When Heartburn Turns to Acid Reflux

After Maura Donovan spent six years struggling with what she thought was simply on and off heartburn, the college student finally went to a new doctor who made her write down everything she ate.

Donovan was experiencing stomach cramps as soon as she ate foods like pizza or Chinese food, then a burning in her chest the next day, which prompted her to take Tums. After years of this, the pain was more frequent, and no matter what she ate, Donovan felt a pressure on top of her diaphragm, as though someone was sitting on her.

Her stomach problems got so bad that any food she ate would cause her pain. Stress and eating on the run made it worse.

It turned out she had gastroesophageal reflux, also known as acid reflux disease, and a treatable illness that many initially dismiss as simply heartburn. When it starts happening daily, or even once a week, experts advise seeing the doctor.

Heartburn on Rise

That aching feeling of heartburn that many of us experience after overindulging in fatty foods is on the rise. Heartburn, a symptom of acid reflux disease, is believed to affect some 15 million Americans a day, and instead of being just a nuisance, it can lead to real health hazards.

"Heartburn is the lay term for the symptoms that could become reflux, or at its most serious, gastroesophageal reflux disease," ABCNEWS' Dr. Tim Johnson told Good Morning America. The latter occurs when the stomach's contents — food and stomach acid — flow backward into the lower part of the esophagus. Normally a muscle ring or sphincter is supposed to stay closed when you swallow, but it can malfunction.

"But as we get older, it doesn't always function, and it can be affected by certain foods, like peppermint and chocolate," Johnson said. Liquor, coffee, carbonated beverages, citrus fruit or juices, tomato sauce, ketchup and mustard, vinegar, and aspirin or other pain medication containing acetaminophen should also be avoided, experts say.

Other factors that could contribute to reflux include being overweight, eating a big meal, lying down after eating a big meal and wearing tight clothes.

"We don't really know the underlying factors of what causes reflux," Johnson said.

Common Symptoms May Be More

In the short term, people experience straightforward symptoms such as heartburn, queasy stomach, hunger-like pain, sense of fullness, gas or bloating. But in a lot of people, there are other symptoms that are more mysterious, including sore throat, chronic cough, or a lump in the throat.

"There are two big dangers for men especially," Johnson said. "It may be written off as heartburn, when it is really heart angina."

In some cases, men have complained of heartburn just before they had heart attacks. With long-term chronic reflux, there are other dangers too. You can irritate the lining of the esophagus, which could develop into esophageal cancer, Johnson said.

Treatment Options

There are a range of lifestyle changes and medical treatments that can help people with acid reflux disease, Johnson said.

"For milder cases, there are lifestyle changes that help: eating smaller and less fatty meals, avoiding chocolate and caffeine, eating dinner three hours before bedtime, and quitting smoking," Johnson said. Another recommendation is elevating the head of the bed four to six inches.

Antacids like Tums or Rolaids are effective in causing immediate relief for those who do not have a chronic problem.

For more chronic cases, there are two classes of drugs that can help. One type is histamine-2 blockers, which cut down on acid secretions and are sold over the counter. They are sold as Tagamet, Zantac, or Pepcid AC. You can get stronger versions of Tagamet by prescription.

The most effective medications are the proton pump inhibitors, or PPI's, like Prilosec and Prevacid, Johnson said. They are only available by prescription. Now most doctors tend to go straight to them when they have a patient with a chronic problem.

For Donovan's gastroesophageal reflux, her doctor prescribed Prilosec, which she said has helped her condition. She also started training for a triathlon, and has run in two of them. She lost 51 pounds, and joined Weight Watchers. Instead of taking Prilosec every day, she began taking it every three or four days, and is now basically off of it.

In worst-case scenarios, Johnson said, a type of surgery called fundoplication can be used. It involves having the top of the stomach wrapped around the esophagus. Some doctors advocate it as a possibility for younger patients, but Johnson says it should be a last resort.

"We're becoming more sedentary and obese, and that's causing the problem in the first place," Johnson said. But as more people recognize that reflux can be chronic, and drug companies promote treatments for it, it is beginning to get under control.