There's nothing pleasant about heartburn, which manifests itself as burning pain in the chest. Even a written description of why heartburn occurs is unpleasant: It happens when stomach acid is regurgitated back up through the upper body thanks to an esophageal sphincter not closing at the right time. To many of us, heartburn seems like just another unpleasant thing to endure, much like taxes, rush hour traffic and the contents of a baby's diaper. For this reason, heartburn is often considered the Rodney Dangerfield of conditions, because it gets no respect. Most people don't take it seriously enough to put down the over-the-counter medications and speak to their doctor about it. So when should you bite the bullet and make an appointment with your doctor?
Your Heartburn Feels More Severe Than Usual
Almost everyone has heartburn from time to time, but if you have a particularly severe episode of it, you should bypass making a doctor's appointment and head straight for the hospital. The chest pain that comes with heartburn is often very similar to a heart attack, so don't write off a persistent or acute ache as heartburn. A heart attack is usually differentiated from heartburn by shortness of breath, sweating and dizziness, but when in doubt, head to the hospital.
Complicating the matter, certain medications taken by those with cardiac issues often bring on acid reflux or heartburn. Calcium channel blockers, which decrease blood pressure, and nitrates, used for coronary artery disease, can cause acid reflux. If you suspect that a heart medication is bringing on heartburn or acid reflux, speak to your doctor before making any changes to your meds or diet.
When You Have a Cough That Just Won't Go Away
There are any number of reasons for why you may have a chronic cough, from a respiratory tract infection to bronchitis. But often, a chronic cough is a symptom of heartburn and gastroesophageal reflux disease (GERD). It's not just a persistent cough, though -- heartburn frequently occurs in conjunction with symptoms of asthma, such as wheezing. Of course, you may not have the chest pain that accompanies heartburn, so you may not think that you're actually seeing a doctor for heartburn until you get the diagnosis. Since the constant coughing can do damage to the esophagus, it's important to seek treatment so that permanent harm isn't done.
If Your Heartburn Lasts Longer Than Two Weeks
Occasional heartburn may not require a visit to the doctor, but if you have heartburn that occurs several times a week, for more than two weeks, then it's time to go to the doctor. For most people, the symptom can be controlled with either over-the-counter or prescription medications. However, in rare instances, that constant heartburn can indicate a far more serious condition. Because heartburn damages the esophagus tissue, you may be at risk for a precancerous condition known as Barrett's esophagus. That, in turn, puts a person at risk for esophageal cancer, which is the fastest-growing cancer in the United States [source: Brody]. To determine the extent of esophageal damage, a doctor will perform an endoscopy, in which a tube is slid down the throat to the esophagus. In some cases, surgery to reinforce the esophageal sphincter may be recommended, so if you suffer from heartburn very frequently, consult your doctor.
If You've Been Taking Medications for a Long Time
Occasional heartburn is often relieved with a simple antacid. However, if you've been devouring antacids for weeks and not seeing results, then see a doctor. You may require a stronger prescription medication.
Prescription medications for heartburn aren't meant to be lifetime drugs, but many people treat them as such. Obviously, it's difficult to stop taking something that relieves possible pain. While heartburn medications are generally safe, doctors do warn that there are some long-term side effects that are cause for concern. Because the drugs decrease your gastric acid, your body absorbs far less calcium from your diet than normal. As a result, you could be at a higher risk for experiencing a bone fracture or osteoporosis. While the benefits of staying on the drugs outweigh the risks for frequent heartburn sufferers, those who suffer from heartburn only infrequently should eventually taper off their use.
If severe heartburn occurs in a relatively young person, who faces a lifetime of taking prescription medications, doctors may consider surgery in which the upper part of the stomach is wrapped around the esophageal sphincter to strengthen it. Surgery is not recommended for everyone due to its invasive nature and due to studies that show that it might not be a permanent fix [source: Jaret].
If You or Your Child Has Trouble Swallowing
If you've had heartburn or acid reflux for so long that you have trouble swallowing, then it's a sign that damage to the esophagus has been building for awhile. The esophagus may be inflamed, scarred or full of ulcers, indicating esophageal cancer. Other symptoms to be on the look out for include nausea and vomiting, particularly if you're vomiting blood.
It's important to note that children can suffer from heartburn and acid reflux as well. Unless you have an extremely advanced child, he or she probably won't be able to put the discomfort into words, so take note if a baby experiences trouble swallowing. Other signs of gastroesophageal reflux disease in children are repeated regurgitation, asthmalike symptoms, frequent arching of the back and irritability after feedings. The good news? Many infants and children outgrow the condition, though don't sit around and wait for them to do so: See a doctor.
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Related HowStuffWorks Articles
- American College of Gastroenterology. "Acid Reflux: GERD Can Masquerade As Persistent Cough or Even Chest Pain." ScienceDaily. Oct. 16, 2007. (June 22, 2009)http://www.sciencedaily.com /releases/2007/10/071015081456.htm
- American Gastroenterological Association. "Nearly 40 Percent of GERD Patients Taking PPIs Experience Recurring Symptoms." ScienceDaily. May 19, 2008. (June 22, 2009)http://www.sciencedaily.com /releases/2008/05/080515145404.htm
- Baldauf, Sarah. "Got Heartburn? A Caution About Your Proton Pump Inhibitor." U.S. News and World Report. May 29, 2009. (June 22, 2009) http://health.usnews.com/articles/health/2009/05/29/got-heartburn-a-caution-about-your-proton-pump-inhibitor.html
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- Brody, Jane E. "Finding, and Treating, Esophageal Cancer." New York Times. Dec. 2, 2008. (June 22, 2009)http://www.nytimes.com/2008/12/02/health/02brod.html?_r=1
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- "Heartburn or chest pain: When is it heart attack?" Mayo Clinic. April 30, 2009. (June 22, 2009)http://www.mayoclinic.com/health/heartburn-gerd/DG00016
- Jaret, Peter. "A Sigh of Relief for Heartburn Sufferers." New York Times. Nov. 8, 2007. (June 22, 2009)http://health.nytimes.com/ref/health/healthguide/esn-gerd-ess.html
- Jaret, Peter. "Personalizing the Management of Heartburn." New York Times. (June 22, 2009)http://health.nytimes.com/ref/health/healthguide/esn-gerd-qa.html
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- Mohan, Venkat, ed. "When to Call the Doctor About Heartburn or GERD." WebMD. Feb. 11, 2008. (June 22, 2009)http://www.webmd.com/heartburn-gerd/guide/when-call-doctor
- "Study Finds a Link Between Some Heartburn Drugs and Hip Injuries in People Over 50." New York Times. Dec. 27, 2006. (June 22, 2009)http://www.nytimes.com/2006/12/27/health/27bone.html