Over-the-counter medications usually relieve most cases of acid reflux, or what some call “nighttime heartburn," but they don’t always work.
Acid reflux happens when acid formed in the stomach comes back up into the esophagus. It’s uncomfortable, but not unusual.
“It is so common that we don’t necessarily consider it a problem,” said Dr. Christian Mayorga, a gastroenterologist with Parkland Hospital and UT Southwestern Medical Center, “unless [it becomes] a daily occurrence or the symptoms become severe, at which point intervention may be necessary to control the symptoms.”
Mayorga says acid reflux is nothing to take lightly.
Advertised over-the-counter meds cure or relieve most cases, but, Mayorga says, when you become dependent on them or they take longer to work or fail to work at all, it’s time to see a doctor.
The same goes for symptoms like difficulty swallowing or unexplained weight loss — signs you may have something more serious.
Interview Highlights
What is acid reflux: Acid reflux is the sensation or act of acid that’s formed in the stomach coming back up into the esophagus, where it doesn't belong. It’s normal for this to happen. What is not normal is for this to happen frequently and for the patient to develop symptoms associated with it.
Symptoms of acid reflux: One of the most common is heartburn. It actually has nothing to do with the heart. It’s a sensation in the middle of the chest which happens to be where the heart is, but also where the esophagus is. And it’s often described as a burning or a painful sensation.
Other symptoms, according to WebMD, include: regurgitation, a sour or bitter-tasting acid backing up into your throat or mouth; bloating; bloody or black stools, or bloody vomiting; burping; dysphagia, a narrowing of your esophagus; hiccups that don't let up; nausea; weight loss for no known reason; and wheezing, dry cough, hoarseness, or chronic sore throat.
It’s also called nighttime heartburn: Acid reflux can occur at any point in the day. It tends to be more pronounced at nighttime simply because a lot of the things that we do influence the symptoms. What a lot of patients do is eat dinner late in the evening and get into bed with a stomach full of food, and alcohol in some cases, and lie flat. It’s a lot easier for the stomach contents of what you just ate to reflux, or come back up, into the esophagus.
When to see a doctor: If you become dependent on taking over-the-counter antacids and you’re not having control of your symptoms, or the same dose that controlled your symptoms before is not working anymore. Also, if you develop "alarm symptoms" that we consider indicators of something more serious, such as difficulty swallowing or pain when you swallow; that is never normal.
Bad reflux or heartburn can cause inflammation of the esophagus, or esophagitis. In the most severe forms of reflux or heartburn, there's a condition called "Barrett's esophagus," where the lining of the esophagus changes the type of cell that is lining it; this we consider to be a precursor to cancer of the esophagus.
The bottom line is: Don't take these symptoms lightly. It’s fine to take these medicines as needed, but don’t overlook symptoms — the difficulty or pain with swallowing or unexplained weight loss. You really want to seek help because it may be a sign of something more serious happening.
To avoid acid reflux:
- Avoid eating before you go to bed. Leave three hours before you go to bed, so you don’t go to bed with a full stomach.
- The foods that we eat (caffeinated and carbonated products, certain foods like onion, garlic and spicy foods) contribute to acid reflux and the sensation of heartburn.
- Smoking can worsen the symptoms.
- Obesity is a major contributor to reflux diseases.
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