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If you have ever experienced heartburn — an uncomfortable, burning sensation in the chest, particularly after eating — you are not alone. More than 60 million Americans experience heartburn or acid reflux at least once a month, and studies suggest that more than 15 million Americans experience heartburn symptoms each day.
Common symptoms of heartburn
The most common symptoms of heartburn are a burning sensation in the lower chest, regurgitation, dry cough, difficulty swallowing and stomach discomfort. While infrequent heartburn can be controlled with medication and lifestyle changes, more frequent episodes of heartburn or acid indigestion may be a symptom of a more serious condition that could worsen if not treated.
Gastroesophageal reflux disease, or GERD, is a chronic condition in which acid from the stomach comes into contact with the lining of the esophagus. Normally, a muscular valve at the bottom of the esophagus keeps acid in the stomach; with GERD, that valve relaxes too frequently, which allows stomach acid to flow backward up into the esophagus.
The dangers of untreated GERD
When GERD is not treated, serious complications can occur, such as severe chest pain that can mimic a heart attack; difficulty or pain with swallowing; bleeding; and a pre-malignant change in the lining of the esophagus — a condition known as Barrett’s esophagus.
“Barrett’s esophagus is what happens when the lining of the esophagus changes, becoming more like the lining of the small intestine,” explains Dr. Michael Lajin, a gastroenterologist affiliated with Sharp Grossmont Hospital. “This changed lining carries a risk of progression into cancer.”
Studies have shown that patients with chronic, untreated heartburn for many years are at greater risk of developing esophageal cancer.
If you experience heartburn more than twice a week for several weeks — or if your symptoms don’t improve with diet and lifestyle changes — you should be evaluated by a doctor.
Treatment options
For occasional acid reflux, treatment includes lifestyle changes such as diet modifications, weight loss and quitting smoking. For more severe or chronic cases, your doctor may prescribe medications such as antacids and proton pump inhibitors (PPIs) to reduce acidity and relieve symptoms.
There are a number of endoscopic and surgical procedures available to treat GERD:
Transoral incisionless fundoplication (TIF) is an incisionless procedure that allows gastroenterologists to insert an endoscope — a flexible, tube-like instrument — through the mouth to repair the valve between the esophagus and stomach, restoring its proper function.
Nissen fundoplication is a minimally invasive laparoscopic procedure during which the doctor wraps the top of the stomach around the lower esophagus to reinforce the lower esophageal sphincter.
LINX is a minimally invasive laparoscopic procedure in which an implantable ring of magnetic beads is placed around the esophagus at the gastroesophageal junction to restore function of the valve and keep acid from flowing backward from the stomach.
“If a patient has Barrett’s esophagus and we detect dysplasia — meaning the tissue is transforming and has become precancerous — we can perform a radiofrequency ablation procedure to destroy damaged esophageal cells to prevent them from progressing into cancer,” says Dr. Lajin. “If early superficial cancer is detected, it can be removed endoscopically using a technique called endoscopic submucosal dissection, or ESD.”
There are many treatment options available depending on the severity and frequency of your symptoms. If you are experiencing acid reflux multiple times per week with no relief from over-the-counter medications — and if you have symptoms such as difficulty or pain with swallowing, persistent hiccups, nausea or unexpected weight loss — it is best to consult your doctor to see what’s right for you.
For the news media: To talk with Dr. Lajin about GERD for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.
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