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When heartburn means trouble

Tens of millions of Americans have heartburn.

Here comes that old familiar feeling. The irritating pain of heartburn. You take some medicine and the burning subsides—until the next time.

Even though it's easy to pop another antacid, ongoing heartburn shouldn't be taken lightly. Heartburn that isn't treated could lead to cancer of the esophagus.

What's going on

Heartburn is a burning sensation in your chest or throat that happens when stomach acid backs up into the esophagus, the tube that connects the mouth and stomach. There is a muscle between the stomach and esophagus that usually prevents acid backup, but if the muscle is weak, the acid can go the wrong way.

Sometimes heartburn pain is so bad, it's mistaken for a heart attack.

Many things can make heartburn worse, according to the American Academy of Family Physicians (AAFP), including:

  • Consuming spicy or fatty foods, carbonated drinks, chocolate, regular or decaffeinated coffee, caffeinated drinks, tomato products, mints, peppermint, or citrus fruits or juices.
  • Being overweight.
  • Smoking.
  • Drinking alcohol.
  • Lying down soon after eating a meal.
  • Wearing tight clothes.
  • Diseases or medications that weaken the muscle between the stomach and esophagus.

More than heartburn

Heartburn that occurs frequently may be a sign of gastroesophageal reflux disease (GERD), according to the National Institute of Diabetes and Digestive and Kidney Diseases.

GERD can cause symptoms other than heartburn, including hoarseness, sore throat, trouble swallowing, dry cough and bad breath.

When you have GERD, the cells in your esophagus are regularly irritated by stomach acid. Over time, this may cause the cells that are supposed to line the esophagus to be replaced with cells similar to those that line the small intestine. This condition is called Barrett's esophagus.

Once the cells in your esophagus have changed, you are at risk for cancer of the esophagus—even if you get your heartburn under control.

If you have Barrett's esophagus, you should have your doctor monitor the changed cells for signs of cancer.

You'll also need to be aware of the symptoms of cancer of the esophagus. According to the American Cancer Society, they can include:

  • Difficult or painful swallowing.
  • Chest pain.
  • Weight loss.
  • Vomiting.
  • Bleeding into the esophagus, which may cause black stools and can lead to anemia.
  • Hoarseness or chronic cough.

Talk to your doctor right away if you have any of these symptoms.

What you can do

It's important to control heartburn before it leads to Barrett's esophagus. According to the AAFP, the following lifestyle changes can help you control heartburn:

  • Quit smoking.
  • Avoid foods that cause heartburn and don't overeat.
  • Lose weight if you are overweight.
  • Don't wear tight clothes.
  • Wait at least two hours after eating before you lie down.
  • Raise the head of your bed 6 to 9 inches. You can use blocks under the legs of the bed.

It's important to talk to your doctor if you have frequent heartburn or have been taking antacids for more than three weeks. There may be prescription medicines that work better for you than over-the-counter antacids.

If medicine and lifestyle changes don't help, you may need surgery. Your doctor can help you figure out the best way to get heartburn under control.

Reviewed 6/18/2021

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