Yesterday, 15 million Americans were miserable. That's how many women and men get heartburn every single day. Over the past month, some 60 million people experienced either the main symptom a severe burning sensation in the chest or another one, such as discomfort in the back of the throat. In some cases, food comes back up, along with a sour taste. If you're one of those millions, the good news is that simple, new treatments can help you feel better fast.
Heartburn is primarily a mechanical problem. When you swallow food, it travels down the esophagus and enters the stomach via a small, muscular valve.
Normally, the valve then closes and stays shut. But sometimes it becomes weak and floppy and doesn't close properly. That's when trouble begins: Food and stomach acids gurgle back up into the esophagus a condition known as acid reflux. If this happens to you frequently (twice a week or more) and if your symptoms are severe, the condition is called gastroesophageal reflux disease, or GERD.
Heartburn can strike anyone, but women suffer more often than men, and pregnant women are especially susceptible. Weight is another key risk factor, and it doesn't have to be extreme. If your weight is normal, but at the upper end of the healthy range, your chances of having frequent heartburn are higher, reported the Harvard Nurses' Health Study last June. For example, if you're a five-foot-four-inch woman weighing 128 pounds, gaining as few as six pounds can up your risk of GERD 38 percent.
As for your diet, it may not be as important as doctors once thought. For years, the forbidden list for heartburn sufferers included spicy or salty dishes, high-acid foods (like oranges), caffeine, carbonated drinks, alcoholic beverages, even chocolate. But a recent review of research at Stanford University questions whether restricting these foods and drinks really helps. "There's currently not enough evidence that they make heartburn worse or that cutting them out will make it go away," says gastroenterologist Lauren Gerson, M.D., lead researcher on the study and director of the university's Esophageal and Small Bowel Disorder Center. Of course, if a certain kind of food seems to aggravate your symptoms, do try dropping it from your menu. And if your diet, whatever type, is causing you to put on pounds, losing weight should improve symptoms, says Dr. Gerson.
Recent studies have also shown that the following measures help:
In extreme cases, surgery may be called for. The traditional GERD procedure involves wrapping the top of the stomach around the lower esophagus to tighten the floppy valve. The operation is performed under general anesthesia and requires a one- to three-day hospital stay and at least a two-week recovery period. Now doctors can often fix a faulty valve with a nonsurgical outpatient procedure that involves stapling the valve with a device called the Plicator. In a study conducted at 15 centers across the country, 65 percent of patients treated with the Plicator had a major improvement in symptoms (and 62 percent no longer needed any medication) comparable to the success rate of traditional surgery.
In October 2004, Cindi Fusco, now 45, started to develop a series of bewildering symptoms. Just about anything she ate or drank triggered a violent coughing spell. So did lying down, making it hard for her to sleep. And then she'd wake up with little or no voice. "Not being able to talk was a huge problem," says Fusco. "My husband and I run an insurance agency. I earn my living on the phone."
Fusco's family life was suffering too. Once an enthusiastic hostess, she no longer had the energy to entertain in her Haslet, TX, home. To get through her son's August 2005 wedding without coughing, she ate literally nothing all day. Most upsetting, her 7-year-old daughter, Mariah, was growing very anxious about her mom.
Nearly a year after Fusco's symptoms appeared and after dozens of medical tests, a lung specialist finally figured out that she had gastroesophageal reflux disease (GERD). The diagnosis had been tricky because the one symptom Fusco didn't have was heartburn. Treatment proved just as tricky: A change in diet (giving up all of her favorite Italian dishes) didn't help, nor did medication. At that point, Fusco's doctor advised surgery the traditional operation, which would mean general anesthesia, several days in the hospital, and a long recovery period.
Fusco wondered if that was her only option. Her mother happened to be watching the news one night and saw a doctor from nearby Baylor medical school talking about the new procedure for GERD using the Plicator, a stapling device that creates a pleat to tighten the weak valve.
On December 2, 2005, Fusco underwent the 20-minute procedure at Baylor. Afterward, she had a slightly sore throat (the device is inserted through the throat) but otherwise felt fine. For 48 hours she ate just soft foods; then, taking her doctor at his word that she could eat "anything she wanted," a week later she invited 17 guests and cooked up one of her feasts. "There I was, eating baked ziti, a chocolate dessert, even drinking red wine, and I didn't cough at all," Fusco says. "Everyone was laughing and having a good time, and I thought, This is what I've been waiting for. "
Lisa Collier - WebMD
