Doctors call it reflux. You probably call it heartburn. But whatever it's called, no one wants to experience the unpleasant sensations of heartburn -- a burning chest pain that moves up toward the throat, and an acid or bitter taste accompanied by a feeling that whatever you just ate is coming back into your mouth or throat.
Almost everyone has had heartburn from time to time -- maybe at Thanksgiving, after overdosing on turkey and pie, and a few glasses of wine, and then lying around all day watching football. But about 20% of the U.S. population experiences reflux at least weekly. Some, who have severe, persistent heartburn, may have a more serious condition called gastroesophageal reflux disease or GERD -- which can contribute to a wide range of other health problems, including a precancerous condition called Barrett's esophagus.
A physical exam for hiatal hernia is similar to that for heartburn, with two additions: X-rays may be ordered to show the hernia, and if anemia is a concern, a blood sample may be taken to check your red blood cell count.
A hiatal hernia can be diagnosed with a specialized X-ray study that allows visualization of the esophagus and stomach (barium swallow) or with endoscopy (a test that allows the doctor to view the hernia directly). An esophageal manometry test (pressure study) may also be performed...
One key to controlling heartburn is to know your personal triggers. After all, although some foods and lifestyle habits are common heartburn triggers, they don't affect all people the same way. One person with heartburn can happily eat citrus fruit, while another ends up miserable less than an hour after a big glass of orange juice.
Here are top foods and behaviors most commonly linked to heartburn:
Eating large meals, eating later in the day, and eating fatty foods. These "top three" triggers affect almost everyone who has heartburn, says gastroenterologist Charlene Prather, MD, an associate professor of medicine at St. Louis University School of Medicine.
Chocolate. This one, unfortunately, is also reasonably consistent, hitting most heartburn sufferers.
Coffee and caffeinated drinks. "Some people have trouble with coffee and caffeine, while others don't," says Prather.
Citrus products, like oranges and orange juice. While caffeine actually induces reflux, says Prather, citrus just mimics the feeling because of its acidity.
Garlic, onions, and other spicy foods.
Tomatoes. "They tend to be more of a problem when they're cooked than when they're raw, but both can bring on heartburn," Prather says.
Alcohol. All types of alcohol can trigger heartburn, but red wine apparently is particularly troublesome for some people.