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WHILE almost everyone experiences mild heartburn from time to time and many individuals have some antacids or another medication on hand for its relief, talk to your doctor, if you have heartburn more than twice a week or if it persists despite the use of medications because frequent heartburn can lead to more serious health problems, if untreated, says the June 2001 issue of the Mayo Clinic Women’s Healthsource.

Heartburn, also referred to acid reflux, happens when stomach acid flows back (refluxes) into your esophagus.

Heartburn isn’t a disease in itself, but rather a symptom of various conditions — most commonly, gastroesophageal reflux disease (GERD), explains the health letter.

Under normal circumstances, the valve between your stomach and esophagus closes quickly after you swallow food to prevent stomach contents from coming back into the esophagus.

With GERD, problems with this valve may prevent it from closing all the way, allowing stomach acid to flow backward (reflux) into the esophagus and irritate it.

Other conditions associated with heartburn include an inflamed stomach (gastritis), peptic ulcer, chronic abdominal discomfort (dyspepsia) and hiatal hernia which occurs when part of the stomach pushes into the chest, adds the letter.

Heartburn, which often follows a large meal, particularly may occur while you’re lying down or bending over, resulting in acid regurgitation with a burning sensation that often begins in your chest and spreads toward your throat, leaving a sour or bitter taste in your mouth.

Many women first experience heartburn during pregnancy, as a result of hormonal changes and pressure from the baby.

Often, occasional heartburn can be controlled with diet and lifestyle changes, but frequent heartburn may signal a more serious problem.

Nevertheless, before you take heartburn medication, take time to learn about the options because heartburn drugs may be overused — and aren’t always needed or helpful, cautions the letter.

GERD can often be diagnosed based on signs and symptoms alone.

However, tests may be done if your signs and symptoms indicate a more serious problem, if the diagnosis isn’t clear or if your heartburn doesn’t go away with treatment.

For instance, your doctor may perform an endoscopy — this procedure uses a thin, flexible tube with a light and camera on the end — to examine your esophagus for changes or signs of damage and take biopsy samples, if needed.

If you experience heartburn just once in a while, changes in your diet and lifestyle might help prevent or control your signs and symptoms.

Thus, the health letter offers these strategies, as appropriate:

• Raise the head of your bed by putting blocks under the bedposts.

• If you light up, ask your doctor to help you quit smoking. Cigarettes aggravate heartburn.

• Work on shedding pounds.

• Avoid foods and beverages that give you heartburn.

Common triggers include coffee, alcohol, fatty and fried foods, chocolate, carbonated drinks and mint.

• After meals, wait at least three or four hours before you lie down.

• Eat smaller meals.

• Ask your doctor if any medications you take might cause or worsen heartburn.

• Avoid tightfitting clothes, such as body shapers and belts at the waist.

If lifestyle changes don’t help, you might benefit from these three main types of drugs that can relieve heartburn:

1) Antacids — Over-the-counter antacids, which use different combinations of magnesium, calcium and aluminum with other substances to neutralize the acid in your stomach, are usually the first type of medication recommended for heartburn. They include Maalox, Mylanta, Phillips’ Milk of Magnesia, Riopan, Rolaids and Tums. Antacids provide rapid relief that lasts 30 minutes, when taken after meals or at bedtime. Side effects may include diarrhea or constipation.

2) H-2-receptor blockers — Available with or without prescription, histamine-2 (H-2) receptor blockers reduce the amount of acid your stomach produces. While they take longer to work than antacids, they can provide relief for four to ten hours. However, they don’t work well for many individuals with GERD and aren’t recommended for long-term use. Side effects include headache, dizziness, diarrhea and fatigue. Brand names include nizatidine (Axid), famotidine (Pepcid), cimetidine (Tagamet) and ranitidine (Zantac).

3) Proton Pump Inhibitors (PPIs) — These also reduce stomach acid and are generally more effective and longer lasting than are the other types of heartburn drugs. Prescription PPIs include omeprazole (Prilosec), lansoprazole (Prevacid), esomeprazole (Nexium), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant). Some doses of Prilosec and Prevacid are available over-the-counter, as is Zegerid, another version of omeprazole. Nonprescription PPIs are taken once a day, about an hour before you eat but you should stop taking the medication after 14 days, unless your doctor advises otherwise. Side effects may include headaches, abdominal pain, diarrhea, nausea, dizziness or lightheadedness, rash and constipation. A more serious issue for women who take PPIs (especially for a year or more) is a possible increased risk of fractures of the hip, wrist and spine due to decreased absorption of calcium and Vitamin D. Older adults who take PPIs may also be vulnerable to certain infections, such as pneumonia. Also, some PPIs may reduce the effectiveness of the blood thinning drug clopidogrel (Plavix).

In as much as chest pain from heartburn can be difficult to distinguish from pain caused by a heart problem, the health letter advises getting emergency medical help if you experience these warning signs of a heart attack:

• Sudden pressure, tightening, squeezing or crushing pain in the center of your chest that lasts more than a few minutes or goes away and comes back.

• Pain spreading to your back, neck, jaw, shoulders or arms.

• Chest discomfort accompanied by shortness of breath, sweating, dizziness, nausea or vomiting.

• Pressure or tightness in your chest during physical activity or when you’re under emotional stress.

Moreover, seek prompt medical attention if:

• Your heartburn seems worse or different from normal.

• You experience new chest pain.

• You have trouble swallowing or pain when swallowing.

• You’ve unintentionally lost weight or have less appetite.

• You’re vomiting blood or have bloody or black stools, concludes the health letter.

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