When to Talk to your Doctor About Heartburn

Heartburn is a common symptom that causes a burning sensation in the chest, often after eating. It occurs when stomach acid flows back into the esophagus, the tube that carries food from your mouth to your stomach. While occasional heartburn is common, frequent or persistent symptoms may be a sign of gastroesophageal reflux disease (GERD).

Understanding the difference between occasional heartburn and GERD can help you recognize when it's time to seek medical care. With the right diagnosis and treatment, many people can manage their symptoms and find lasting relief.

What Is the Difference Between Heartburn and GERD?

Heartburn is a symptom of acid reflux, which happens when stomach contents flow backward into the esophagus. This can occur when the lower esophageal sphincter, a ring of muscle between the esophagus and stomach, does not close properly.

GERD is a condition in which acid reflux causes frequent or troublesome symptoms or complications. While heartburn is one of the most common symptoms, GERD can also cause:

• A sour taste in the mouth or regurgitation of food or stomach acid
• Burning or discomfort in the chest, particularly after meals or when lying down
• Difficulty or pain when swallowing
• Persistent coughing or hoarseness
• A feeling of irritation or a lump in the throat

Not everyone with heartburn has GERD. However, if you experience heartburn two or more times a week, or your symptoms interfere with daily activities, it may be time to speak with a healthcare professional.

When Should You See a Doctor for Heartburn?

Occasional heartburn may improve with changes to your eating habits or over-the-counter medications. However, symptoms that occur frequently, worsen over time or do not respond to treatment should be evaluated by a healthcare professional.

Consider making an appointment if you experience:

• Heartburn two or more times a week
• Symptoms that continue despite using over-the-counter medications as directed
• Nighttime reflux that regularly interrupts your sleep
• Heartburn that interferes with eating, work or daily activities
• Frequent regurgitation or a sour taste in your mouth
• Persistent coughing or hoarseness that may be related to reflux

A healthcare professional can review your symptoms, identify possible causes and determine whether additional testing or treatment is needed. Depending on your symptoms, you may be referred to a gastroenterologist, a specialist who diagnoses and treats digestive conditions.

What Are the Warning Signs of Serious Acid Reflux?

Although heartburn is often manageable, certain symptoms may indicate a more serious condition that requires prompt medical evaluation.

Contact a healthcare professional promptly if you experience:

• Difficulty or pain when swallowing
• Unexplained weight loss
• Persistent vomiting
• Symptoms that become progressively worse

Vomiting blood or material that resembles coffee grounds, or passing black, tarry stools, may indicate gastrointestinal bleeding and requires emergency medical evaluation.

Important: Chest pain should never automatically be assumed to be heartburn. A heart attack can sometimes cause symptoms that feel like indigestion or acid reflux. If you experience new or unexplained chest discomfort, especially with shortness of breath, sweating, dizziness or pain spreading to your arm, back or jaw, call 911.

Can Untreated GERD Cause Complications?

Over time, ongoing acid reflux can irritate or damage the lining of the esophagus. In some people, untreated GERD may contribute to complications such as inflammation of the esophagus, narrowing of the esophagus or Barrett's esophagus.

Barrett's esophagus is a condition in which the lining of the esophagus changes, increasing the risk of esophageal cancer. However, most people with GERD do not develop esophageal cancer.

Recognizing persistent symptoms and seeking appropriate care can help reduce the risk of complications and improve quality of life.

What Over-the-Counter Medications Help Heartburn?

Several types of over-the-counter medications can help relieve heartburn. The best option depends on how often symptoms occur, their severity and your overall health.

Antacids: Products such as Tums and Maalox neutralize stomach acid and may provide quick, temporary relief for occasional heartburn. They do not treat the underlying cause of frequent acid reflux.

H2 blockers: Medications such as famotidine (Pepcid AC) reduce the amount of acid produced by the stomach. They may help relieve or prevent heartburn and generally provide longer-lasting relief than antacids.

Proton pump inhibitors (PPIs): Medications such as omeprazole (Prilosec OTC) reduce stomach acid production and are commonly used for frequent heartburn. Unlike antacids, PPIs are not intended to provide immediate relief. Certain over-the-counter PPIs are designed to be taken as a 14-day course, following the product's instructions.

