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Heartburn and Gastroesophageal Reflux

These conditions may be caused by insults to the digestive system.  One may present with a variety of symptoms all of which can be addressed with changes in diet, position and medicine.

Heartburn is a pain or burning sensation in the middle chest or high abdomen which medically is associated with the regurgitation of acid into the esophagus from the stomach.  This pain may be constant or intermittent and one may see a direct relation between certain foods and the worsening of the pain.  Heartburn is often worse after lifting or rebumbency; it may follow overeating or alcohol ingestion.  Sometimes the pain may travel across the chest and into the jaw area.  One may describe a sour taste in the mouth, regurgitation, especially upon awakening in the morning.

TREATMENT;

NONPHARMACOLOGIC MEASURES -

•    In terms of body position and gravity:  Do not lie down immediately after eating.

•    Elevate the head of the bed 6-8 inches.  This can be done by placing blocks under the head posts of the bed or placing pillows beneath the mattress at the head of the bed.  This helps to keep an angle from your head to your stomach which may decrease the tendency of reflux of stomach contents upward into the chest.

•    Avoid large evening meals.

•    Small frequent meals may be better for ease of digestion.

•    Avoid snacking in the nighttime.

  FOOD SELECTION:

•    Avoid fatty foods.  Avoid caffeine products such as coffee, tea, cola, chocolate.  Peppermint and citrus food like orange juice and tomatoes should be avoided.  Increase protein into your diet which will diminish the tendency for reflux and therefore heartburn.

•    Avoid alcohol which causes irritation in the gastrointestinal tract and increases reflux into the esophagus.

•    Stop smoking - nicotine predisposes one to reflux.

•    If obesity is a problem, weight loss is recommended for this condition to decrease the abdominal pressure on the chest cavity as a result of the added weight.

DRUG THERAPY:

•    We recommend antacids, which are medicines one can purchase in any pharmacy or supermarket.  The real difficulty is the frequency of taking antacids in order to arrest the symptoms.  One needs to take the medicine 20 minutes to 30 minutes after eating and every two hours.  Theoretically, one needs to take these for at least 6 to 8 weeks for containment of the process.  Compliance is a real issue here.

•    In addition to antacids, the physician can order a prescription which may be used in substitution or along with antacid therapy for treatment.  One needs to make an appointment in order to receive this medication.

•    There is a range of severity of heartburn.  One may "get away with" a few doses of antacids and resolve the situation.  For a more persistent problem, please come in to be evaluated.
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