Question: I’m getting heartburn a lot since I turned 60. Is
more heartburn something that comes with more years?
Answer: More than 60 million Americans experience heartburn at
least once a month, and more than 15 million Americans experience heartburn daily.
Heartburn is more common among the elderly.
Heartburn two or more times weekly may be caused by
gastroesophageal reflux disease. See a doctor if you have heartburn too often.
The doctor can test for GERD.
In a test called an upper GI series, you swallow a liquid barium
mixture.
Then a radiologist watches the barium as it travels down your
esophagus and into the stomach. Another test is an endoscopy, in which a small
lighted flexible tube is inserted into the esophagus and stomach.
GERD makes stomach acid flow up into your esophagus. There is a
valve at the lower end of the esophagus that is designed to keep acid in the
stomach. In GERD, the valve relaxes too frequently, which allows acid to
reflux, or flow backward.
A hiatal hernia may contribute to GERD. A hiatal hernia occurs
when the upper part of the stomach is above the diaphragm, which is the muscle
wall separating the stomach from the chest. The diaphragm helps the valve keep
acid from coming up into the esophagus.
When GERD is not treated, you can suffer from severe chest pain,
narrowing or obstruction of the esophagus, bleeding, or a pre-malignant change
in the lining of the esophagus.
One study showed that patients with chronic, untreated heartburn
were at substantially greater risk of developing esophageal cancer.
The following are some symptoms that may mean there has been
damage to your esophagus: difficulty swallowing, a feeling that food is trapped
behind the breast bone, bleeding, black bowel movements, choking, shortness of
breath, coughing, hoarseness, weight loss.
You can control infrequent heartburn by changing your habits and
using over-the-counter medicines.
For example, you should avoid heartburn-producers such as
chocolate, coffee, peppermint, tomato products, alcoholic beverages, greasy or
spicy dishes. Quit smoking because tobacco inhibits saliva that helps with
digestion. Tobacco may also stimulate acid production and relax the esophageal
valve. Lose weight. And, don’t eat two hours before you go to sleep.
For infrequent episodes of heartburn, take over-the-counter
antacids, such as Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, and
Riopan. Or, you can take an H2 blocker. H2 blockers are available in both
over-the-counter and prescription forms.
For example, Pepcid, Tagamet and Zantac are all over-the-counter
H2 blockers which are available by prescription at higher doses.
Then there are proton pump inhibitors, a group of prescription
medications that prevent the release of acid in the stomach and intestines.
Doctors prescribe PPIs to treat people with heartburn, ulcers of
the stomach or intestine, or excess stomach acid. PPIs include Prilosec,
Prevacid, Nexium and Aciphex.
GERD is a chronic disease that calls for continuous long-term
therapy.
To decrease the acid in your esophagus, raise the head of your bed
or place a foam wedge under the mattress to elevate the head about 6-10 inches.
Avoid lying down for two hours after eating. And don’t wear tight clothing.
Prescription medications to treat GERD include the H2 blockers and
the PPIs, which help to reduce the stomach acid and work to promote healing at
prescription strength. In addition, there are agents that help clear acid from
the esophagus.
Surgery is an option if other measures fail. A surgeon can improve
the natural barrier between the stomach and the esophagus that prevents acid
reflux.
If you have a question, please write to fred@healthygeezer.com
Copyright © 2008 by Fred Cicetti.
All rights reserved.