Managing and Preventing Heartburn

Overview and Heartburn Facts

Heartburn is a burning sensation in the chest. It occurs when the stomach acid or other stomach contents backs up (“refluxes”) into the esophagus. Approximately 60 million individuals in the United States experience heartburn at least once a month and almost 15 million people experience heartburn daily.

 

Heartburn Signs and Symptoms

Patients with heartburn can experience signs and symptoms in a variety of ways. Symptoms can include:

•   Burning pain behind the breastbone area that usually occurs after eating

•   Pain that is worse when bending over or lying down

•   Bitter taste in the mouth

•   Indigestion

•   Belching

 

Causes: Common Triggers

The specific triggers of heartburn vary for each person. Factors that can contribute to heartburn include:

•   Obesity

•   Drinking caffeinated or carbonated beverages

•   Consuming large meals, eating <2 hours before bedtime, and high consumption of fatty or fried foods

•   Drinking alcoholic beverages, especially before bedtime

•   Smoking

•   Stress

•   Certain medications

 

Tests and Diagnosis

Forpatients who cannot find heartburn relief with lifestyle modifications and OTC products, a gastroenterologist may suggest a more comprehensive diagnostic evaluation. Patients may undergo an endoscopy, a biopsy, and ambulatory pH monitoring. Surgery may be an option for patients with severe reflux or who are poor responders to medical treatment plans.

 

Prevention

Patients can reduce the occurrence of heartburn symptoms with lifestyle changes and by avoiding heartburn triggers and behaviors that contribute to acid reflux flare-ups.

 

Day-to-Day Management

Heartburn is manageable if patients:

•   Avoid common heartburn triggers

•   Take OTC heartburn products as directed by their physician and/or pharmacist

•   Keep a diary to better help manage symptoms

 

Treatment and Care

Patients should consult with their physician about the best course of treatment to relieve heartburn symptoms. If symptoms do not abate with lifestyle changes and OTC medications, patients should inform their physician and discuss next steps in the treatment plan.

 

Lifestyle Modifications and Alternative Medicine

Patients can find symptom relief by making small lifestyle changes. These include:

•   Maintain a healthy weight

•   Avoid restrictive or tight clothing

•   Avoid food and beverages that trigger heartburn

•   Eat smaller meals

•   Avoid lying down after a meal, particularly within 2 hours of eating

•   Elevate the head of the bed 4 to 6 inches

•   Stop smoking

 

Stress and anxiety can exacerbate heartburn. If these 2 factors contribute to heartburn, patients may want to consider:

•   Light-to-moderate exercise

•   Relaxation techniques

•   Massage

 

Self-Care

In recent years, the variety of OTC medications to relieve heartburn pain has increased. These products include:

•   Antacids

•   H-2 blockers and H-2 blockers with antacids

•   Proton pump inhibitors

Pharmacists should counsel heartburn patients to use these products appropriately for the recommended length of time. Patients should inform the pharmacist of all medications they are taking to help prevent serious drug interactions or contraindications.

 

Resources for Patients

In addition with consulting with their physician and/or pharmacist, patients can find information from the following resources:

•   National Heartburn Alliance (www.heartburnalliance.org)

•   American Gastroenterological Association (www.gastro.org)

•   American College of Gastroenterology (www.gi.org)

•   Digestive Disease National Coalition (www.ddnc.org)