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When is Heartburn Just Heartburn?

Posted Aug 24 2008 1:49pm
ANNOUNCER: Heartburn is one of the most common, minor medical complaints, affecting as many as 60 million Americans.

STREET INTERVIEW #1: Chances are I'm probably going to get a little heartburn from this.

STREET INTERVIEW #2: I am going to go with a yes on that.

STREET INTERVIEW #1: Yeah. Well worth it, though.

STUART SPECHLER, MD: Heartburn is a very big problem in this country.

WOMAN ON STREET: I get heartburn every couple of months. Sometimes it's pretty bad. It's a burning sensation.

STUART SPECHLER, MD: There have been some surveys conducted that suggest that about one person in five in the United States, one adult out of every five, has heartburn at least once a week.

MAN ON STREET: Actually, I noticed since I hit my forties it's become a regular occurrence. Particularly with things like hot spicy foods. Or tomato sauces. Almost anything acidic.

STUART SPECHLER, MD: Probably 40% of adult Americans experience heartburn at least once a month. So you're talking about an awful lot of people getting a lot of heartburn.

ANNOUNCER: The good news is, the vast majority of heartburn sufferers can find safe and effective relief on the shelves of their supermarkets and drugstores.

STEVEN PEIKIN, MD: When people come with heartburn, what we call their problem is gastro esophageal reflux. And what that means is that food and acid that should be in the stomach refluxes back up into the esophagus. That's gastro esophageal reflux. The most common symptom of gastro esophageal reflux is heartburn.

STUART SPECHLER, MD: Heartburn is a burning sensation that's usually located in the chest. A lot of patients say, "I feel it behind the breastbone."

STEVEN PEIKIN, MD: The second most common symptom of gastro esophageal reflux is regurgitation. That may be that sour taste in the mouth that you feel maybe when you bend over to tie your shoes or when you're laying down at night.

ANNOUNCER: The problem is in the design of the plumbing.

STUART SPECHLER, MD: Ordinarily, there's a muscle arrangement at the end of the esophagus-it's called the lower esophageal sphincter-and what that muscle is supposed to do is to squeeze, and by squeezing just keep material down in the stomach where it belongs. That muscle obviously has to relax when you eat. Otherwise things wouldn't get through. But what happens is, when you swallow that muscle relaxes. It allows the food to enter into the stomach, and then it's supposed to close back up and prevent reflux.

In people who have heartburn, that muscle, for whatever reason, is not functioning very well and you have a leaky valve. The lower esophageal sphincter is not working... Acid gets into the esophagus, and that triggers heartburn.

ANNOUNCER: Most of the time heartburn is no threat to health. And simple changes in eating habits and daily routines can lessen the number of episodes in the future.

STEVEN PEIKIN, MD: First thing what you do when you have a person with heartburn, is I talk about lifestyle changes.

I tell patients to avoid foods that can precipitate heartburn. These are foods that can relax the lower esophageal sphincter. The foods that tend to relax that sphincter are peppermint, chocolate, nuts, caffeine, and greasy foods.

One other thing I tell the patients is don't eat for three hours or four hours before lying down. If you lie down soon after eating, then the acid is going to be in the stomach and it's easier to come back up into the esophagus.

ANNOUNCER: There are occasions when acid reflux can cause changes in the lining of the esophagus that sometimes progresses to a more serious condition.

What are the symptoms that should send a person to a doctor?

STUART SPECHLER, MD: If you're getting heartburn and you notice that your weight is dropping, you'd better get in to be evaluated quickly.

If food gets stuck in your chest on the way down -- that's something that could also be more than just simple heartburn. If you have any signs of bleeding -- in other words, if you've either thrown up blood or if you notice that your stools have become black, that's a warning symptom that you really ought to get yourself into the, into the physician.

If it hurts when you swallow -- that is, whenever you're swallowing you're feeling pain in your chest at the same time, that's another warning symptom.

ANNOUNCER: Gastroenterologists want people to know that acid reflux can lead to serious disease.

But they also want people to understand usually it does not.

STEVEN PEIKIN, MD: When you want to let the population know that there is a risk of developing complications to heartburn, you don't want to overstate the risk. I think there's a possibility that maybe we have scared some people thinking, "Oh, if I have heartburn, I'm going to get cancer."

ANNOUNCER: And when no signs point toward a more serious condition, doctors say patients should feel confident relying on readily-available medications.

MAN ON STREET #2: I use the antacids throughout the day usually. I like to drink a lot of coffee and coffee seems to really give me give me a lot of heartburn.

ANNOUNCER: Antacids are just one type of over-the-counter medicine for heartburn. They provide quick relief by neutralizing stomach acid.

Other drugs, called H-2 blockers, provide longer relief, by reducing acid production.

These medications can be taken alone, or in combination.

STUART SPECHLER, MD: Somebody who has heartburn that doesn't have any alarm symptoms, just simple heartburn, I think that person is very well justified in trying over-the-counter medications.

MAN ON STREET #2: I have some spicy mustard on there with a hint of barbecue sauce. So yeah, this going to be a doosy. You know it's a great sandwich. But definitely does give you heartburn. Right here. It's absolutely no question about it.

STEVEN PEIKIN, MD: Even if it isn't the most serious problem in the world, it's something that really affects a lot of people and they really ought to know that there are very good remedies for this condition.

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