Heartburn is commonly used to describe a burning, or aching sensation in the chest. It may occur infrequently or relentlessly without some form of intervention. It is caused by stomach acid irritating the lining of your esophagus or stomach. Increased stomach acid production may result from ingestion of liquids or solid food. Nicotine, chocolate, and some medications may increase the acid production beyond normal levels resulting in heartburn type symptoms.

Heartburn can be mistaken for the same type of pain experienced with heart attacks. This may occur if the irritation of the esophagus is severe enough to cause spasm of the esophagus. Mild discomfort, from heartburn, can be relieved with over the counter antacids (maalox, mylanta, gaviscon). More severe symptoms may require taking zantac, pepcid, tagament, or the now popular proton pump inhibitors prilosec, nexium, prevacid, protonix, and aciphex. If symptoms persist after taking medication for 30 days, further testing should be done to look for more serious complications such as cancer of the stomach or esophagus.

The test performed for further evaluation include the upper gastrointestinal series (Upper G.I.) and esophagogastroduodenoscopy (EGD). An upper G.I. involves drinking barium (type of liquid chaulk) followed by x-rays. The EGD involves having a long flexible scope, with a light on the end, inserted through the mouth and passed down into the esophagus and stomach. This procedure is performed after receiving sedation. It allows the physician to directly visualize the esophagus and stomach.

Zollinger Ellison Syndrome is a condition in which too much stomach acid is produced. This can result in severe and recurrent stomach ulcers. Laboratory testing can be done to see if you are at risk of having this disorder.

Additional measures to help decrease the severity or frequency of heartburn include elevating the head of bed, not eating later than 6 p.m., discontinuation of smoking and coffee. Avoiding foods that may exacerbate symptoms, and antacids prior to meals may also be beneficial.

If your symptoms have been present for a short time or occur intermittently, your physician may recommend using antacids that you can buy without a prescription. Medications such as maalox, gaviscon, tums, rolaids work by buffering the acid produced by the stomach. They are useful for obtaining immediate relief or preventing symptoms if taken just before a meal. The H2 antagonist are a class of medications that work by inhibiting the production of acid by the stomach. These are the medications that are now available in most convenience stores, grocery stores and pharmacies without a prescription. These include pepcid (famotidine), zantac (ranitidine), and tagamet (cimetidine). The proton pump inhibitors, mentioned above, are the most effective class of medications at completely inhibiting acid production. They are usually reserved for symptoms refractory to other medications or for healing ulcers and erosions that can occur with long term exposure to stomach acid.

Cancer of the stomach and esophagus can be very elusive, so when in doubt about the severity of your symptoms, seek medical advice from your primary care physician.