среда, 24 августа 2011 г.

10 Things You Should Know About Heartburn


Heartburn is a serious condition, and living with it takes a toll on you.


But staying informed about what causes it, how to treat it and when it may be more than just indigestion can be helpful when it comes to managing discomfort.

1. Heartburn isn’t the only symptom. That uncomfortable burning sensation in your chest is the most common sign of acid reflux, but some people don’t experience it. Instead, they may have trouble swallowing or even cough up blood. Acid reflux happens when your sphincter muscle (which connects the esophagus to the stomach) relaxes at the wrong time and stays open too long (it normally only opens for a few seconds when you swallow), allowing stomach acid to flow back up into the esophagus, explains Lauren Gerson, MD, associate professor of medicine and gastroenterology at Stanford University.


2. Antacids may not be enough. For occasional heartburn, antacids like Maalox or Tums work well. But if you’re experiencing symptoms at least twice a week, or if it’s so bad that it’s interfering with your daily life (it’s keeping you up at night, for example), see your doctor. You might be one of the 10 percent of Americans who have chronic acid reflux, which is known as GERD (gastroesophageal reflux disease). This condition needs to be treated by cutting off acid at the source, and drugs like Prilosec and Nexium can help by turning off the acid pumps in the stomach. Many of these meds are now available over the counter, but talk to your doc first to confirm your diagnosis. She may also suggest a higher, prescription-only dose.

3. Ignoring it is dangerous. Left untreated, chronic acid reflux can increase your risk of developing an esophageal infection, ulcers, scarring of the esophagus, and even a precancerous condition called Barrett’s esophagus, says Julia LeBlanc, MD, associate professor of medicine and gastroenterology at Indiana University.

4. Women are just as likely as men to have it. Women are especially prone during pregnancy, and some experience more symptoms right before their period. Obesity is a risk factor as well. “Extra weight puts pressure on the sphincter muscle, triggering reflux,” says Dr. Gerson.

5. You may not have to give up your favorite foods. Your doctor may advise you to avoid spicy foods and citrus because they relax the sphincter muscle in some people, but the truth is these foods don’t bother everyone. In fact, a study led by Dr. Gerson found that abandoning spicy foods, citrus and chocolate didn’t reduce symptoms in participants with GERD. Keep a food diary to track symptoms; there’s no reason to cut out foods you enjoy if they’re not causing problems.

6. Elevating your bed may help reduce symptoms. Bump up the head of your bed with telephone books or blocks under the legs (instead of just using an extra pillow). “Tilting your whole body downward during the night can help your esophagus clear out,” says Dr. LeBlanc.

7. Don't eat right before bedtime. Wait at least two hours after dinner before you lie down. That will give your stomach plenty of time to digest the food and empty out, says Dr. Gerson.

8. Lose some weight. It doesn’t have to be drastic, but dropping as little as 10 pounds can help.

9. Chew sugar-free gum. “Chewing gum increases saliva production, which may help neutralize acid,” says Prateek Sharma, MD, member of the American Gastroenterological Association and professor of medicine at
the University of Kansas School of Medicine.

10. Symptoms of a heart attack. “Heart attack symptoms in women are sometimes subtle and easy to confuse with reflux because they both feel like pain in the chest,” says Dr. LeBlanc. “When a woman comes to me with what she thinks is serious heartburn, I check that it’s not cardiac-related.” Possible indicators that it may be a heart issue and you need to see a cardiologist: sweating, getting symptoms (nausea, sweating, chest pain) during exercise or exertion, chest pain that radiates to the neck or left shoulder, heartburn symptoms that don’t occur soon after eating, and a family history of heart attacks.



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