While over-the-counter PPIs have specific directions for self-treatment, healthcare professionals may prescribe PPIs for longer periods when medically appropriate. Do not extend an over-the-counter treatment course beyond the product's instructions without medical guidance.

If you regularly rely on heartburn medication or your symptoms return after treatment, speak with a healthcare professional. They can help determine whether you have GERD or another condition and recommend an appropriate treatment plan.

How Is GERD Treated?

GERD treatment depends on the frequency and severity of symptoms, your medical history and whether complications are present. Many people can manage GERD through lifestyle changes and medication, while others may benefit from additional testing or procedures.

Lifestyle and Dietary Changes

Making adjustments to your daily habits may help reduce acid reflux and improve symptoms. Your healthcare professional may recommend:

• Eating smaller meals instead of large meals
• Avoiding foods and drinks that trigger your symptoms, which may include spicy foods, fatty foods, caffeine or alcohol
• Waiting at least two to three hours after eating before lying down or going to bed
• Elevating the head of your bed if you experience nighttime reflux
• Weight management, when appropriate, as it may improve reflux symptoms for some people
• Avoiding smoking and tobacco products

Not everyone has the same food triggers. Keeping track of what you eat and when symptoms occur can help you identify patterns without unnecessarily restricting your diet.

Prescription Medications

If lifestyle changes and over-the-counter medications do not provide enough relief, your healthcare professional may recommend prescription treatment. PPIs are commonly prescribed for GERD because they reduce stomach acid and help heal inflammation or damage caused by reflux.

The length of treatment varies depending on your condition. Some patients benefit from a short course of medication, while others need ongoing treatment. Your healthcare professional can help determine the lowest effective dose and whether continued treatment is appropriate.

Procedures and Surgery

For patients with confirmed GERD whose symptoms are not adequately controlled with medication, or who have certain complications, additional treatment options may be considered.

Fundoplication: This surgical procedure involves wrapping the upper portion of the stomach around the lower esophagus to strengthen the barrier that helps prevent reflux.

Magnetic sphincter augmentation (LINX): This procedure involves surgically placing a small ring of magnetic beads around the lower esophagus. The device helps keep stomach contents from flowing backward while allowing food to pass into the stomach.

Not every patient is a candidate for these treatments. A gastroenterologist or surgeon may recommend tests to confirm GERD and determine whether a procedure is appropriate.

At the Heartburn Center at Broward Health Coral Springs, specialists evaluate chronic heartburn and GERD using diagnostic tests such as acid monitoring, esophageal function testing and endoscopy. Treatment options range from lifestyle changes and medication to minimally invasive procedures, depending on each patient's needs.

What Questions Should You Ask Your Doctor About GERD?

If you experience frequent heartburn or have been diagnosed with GERD, preparing questions before your appointment can help you better understand your symptoms and treatment options.

Consider asking your healthcare professional:

• What could be causing my heartburn or acid reflux?
• Could my symptoms be related to GERD or another condition?
• Are there dietary or lifestyle changes that may improve my symptoms?
• Which over-the-counter or prescription medications are appropriate for me?
• How long should I take medication, and what side effects should I know about?
• Do I need additional testing, such as an upper endoscopy or reflux monitoring?
• Am I at risk for complications from long-term acid reflux?
• When should I consider seeing a gastroenterologist or discussing other treatment options?

Sharing details about your symptoms, including when they occur, how frequently they happen and what seems to make them better or worse, can also help your healthcare professional recommend appropriate care.

Find Heartburn Relief at Broward Health

Frequent heartburn can affect your sleep, eating habits and overall quality of life. If your symptoms persist or over-the-counter medications aren't providing relief, the Heartburn Center at Broward Health Coral Springs can help you understand your symptoms and explore treatment options.

Our team offers diagnostic testing and personalized treatment for chronic heartburn, acid reflux and GERD. From medication management to minimally invasive procedures, we work with you to find an approach that meets your needs.

Learn More About the Broward Health Heartburn Center