Health A-Z

Heartburn and gastroesophageal reflux disease (GERD) are conditions characterized by the regurgitation of stomach acid into the esophagus, causing irritation and discomfort. Here's an overview of symptoms, treatment plans, diagnosis, and testing related to heartburn and GERD.

1. Burning sensation: A burning pain or discomfort in the chest, often behind the breastbone, that can worsen after eating, lying down, or bending over.
2. Acid reflux: Sour or bitter taste in the mouth, often accompanied by regurgitation of stomach contents into the throat or mouth.
3. Difficulty swallowing: Sensation of food sticking in the throat or chest, also known as dysphagia.
4. Chronic cough: Persistent cough, especially at night, which may be aggravated by stomach acid irritating the throat.
5. Hoarseness or sore throat: Irritation of the throat caused by acid reflux.
6. Regurgitation: Bringing up food or liquid into the mouth, sometimes with a sour taste.
7. Chest pain: Chest pain that can mimic heart-related chest pain (angina), particularly if it occurs after eating or when lying down.

1. Lifestyle modifications: Making changes to diet and lifestyle habits can help manage symptoms of heartburn and GERD. These may include:
   • Avoiding trigger foods and beverages that worsen symptoms, such as spicy, fatty, or acidic foods, caffeine, alcohol, and carbonated drinks.
   • Eating smaller, more frequent meals rather than large meals, and avoiding eating close to bedtime.
   • Elevating the head of the bed to prevent acid reflux during sleep.
   • Quitting smoking, as smoking can exacerbate symptoms of GERD.
2. Medications: Over-the-counter and prescription medications can help reduce acid production and relieve symptoms. These may include:
   • Antacids: Neutralize stomach acid and provide quick relief from heartburn.
   • H2-receptor antagonists: Reduce the production of stomach acid and provide longer-lasting relief compared to antacids.
   • Proton pump inhibitors (PPIs): Block acid production in the stomach and are often used for more severe or frequent symptoms of GERD.
   • Prokinetics: Help strengthen the lower esophageal sphincter and promote gastric emptying, reducing reflux episodes.
3. Surgery: In some cases, surgical intervention may be considered for severe GERD that does not respond to medication or lifestyle changes. This may include procedures such as fundoplication to strengthen the lower esophageal sphincter or LINX device implantation to prevent reflux.
4. Behavioral therapy: Techniques such as relaxation therapy or cognitive-behavioral therapy (CBT) may help reduce stress and anxiety, which can exacerbate symptoms of GERD.

1. Medical history and physical examination: A healthcare provider will inquire about symptoms and risk factors and perform a physical examination.
2. Trial of medication: If symptoms are typical of GERD, a trial of acid-suppressing medication may be initiated to see if symptoms improve.
3. Endoscopy: A procedure in which a thin, flexible tube with a camera (endoscope) is inserted into the esophagus to examine the lining and identify any abnormalities or signs of inflammation.
4. Esophageal pH monitoring: A test that measures the level of acid in the esophagus over a 24-hour period to assess the frequency and severity of acid reflux episodes.
5. Esophageal manometry: A test that measures the strength and coordination of the muscles in the esophagus to evaluate esophageal function and assess for conditions such as esophageal motility disorders.