By Murthy Badiga, MD
DHR Health Gastroenterology Institute
Heartburn is a burning sensation or pain in your chest, typically in the mid chest, just behind your breastbone or sternum. This tends to occur or worsen after meals–especially the evening meal–or when lying down. It can be accompanied by bitter or acidic taste in the mouth. Heartburn is caused by reflux or back-flow of stomach acid into the food pipe, or esophagus, which results in irritation of the lining of the esophagus.
Occasional heartburn is fairly common and no cause for alarm. Normally, heartburn can be treated with lifestyle changes such as limiting spicy and greasy foods, losing excess weight, and eating the dinner meal earlier–at least three hours before you go to bed and taking over-the-counter medicines.
When a person experiences heartburn more than twice a week, it is referred to as gastro-esophageal reflux disease or, popularly, GERD. Patients with GERD can experience chest pain and regurgitation of food and acid at night. GERD can lead to more serious or “alarm” symptoms in some, including difficulty in swallowing or a sensation of a lump in the throat, a persistent cough, hoarseness of voice or laryngitis, new-onset asthma, vomiting blood, black stools, and/or anemia and weight loss.
If you have persistent heartburn that does not respond to lifestyle changes and over-the-counter remedies or you develop alarm symptoms, it is advisable to seek medical attention. GERD can sometimes result in serious complications, such as an esophageal stricture (narrowing of the esophagus due to scarring) and Barrett’s esophagus (change in the lining of the esophagus to that of the stomach, which sometimes can progress to dysplasia and cancer).
Endoscopic evaluation by a gastroenterologist can identify whether one has a hiatal hernia, erosive esophagitis, strictures, Barrett’s syndrome, or esophageal cancer. We also perform a Bravo test in conjunction with an EGD (esophago-gastro-duodenoscopy or upper endoscopy), when indicated, which actually continuously measures the pH/presence of acid in the esophagus for 48 hours. We can treat Barrett’s with dysplasia endoscopically with RFA (radiofrequency ablation), thus preventing progression to esophageal cancer. We can dilate the esophageal strictures with a balloon, solving dysphagia (or difficulty in swallowing). In summary, the gastroenterologist can precisely diagnose and treat GERD and its complications.
If you are experiencing symptoms and would like to speak to one of our expert physicians, please call the DHR Health Gastroenterology Institute at 956-362-3636. We are available to answer any questions you may have and can help you schedule a consultation to discuss the steps you can take to help ease your symptoms.