When It’s Time to Call Your Doctor about Heartburn
Feeling the burn is great when you’re exercising—not so great when it’s your stomach that’s on fire.
Of course, everyone gets an upset stomach occasionally. But when your heartburn never seems to go away, it’s time to contact one of our compassionate digestive specialists at Parkview Medical Center.
What Causes Heartburn
Despite its name, heartburn has nothing to do with your heart. Acid reflux is the burning sensation in your stomach and/or throat which can happen when acid from your stomach backs up into your esophagus because the band of muscle at the bottom of your esophagus isn’t working correctly to keep out the acid. The result is a burning chest pain, usually after eating or at night, that gets worse when you lie down or bend over. You might also get a bad taste in your mouth from the acid.
A more serious form of acid reflux with severe symptoms that go on for a long time is known as GERD (gastroesophageal reflux disease). If you have GERD, you may develop other symptoms too, such as a cough or hoarseness.
So how do you know you’ve hit the point where a medical exam is needed?
“Any kind of heartburn that’s persistent for more than a few weeks, and something that’s new for you,” is reason for a call to the doctor, says Dr. Paula Dionisio, a gastroenterologist with Parkview Medical Group. “It’s important to be seen by a doctor at least once because [heartburn] can be associated with damage to the esophagus or precancerous changes [in the body].”
If your heartburn is persistent and you also are losing weight or having difficulty swallowing, or you find yourself reaching for more and more medications to keep your heartburn under control, it’s important to schedule an appointment with your physician, Dr. Dionisio adds.
Easing the Pain
Your doctor may recommend an X-ray, endoscopy or other medical tests to determine the exact cause of your symptoms. Beyond GERD, your heartburn could be caused by pancreatitis, gallbladder disease, ulcers or other conditions that could affect the treatments recommended.
For GERD, you’ll likely start with medication—either over the counter or prescription—along with lifestyle changes such as cutting back on fatty foods and big meals, not eating more than three hours before bedtime, maintaining a healthy weight and not smoking. Antacids, H2RAs and proton pump inhibitors (PPIs) are the most common medications, although recent research suggesting health risks with extended use of PPIs may result in physicians prescribing lower doses for shorter amounts of time, says Dr. Dionisio.
“It’s a conversation I have with people every time I prescribe [a PPI],” Dr. Dionisio says. “There’s more of a goal now of using it in the short term, and potentially transitioning to something a little more like [H2RAs].”
“Most physicians now say you should be on the lowest [PPI] dose needed to control the symptoms, and maybe [put] a little more attention on dietary control and lifestyle modifications,” says Dr. Dionisio.
Surgery or endoscopic treatments are options for GERD that doesn’t respond well to medication and lifestyle changes, but they aren’t as commonly used, says Dr. Dionisio.
“If you can manage it with diet, lifestyle and habits, that’s probably the best way for go for anybody,” she says. “A lot of people can improve their symptoms with those measures.”
Some foods and drinks can act as triggers for heartburn, so you may want to try avoiding them:
- Carbonated beverages
- Coffee and other caffeinated drinks
- Spicy foods
- Citrus fruits
- Tomato products
- Fatty/fried foods
- Large meals
Heartburn or Heart Attack?
Heart attack symptoms can sometimes be mistaken for heartburn, so get immediate medical care if you have severe chest pain or pressure and:
- Pain in the arm, jaw or back
- Difficulty breathing
- Cold sweat
- Lightheadedness or dizziness
A Glossary of Heartburn Medications
Antacid: neutralizes (weakens) the acid in the stomach, works quickly to treat mild symptoms
Examples: calcium carbonate (Tums), calcium carbonate/magnesium hydroxide (Rolaids)
H2RA (H-2 receptor antagonist): causes the stomach to produce less acid by blocking the action of histamine, available over the counter or by prescription
Examples: famotidine (Pepcid AC), cimetidine (Tagamet)
Proton pump inhibitor (PPI): causes the stomach to produce less acid by blocking the enzyme system that produces it, available over the counter or by prescription
Examples: lansoprazole (Prevacid), omeprazole (Prilosec)
Paula Dionisio, MD
Dr. Paula Dionisio, a Pueblo native and graduate of Central High School, graduated magna cum laude from the University of Notre Dame in 3 years before attending Georgetown University School of Medicine. Dr. Dionisio then completed her Internal Medicine Residency and Gastroenterology Fellowship at the esteemed Mayo Clinic.
Lirio S. Polintan, MD
Specialties: Gastroenterology and Internal Medicine
Dr. Lirio S. Polintan has been practicing in Pueblo since 1981. Dr. Polintan is Board Certified in Internal Medicine and Gastroenterology and is a Fellow of the American College of Physicians; American College of Gastroenterology, and American Gastroenterological Association. He is also a member of the American Society of Gastrointestinal Endoscopy.
Charles Ruzkowski, MD
Dr. Chuck Ruzkowski attended Chicago Medical School, Loyola University Medical Center, and the University of Arizona. He has held academic appointments at the University of Arizona and the University of Iowa. He is Board Certified in Internal Medicine and Gastroenterology and has over 15 years of endoscocpic and practice experience.
Barbara Niven, PA-C
Barbara Niven is a certifed Physician Assistant with extensive experience in caring for patients with gastroenterology disorders. She has a special focus on treating patients diagnosed with Hepatitis-C and helping them to understand their treatment options and pathways.