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.
