Should I Get Medical Help for My Heartburn?

For many of us, heartburn is an all-too-familiar sensation:  a burning in your chest, throat and stomach. Sometimes called "acid indigestion," it occurs when stomach acid comes up from the stomach and into the throat. While certain foods can trigger heartburn symptoms for some, regularly-occurring heartburn can also be a sign of a more serious condition like GERD (gastro-esophageal reflux disease), which is the chronic reflux of stomach acid into the esophagus.
 
Two signs that indicate you could have a more serious problem than heartburn alone include 1) experiencing heartburn two or more times per week and 2) having difficulty swallowing  even when heartburn isn't present (due to acid irritation that has caused the esophagus to become inflamed).  If either of these sound like you, make an appointment with your doctor right away.
 
In addition, if you experience any two or more of the symptoms or habits below, you should consider seeing your doctor: 
  • A sour taste in the back of your throat
  • A sore throat that won't go away
  • A dry cough without other cold symptoms
  • Throwing up small amounts of semi-digested food
  • Waking up with a burning in the back of your throat
  • Feeling like there's always a lump in your throat
  • Taking antacids two or more times a week
  • You are overweight or obese
  • You smoke
  • You've been diagnosed with a condition that effects the ability of your stomach to empty properly (such as gastroperesis, scleroderma or Zollinger-Ellison syndrome).
  • Using over-the-counter antacids for more than two weeks
  • Worsening asthma symptoms
Left untreated, chronic heartburn and GERD can lead to esophagitis, ulcers or strictures (narrowing of the esophagus) and can increase the risk of esophageal cancer—so these symptoms aren't something to ignore.

What to Expect at Your Doctor's Visit
To prepare for your doctor's visit, you should consider keeping a heartburn journal to track your symptoms. Plan to do this for at least two weeks to make sure you have enough information collected. Each time you experience a bout of heartburn, note symptoms, timing, foods you ate and other activities that may be related. Be sure to note the time of day, how long the symptoms persist and if you take any over-the-counter heartburn remedies.

To diagnose GERD and ascertain the damage to your esophagus, your doctor will likely order one or more tests including:
  • A barium swallow or upper GI series: You'll been given a thick, chalky liquid to swallow and then an X-ray will be taken of your upper digestive track.
  • Endoscopy: You'll be lightly or completely sedated and the doctor will pass a thin tube down your throat that houses a light and a camera to get a closer look at your esophagus and stomach.
  • Ambulatory acid probe test: Your doctor will place a probe in your throat to collect data about the amount of acid present there. The information will be sent to a computer that you wear around your waist for a couple of days.
  • Esophageal manometry test: Your doctor will pass a thin tube through your nose and down your throat into your stomach to examine the muscular contractions of your esophagus.
Treatment usually starts with over-the-counter medication, then moves on to prescription medication and finally, if your symptoms aren't resolved, surgery. While you're waiting to see your doctor, there are plenty of ways to reduce your symptoms at home, including quitting smoking, elevating the head of your bed several inches when sleeping, losing weight if overweight or obese and reducing your alcohol consumption.
 
Heartburn isn't—and shouldn't be—something you just have to put up with forever. And it isn't something you should ignore either. Your healthcare provider can help you prevent and treat frequent heartburn and prevent its complications so you can improve your everyday life—and your health.

This article has been reviewed and approved by Becky Hand, Licensed and Registered Dietitian.
 
Sources
Mayo Clinic, "Gerd," accessed on April 29, 2013. www.mayoclinic.com.
Medline Plus, "Gerd," accessed on April 29, 2013. www.nlm.nih.gov.
WebMD, "When to Call the Doctor about Heartburn or Reflux," accessed on April 29, 2013. www.webmd.com.