Frequently Asked Questions About Heartburn and Reflux
2. It seems that my husband has heartburn every night. I think he should see a doctor. He thinks he should just continue taking antacids. Who's right?
Occasional heartburn is common and generally not serious. However, prolonged heartburn can be a symptom of a serious problem, such as esophagitis. Esophagitis is an inflammation of the lining of the esophagus, the food tube. Esophagitis occurs when stomach acid repeatedly comes into contact with the lining of the esophagus. If esophagitis is severe, the person can develop Barrett's esophagus and even cancer. Over time, this condition can narrow the passageway from the esophagus to the stomach. Your husband should consult his doctor for further evaluation. When a person requires more than twice-weekly over-the-counter drugs for heartburn, a doctor should be consulted. An endoscopy to visualize his esophagus may also be recommended.
3. I am a 55-year-old male who is about 30 pounds overweight. Lately, I've been experiencing frequent heartburn and have an acid taste in the back of my throat. Now, my doctor is telling me I have a hiatal hernia. Is this a serious problem? Will it require surgery?
A hernia is the pressing of an organ through an opening in the muscle wall of the cavity that protects it. With a hiatal hernia, a portion of the stomach pushes through the hole where the esophagus and the stomach join.
The most common cause of a hiatal hernia is an increase in pressure on the abdominal cavity. Pressure can come from coughing, vomiting, straining during a bowel movement, heavy lifting, or physical strain. Pregnancy, obesity, or excess fluid in the abdomen also can cause hiatal hernias.
A hiatal hernia can develop in people of all ages and both sexes, although it frequently affects middle-aged people. In fact, the majority of otherwise healthy people over age 50 have small hiatal hernias.
Many people with a hiatal hernia never have any symptoms. In some people, acid and digestive juices escape from the stomach into the esophagus (gastroesophageal reflux). This causes:
- A bitter or sour taste in the back of the throat
- Bloating and belching
- Discomfort or pain in the stomach or esophagus
Most hiatal hernias do not cause problems and rarely need treatment. Successful treatment of hiatal hernias usually involves treating the symptoms of gastroesophageal reflux disease (GERD) that are triggered by the additional pressure in the abdomen.
Making lifestyle changes, such as:
- Losing weight, if you are overweight, and maintaining a healthy weight
- Having a common-sense approach to eating, such as eating moderate to small portions of foods, and limiting fatty foods, acidic foods (such as tomatoes and citrus fruits or juices), foods containing caffeine, and alcoholic beverages
- Eating meals at least three to four hours before lying down and avoiding bedtime snacks
- Elevating the head of your bed by 6 inches (this helps allow gravity to keep the stomach contents in the stomach)
- Not smoking
- Wearing looser clothing, especially around the waistline
- Taking medications, such as over-the-counter antacids or H2 blockers or PPIs. Note: If you take over-the-counter drugs and see no improvement or take them for longer than two weeks, see your doctor. He or she may prescribe a stronger medication.