Heartburn

Acid or bile from the stomach or intestine may back up into the chest and cause heartburn. This is often described as a burning sensation beneath the breastbone. It may be associated with a salty or metallic taste in the mouth.

The presence of acid or bile in the chest may cause spasms (muscle contractions) of the esophagus resulting in chest pain. Sometimes, this can be difficult to distinguish from the chest pain of a heart attack or angina.

Reflux may also be associated with hoarseness, bronchospasm "wheezing" (asthma) or a lump in the throat. In longstanding cases, the irritation may cause scar tissue to form which will then interfere with swallowing. This results in difficulty swallowing or perhaps actual pain on swallowing.

Helpful hints:

Avoid fried foods, fatty foods, alcohol, chocolate and caffeine (in coffee/tea and sodas).

Do not eat for at least 3-4 hours prior to bedtime (six is even better).

Do not lie down after meals.

Keep the head of your bed inclined and elevated 6 inches (using bed blocks - not pillows).

Avoid tight fitting clothing.

Maintain your ideal body weight.

Avoid bending over after eating.

Quit smoking.

Review your medications with your doctor for possible adverse effects. Certain drugs such as calcium channel blockers used for high blood pressure and angina may increase reflux symptoms.

In selected cases, antacids, alginic acid/Gaviscon, H-2 blockers (Cimetidine/Tagamet, Ranitidine/Zantac, Famotidine/Pepcid, Nizatidine/Axid, and metoclopramide/Reglan  may be helpful.

Surgery is a treatment of last resort.

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