(StatePoint) Heartburn is one of the most common reasons people visit their doctors. If you suffer from a burning feeling in your chest or throat, experts recommend preparing for your next doctor’s appointment by learning more about heartburn and what you can do to manage the condition.
“Physicians often use upper endoscopy to diagnose and manage gastroesophageal reflux disease, or GERD,” says Dr. Molly Cooke, president of the American College of Physicians (ACP). “But this is not an appropriate first step for patients with typical heartburn.”
The ACP advises against upper endoscopy for heartburn, unless other serious symptoms are present. According to the ACP’s recommendations, it can be an expensive test that doesn’t necessarily improve the health of patients, exposes patients to preventable harms, and can lead to unnecessary interventions down the line.
“For those whose heartburn is accompanied by difficult or painful swallowing, bleeding, anemia, weight loss, solid food sticking in the esophagus, or recurrent vomiting, an upper endoscopy is appropriate,” advises Dr. Cooke.
Sensible diagnosis is just part of the equation. Prevention and management of the condition is important too. The ACP recommends the following steps to help relieve occasional heartburn as well as GERD:
• Make lifestyle changes. Lose excess weight, stop smoking, eat smaller meals, don’t lie down for several hours after eating, wear loose-fitting clothes, and limit how much alcohol you consume. Resist foods and beverages that can trigger your heartburn, such as chocolate, peppermint, coffee (with or without caffeine), garlic, onions, and fried, spicy, fatty or tomato-rich food.
• Raise head of your bed. Place wood blocks under your bedposts to raise the head of your bed six to eight inches.
• Control acid. Over-the-counter antacids such as Maalox, Mylanta, Rolaids, or Tums may ease heartburn. For a stronger acid-reducer, try an H2 blocker such as famotidine (Pepcid and generic) or ranitidine (Zantac and generic).
• Consider proton pump inhibitors (PPIs). Medicine to reduce gastric acid production is warranted in most patients with typical GERD symptoms such as heartburn or regurgitation.
PPIs are a group of drugs that relieve symptoms and heal the lining of the esophagus in almost all sufferers. For best results, take them 30 to 60 minutes before a meal. Omeprazole and lansoprazole are sold over-the-counter as low-cost generics. If symptoms don’t improve after two to four weeks, ask your doctor about taking two doses daily.
Free online resources can help you discover the best treatment for you. For example, you can visit www.CRBestBuyDrugs.org and click on “heartburn” for a free drug report on PPIs.
Left untreated, GERD can inflame the lining of the esophagus, causing a condition known as esophagitis. A few GERD patients develop Barrett’s esophagus, a disorder that can, in rare cases, lead to cancer of the esophagus.
Visit http://hvc.acponline.org for more tips on managing your health care, including resources developed in collaboration with Consumer Reports.
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