It never fails. Just after you polish off that double cheeseburger — with a large order of fries on the side — you feel that familiar burning sensation winding its way up your chest. Wow, you think, that’s the third time this month.

Before you reach for the antacids, though, you may want to ask yourself if it’s heartburn — or something more. Heartburn can be a sign of a more serious condition that requires a physician’s intervention. 

When Heartburn Strikes

Many Americans are familiar with heartburn — a feeling of warmth, burning or discomfort that usually starts in the upper abdomen, just below the lower breastbone, and radiates up and down the chest. The condition may cause a sour taste in the mouth, burping, nausea or bloating, and can last up to two hours or more. It often occurs after eating.

“Heartburn is very common; just take a look at the number of television and magazine ads devoted to the topic,” says Mark Jacobs, M.D., chief of the Section of Gastroenterology at Delaware County Memorial Hospital. “Not everyone with heartburn needs to see a doctor. However, since heartburn can be indicative of other conditions, it’s important to monitor it carefully and see a physician if you notice any ‘red flags.’”

Heartburn is considered mild if it occurs once a month, and moderate if it occurs once a week. Mild to moderate heartburn is usually not a concern. Home treatment measures and nonprescription medications are usually all that is needed to relieve mild to moderate heartburn discomfort.

When heartburn becomes more severe, or is accompanied by other symptoms, it may be indicative of something more serious.

“Heartburn that occurs more than once or twice per week is considered significant, and you should see a physician to evaluate whether or not you are suffering from a more serious medical condition like erosive esophagitis,” says Immanuel Ho, M.D., chief of the Division of Gastroenterology at Crozer-Chester Medical Center. “You should also see a physician if you have any other symptoms, such as anemia, breathing problems, weight loss, difficulty swallowing, or blood in the stools. Your condition may require more potent medications or surgical intervention.”

Symptoms of heartburn and symptoms of a heart attack may feel the same. If you have a history of heart problems or risk factors for a heart attack and experience shortness of breath, sweating, dizziness or severe pain that radiates through the chest and/or arm, call 911 immediately.

Is it Something More?

More severe heartburn and accompanying symptoms could be a sign of one of several conditions:

·         Gastroesophageal reflux disease (GERD), a condition in which a muscular “valve” that joins the esophagus and the stomach, called the lower esophageal sphincter, relaxes and allows stomach contents to back up into the esophagus. Left untreated, GERD can cause breathing problems, ulcers, bleeding in the esophagus and permanent changes to the cells of the esophagus.

·         An esophageal stricture, or blockage of the esophagus.

·         Esophagitis, an inflammation of the lining of the esophagus that can lead to problems with swallowing, ulcers and scarring of the esophagus.

·         Barrett’s esophagus, a change in the lining of the esophagus that can lead to esophageal cancer.

·         Esophageal cancer.

What You Can Do

If your heartburn is considered mild or moderate, your physician may recommend making a few lifestyle changes, such as avoiding certain foods (particularly foods that are fatty or spicy or those that contain caffeine); losing weight to decrease abdominal pressure on the esophagus; avoiding smoking and alcohol; propping the head of your bed or using two or three pillows when sleeping; and avoiding having anything to eat within four hours of bedtime. You may also benefit from an over-the-counter medication, such as antacids, bismuth subsalicylate or a heartburn drug.

If home treatment and over-the-counter medications aren’t helpful, your physician may prescribe a prescription heartburn medication, such as a proton pump inhibitor.

“If prescription medications fail, or if it is more beneficial for a particular patient, we may recommend a surgical intervention,” Ho says. “People who come to us with severe symptoms may need a fundoplication, an operation which involves wrapping the first portion of the stomach around the end of the esophagus, and thus, restores the integrity of the lower esophageal sphincter. The surgery requires only a short hospital stay and can prevent the need for lifelong medications to treat heartburn.”

If you are concerned about your heartburn, call your physician.

“Make an appointment with your primary care physician to discuss your condition,” Jacobs says. “He or she may be able to help you, or may refer you to a gastroenterologist. Either way can be a great start toward reducing or curing your heartburn symptoms.”

To find a Crozer-Keystone gastroenterologist who’s right for you and to make an appointment, call 1-800-CK-HEALTH (1-800-254-3258).