Heartburn - what to ask your doctor
What to ask your provider about heartburn and reflux; Reflux - what to ask your provider; GERD - what to ask your provider; Gastroesophageal reflux disease - what to ask your provider
You have gastroesophageal reflux disease (GERD). This condition causes food or stomach acid to come back into your esophagus from your stomach. This process is called esophageal reflux. It can cause heartburn, chest pain, cough, or hoarseness.
Below are questions you may want to ask your health care provider to help you take care of your heartburn and reflux.
Do you feel a burning in your chest not long after you eat or lie down? If so, you may have Gastroesophageal reflux disease, or GERD. When we swallow food, it travels down our esophagus into the stomach, where it's greeted by a rush of Hydrochloric acid in the stomach to begin digestion. This acid is so powerful, it could eat the paint right off your car! Fortunately, there's a band of muscle between the stomach and the esophagus - called the Lower Esophageal Sphincter or L-E-S, that clamps down to prevent the stomach contents from moving or refluxing upward and burning the lining of the esophagus. If that band of muscle does not adequately clamp down, this backwash causes the irritation and burning that's known as heartburn or GERD. Maintaining good tight L-E-S muscle tone is the key to preventing this condition. Causes of GERD include being overweight, smoking, and drinking too much alcohol. Certain foods, like chocolate and peppermint and if you're a woman, pregnancy can bring on GERD. To determine if you have GERD, your doctor may request an upper endoscopy exam to look into your esophagus and stomach to diagnose reflux. Other tests can measure the acid and amount of pressure in your esophagus, or if you have blood in your stool. If you do have GERD, lifestyle changes can help. First, avoid foods that cause problems for you and avoid eating large meals. If you're a little on the heavy side, try to lose some weight. Since most GERD symptoms are experienced lying down in bed, let gravity help. Elevating the head of your bed 4 to 6 inches using blocks of wood may help. If symptoms continue, see your doctor or a Gastroenterologist for evaluation and an upper endoscopy exam. Your doctor may suggest you take over-the-counter antacids or may prescribe stronger medications. Call your doctor if you are bleeding, feel like you are choking, have trouble-swallowing, or experience sudden weight loss. The good news is most people who have GERD do not need surgery. For the worst cases, surgeons may perform a laparoscopic procedure to tighten a weak L-E-S muscle. If you have occasional heartburn, antacid tablets can be used as needed. However! If you're having heartburn more than 3 to 4 times a week, see your doctor & take the prescribed medication to prevent this condition.
Questions
If I have heartburn, can I treat myself or do I need to see the provider?
What foods will make my heartburn worse?
How can I change the way I eat to help my heartburn?
- How long should I wait after eating before lying down?
- How long should I wait after eating before exercising?
Will losing weight help my symptoms?
Will cigarettes, alcohol, or caffeine make my heartburn worse?
If I have heartburn at night, what changes should I make to my bed?
What medicines will help my heartburn?
- Will antacids help my heartburn?
- Will other medicines help my symptoms?
- Do I need a prescription to buy heartburn medicines?
- Do these drugs have side effects?
How do I know if I have a more serious problem?
- When should I call the provider?
- What other tests or procedures will I need if my heartburn does not go away?
- Can heartburn be a sign of cancer?
Are there surgeries that help with heartburn and esophageal reflux?
- How are the surgeries done? What are the risks?
- How well do the surgeries work?
- Will I still need to take medicine for my reflux after surgery?
- If I have surgery, will I ever need to have another surgery for my reflux?
References
Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308-328. PMID: 23419381
National Institute of Diabetes and Digestive and Kidney Diseases website. Acid reflux (GER & GERD) in adults.
Richter JE, Vaezi MF. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 46.
Version Info
Last reviewed on: 3/2/2023
Reviewed by: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.