In the right concentration, the acid in your
stomach is powerful enough to dissolve a penny. It can also wreak
havoc in your throat, as millions of sufferers of heartburn know.
``It's a burning pain,'' said Dr. Richard MacDermott, chief of
gastroenterology at the Albany Medical Center. ``Some patients will
have a feeling of acid in their throat or a bad taste in the
mouth.''
Such discomfort is common, affecting up to half of all American
adults. Most people treat heartburn on their own, spending a total
of $1 billion a year on over-the-counter remedies such as Tums and
Maalox.
But many people still wonder when it's appropriate to see a
doctor.
Heartburn, according to MacDermott, occurs when the gastric acid
that normally stays in the stomach to digest food leaks back up
into the esophagus, the tube that links the mouth to the stomach.
Persistent leakage causes irritation and pain.
``Everybody refluxes acid into their esophagus, but we all have
mechanisms to get the acid out,'' MacDermott said. A patient with
heartburn, however, may be unable to move the acid out because of a
defective or weak sphincter, the ringlike muscle that separates the
stomach from the esophagus.
A highly publicized study last year caused concern when it
reported that heartburn sufferers were almost 45 times more likely
than normal to develop cancer of the esophagus, an especially
aggressive type of cancer.
Heartburn, with its intense and sudden chest pain, can also
mimic the symptoms of a heart attack. This makes it difficult to
know when the problem is a potentially life-threatening condition
or ``just heartburn.''
``No one is going to die from not treating heartburn for a few
days or a week, but not treating angina is a serious problem,''
said Dr. Edward Orris, the chief of gastroenterology at St. Peter's
Hospital in Albany.
As a general rule, he advises anyone over 40 or 50 who has any
risk factors for heart disease, whether it's high blood pressure or
obesity, to seek treatment for such pain, especially if it's
accompanied by shortness of breath or sweating.
For those who know their problem is heartburn, the question
about when to go to the doctor is a matter of severity and
frequency.
``If someone has a history of heartburn related to a specific
food, a cautious diet and a little self-medication is fine,'' Orris
said.
But when the pain turns into a weekly or daily event, and not
just with the chili or tacos, take heed. At that point, doctors say
the symptoms might point to a more serious problem, known as
gastroesophageal reflux disease.
Warning signs include painful swallowing, coughing, weight loss,
bleeding and anemia. If the acid reaches the mouth, it can even
cause tooth decay.
Even more serious, such reflux can lead to cancer.
Fortunately, chronic heartburn sufferers can get relief, with a
host of medicines or surgery. But two weeks ago, the Food & Drug
Administration cracked down on one of the more popular treatments
for severe nighttime heartburn, called Propulsid.
That drug has been linked to 341 reports of heart rhythm
abnormalities, including 80 deaths. People on the drug are advised
to talk to their doctors. Although it will be available through
July 14 to give patients time to find alternatives, the drug will
be available after that only a limited basis.
For most people with mild heartburn, the best strategy for
minimizing symptoms is to make lifestyle changes, according to
Orris.
``You want to avoid fatty foods, large meals, caffeine-rich
foods,'' he said. People should be especially careful not to eat
close to bedtime, to give the stomach plenty of time to empty.
``That's the first line of treatment,'' he said.
