Heartburn is a burning feeling behind the breastbone. Stomach acid and food back up from the stomach into the esophagus. It irritates the lining of the esophagus. Heartburn happen often or every once in a while.
Heartburn that occurs more than 2 times a week for several weeks may be gastroesophageal reflux disease (GERD). It can cause permanent damage over the course of time.
A muscular ring controls the opening between the esophagus and the stomach. It relaxes to let food pass into the stomach. Then it closes shut to keep stomach acid and food in the stomach. If the ring does not close completely, stomach acids can escape up into the esophagus. The acid irritates the esophagus and causes heartburn. There are a number of reasons that the ring may not close tightly including:
Problems with the nerves that control the muscles of the ring
Problems with muscle tone of the ring
Muscles that move food down into the stomach are weak
Abnormal pressure on the area
Increased relaxation of the muscles
Increased pressure within the abdomen—pushes up against the stomach
Make an appointment to see your doctor if you have heartburn 2 or more times a week, every week.
The doctor will ask about your symptoms and medical history. Heartburn or GERD will be suspected based on your symptoms. Your doctor may do a trial with medicine. If your symptoms are managed with medicine it will confirm GERD.
Further testing is not always needed.
Your doctor may order the following to look for complications:
Avoid belts and clothing that are too tight. They can increases pressure on the abdomen.
Elevate head of your bed 6-8 inches. It may relieve heartburn at night.
Medicine may help relieve symptoms. Some can also help to repair damage. Many heartburn medicines are available over-the-counter. Options include:
Talk to your doctor about which ones may be best for you.
Surgery may be an option if:
Symptoms are severe
Other treatment methods fail
Medicine cannot be tolerated
Surgical treatments include:
The most common surgery for GERD is
fundoplication. The doctor wraps the stomach around the esophagus. This creates extra pressure on the opening to the stomach and helps keep it closed.
Endoscopic Antireflux Procedures
There are a number of procedures that can be done with an endoscope. These procedures use a long thin tube called a scope. It is passed through the mouth and down the throat and has a camera that will help the doctor see inside. Small tools can also be passed through the scope to do a number of procedures. One example is transoral incisionless fundoplication (TIF). With TIF, fasteners are used to reshape the upper part of the stomach. It will help tighten the ring muscles.
LINX Reflux Management System
LINX is a small band with magnetic beads. A surgeon places the band around the end of the esophagus where it meets the stomach. The magnets pull together to help close the opening. Swallowed food or drink push apart the beads so that it can move into the stomach.
Some people will be able to stop or reduce medicine after surgery.
Acid reflux (GER & GERD) in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults. Accessed April 4, 2018.
Heartburn. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/heartburn/. Updated November 8, 2017. Accessed April 4, 2018.
Warning signs of a heart attack. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Warning-Signs-of-a-Heart-Attack_UCM_002039_Article.jsp#.WsUYIy7wZQJ. Updated January 11, 2018. Accessed April 4, 2018.
Last reviewed March 2018 by
EBSCO Medical Review Board
Daus Mahnke, MD
Last Updated: 7/9/2015
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