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I'm a 55-year-old woman who gets heartburn at least three times a week. Is this something I should worry about?
Sept. 11, 2000 -- A number of conditions could be causing the heartburn, some minor and some not.
First, you should know that heartburn is common. Overall, about 60% of American adults experience heartburn. The most common cause is gastroesophageal reflux disease (GERD), more commonly known as acid indigestion.
The symptoms of GERD occur when stomach contents, including acid, flow back into your esophagus -- the tube that transports food from your mouth to your stomach -- resulting in the burning sensation. The source of the problem seems to be weakness in the lower esophageal sphincter, a ring-like muscle that normally pinches closed the junction between the esophagus and the stomach, preventing the backflow.
If your heartburn occurs with exercise, you should definitely see your doctor to rule out cardiac problems because your symptoms might represent angina -- lack of oxygen to the heart that may be a warning sign of an impending heart attack.
If your symptoms occur primarily at rest, you might get relief by taking simple steps (although the presence of severe pain should prompt an urgent doctor's visit). Typically, people with GERD report heartburn after eating or drinking specific foods. Among these are alcohol, coffee and other caffeine-containing drinks (including soft drinks), fried, fatty, and spicy foods, citrus juices and fruits, tomato products, peppermint, and spices in general. You may want to assess your diet to see if it includes large quantities of these foods and, if so, avoid or eliminate them. Later you might try reinstating them one at a time to determine which food seems to be causing your symptoms.
Being overweight -- especially 20% or more above ideal weight -- can also promote GERD. Smoking can worsen it, as can wearing tight-fighting clothing.
If changing your diet and other habits does not alleviate your heartburn, consider a trial of antacids or over-the-counter medicines such as Tagamet or Pepcid that suppress acid production in the stomach. Use these cautiously and follow the dose instructions.
If these measures don't help within a week or so, or your symptoms worsen, you should see your doctor. Heartburn can stem from other causes, such as a peptic ulcer, inflammation of the esophagus due to medications like antibiotics or potassium supplements, and use of medications for blood pressure or asthma control. Cancer of the esophagus, although unlikely, is another possibility.
Depending on the findings, your doctor might recommend a regimen of antacids or over-the-counter acid blockers, or various prescription medications to be taken long-term. And if that doesn't work, a last resort is surgery to tighten the lower esophageal sphincter. But in many cases, a few simple changes in eating and drinking can bring relief.
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