chooz, a brand of gum (available online) that contains an antacid.
  • Picking the right medication. If you have only occasional or mild heartburn, an over-the-counter antacid like Tums, Rolaids, or Mylanta can deliver temporary relief. But if you're taking an antacid more than two or three times a week, see your doctor, who may suggest either a proton pump inhibitor (brand names: Prilosec, Prevacid, Nexium, Protonix) or an H2-receptor antagonist (Pepcid, Tagamet, Zantac). These are available by prescription or, at a lower dose, OTC. Both types decrease the production of stomach acid, but a recent review of 31 clinical trials involving nearly 10,000 patients found that PPIs work better.

In extreme cases, surgery may be called for. The traditional GERD procedure involves wrapping the top of the stomach around the lower esophagus to tighten the floppy valve. The operation is performed under general anesthesia and requires a one- to three-day hospital stay and at least a two-week recovery period. Now doctors can often fix a faulty valve with a nonsurgical outpatient procedure that involves stapling the valve with a device called the Plicator. In a study conducted at 15 centers across the country, 65 percent of patients treated with the Plicator had a major improvement in symptoms (and 62 percent no longer needed any medication) — comparable to the success rate of traditional surgery.

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