Understanding heartburn, acid reflux and GERD


Commentary by Robert Siwiec, MD, IU Health Physicians Digestive & Liver Disorders – Carmel

Robert Siwiec, MD

Robert Siwiec, MD

Heartburn, a burning sensation behind the breastbone, is often considered merely an uncomfortable nuisance. People are sometimes surprised to learn that heartburn is not a disease. It’s actually a symptom of acid reflux or gastroesophageal reflux disease (GERD).

Acid reflux occurs when stomach acid splashes back up into the esophagus, causing irritation and often heartburn. GERD is a more severe and chronic form of acid reflux that can lead to serious health problems.

Common causes of acid reflux disease include:

  • Faulty valve (called the lower esophageal sphincter) between the stomach and esophagus that relaxes more often than it should, resulting in acid reflux
  • Hiatal hernia (This occurs when part of the stomach moves above the diaphragm, a muscle wall that separates the stomach and chest, which can lead to acid reflux.)
  • Being overweight or obese
  • Lying down right after eating
  • Eating too close to bedtime
  • Pregnancy (The expanding uterus pushing up on the stomach, in addition to circulating pregnancy hormones, can both lead to acid reflux.)
  • Smoking
  • Consuming certain foods and beverages, including citrus, carbonated beverages, alcohol, chocolate, and spicy or fatty foods
  • Taking medications, such as aspirin, ibuprofen and certain blood pressure medicines

While occasional heartburn is not generally a cause for concern, heartburn that occurs more than two or three times a week should be evaluated by a primary care doctor or gastroenterologist. If left untreated, GERD can lead to complications, such as Barrett’s esophagus or esophageal cancer. Tests used to diagnose acid reflux and GERD include pH monitoring of the esophagus, endoscopy and manometry.

Once a diagnosis of GERD is made, there are several ways to properly manage and treat this condition. Many doctors will consider lifestyle modifications as a first-line treatment. This may mean losing weight in addition to altering the diet and/or changing eating behaviors.

Prescription medications that work by reducing stomach acid are also commonly used in the treatment of GERD. It’s important to talk to your primary care doctor or a gastroenterologist if you suffer from frequent or recurring heartburn.

Robert Siwiec, MD, is a board certified gastroenterologist. He is a guest columnist located at IU Health Physicians Digestive & Liver Disorders, IU Health North Hospital, 11725 N. Illinois St., Ste. 275, in Carmel. He can be reached by calling the office at 688-4864.

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