You thought you have a simple case of heartburn, but lately, after adding a few inches to your waistline, it's more than that: a frequent feeling of pain under your breastbone; the faint taste of acid on the back of your tongue; trouble sleeping a few times a week; and problems swallowing.
It happens when you eat too much, when you doze on the couch after dinner, and when you have too many drinks during cocktail hour. Chowing down a few slices of pepperoni pizza doesn't seem to be a problem, but tacos almost guarantee a night of chest pain and tossing and turning. For other people, the reverse could be true, or the problem could come from other foods.
For most people, heartburn is a treatable symptom. Frequent heartburn may indicate acid reflux or gastroesophageal reflux disease, also known as GERD. When treatment doesn't work and heartburn is severe despite lifestyle changes, surgery may be an option. It may also be an option if GERD causes other medical problems. Minimally invasive procedures using endoscopy are also available to treat acid reflux.
What's going on? Your occasional bout of heartburn has now become one part of a larger problem -- GERD, or gastroesophageal reflux disease.
"Everybody has a little bit of heartburn," says Joel Richter, MD, a gastroenterologist and chairman of medicine at Temple University. "But GERD is when it becomes chronic, occurring two or three times a week or more; when it's interfering with your lifestyle so that you're avoiding eating various foods; when you're not exercising because you get heartburn; and when it's interfering with sleep and when swallowing."
Heartburn: A Symptom of GERD
More than 15 million Americans, usually adults but also children, have GERD. Many of these people deal with heartburn, its most common symptom, two or more times a week. The root cause of the disease is a faulty valve between the esophagus and the stomach, called the lower esophageal sphincter, that relaxes more often than it should. The result is that juice from the stomach -- made up of acid, digestive enzymes, and other unpleasant substances -- sneaks back up into the esophagus and damages its lining.
Why this happens isn't always clear, but doctors do know that the valve may stop working properly if a person:
Is overweight. Extra weight puts pressure on the valve, causing it to relax.
Is pregnant. Hormones play a role in relaxing the valve, and the growing fetus puts pressure on the stomach.
Has a hiatal hernia. This prevents the muscle wall between the chest and the stomach from supporting the valve as it should.
GERD can be just heartburn or heartburn plus other symptoms, including excessive clearing of the throat, problems swallowing, the feeling that food is stuck in your throat, burning in the mouth, and burning pain in the chest. Untreated, GERD can lead to serious health problems, so it needs to be taken seriously and managed with both medication and smart lifestyle choices, starting with maintaining a healthy weight.