Is It Heartburn or Something More?

For many of us, acid reflux is an occasional fact of life. Eating a heavy meal or lying down in bed right after eating can send stomach acid up where it doesn’t belong.

While painful, some acid reflux — also known as heartburn, even though it has nothing to do with the heart — is normal. But when heartburn happens often, it may be a condition called gastroesophageal reflux disease, or GERD, and the damage can add up.

Acid can harm the esophagus, the tube that connects the throat and stomach, along with our teeth, voice box and lungs. In rare cases, when the damage to the esophagus lasts for many years, it can even cause esophageal cancer.

And in addition to these serious physical problems, GERD has been connected with mental health trouble like depression and anxiety. Stress can make heartburn worse and the chest pain it causes can easily be mistaken for a heart condition, both of which add up to more anxiety.

Recognizing when you have GERD is the first step to getting treatment. Here's some important information to help you consider whether your acid reflux could be adding up to something more serious.

What is Acid Reflux?

Our stomachs are special places — to digest food, they need to be so acidic that just a drop of stomach acid eats through wood. While our stomachs are lined with special cells to protect us from that acid, the rest of our body isn’t.

That includes the esophagus, a tube about eight inches long that connects the throat and stomach. Usually, a special muscle at the bottom of the esophagus closes off, but problems with this muscle can let acid flow back up.

When that happens, the acid irritates the inside of the esophagus, causing it to swell up. A few bouts of acid reflux over time usually aren’t a big deal for your body to repair.

But repeated acid reflux can be trouble, explains AdventHealth Medical Group board-certified gastroenterologist Markus Agito, MD. “If you experience regurgitation or heartburn at least twice a week, or feeling like food getting stuck in your chest, then come in for a visit and let’s talk about it.”

In some cases, the pain of heartburn is sending you a serious signal worth listening to.

How is it Treated?

The first line of defense is to change the foods or behaviors that cause acid reflux. For some people, that may mean making one or more of the following lifestyle changes, according to the National Institutes of Health:

• Avoiding food that causes acid reflux, including spicy or greasy food
• Not overeating or eating within two or three hours of bedtime
• Losing weight if you’re carrying extra pounds
• Quitting smoking and avoiding secondhand smoke
• Wearing loose clothing, as tight clothes can squeeze your stomach and push acid out
• Staying upright after meals

There are also a wide variety of medications that may be great options for people with acid reflux.

Because they act quickly, are available without a prescription and are inexpensive, antacids like Tums, Mylanta and Rolaids are the most common treatment for heartburn. They work by weakening your stomach acid, robbing it of the ability to burn your esophagus.

Antacids have been used for thousands of years — even the ancient Sumerians used salts to cure heartburn. But one problem with this treatment is it doesn’t heal the esophagus.

Other medications, like Zantac, work a different way, by decreasing the amount of acid your stomach produces. Some are available by prescription.

Finally, other medications, called proton pump inhibitors like Prevacid and Prilosec, take longer to take effect but can provide longer relief.

“We may discuss surgery as a treatment option, but only if medications and lifestyle changes don’t have you feeling better,” says Dr. Agito. The most common surgery is called fundoplication. It involves a surgeon sewing the part of the stomach near the esophagus (called the fundus) around the esophagus.

It might seem unexpected for surgery to wrap the stomach around the esophagus, but this increases pressure and prevents acid from slipping up.

What Are Its Long-Term Effects?

Repeated acid reflux can lead to plenty of different problems, but they generally have the same cause: damage from escaped stomach acid. Here are some of the potential issues:

• Esophagitis. When the esophagus is irritated by stomach acid, it can swell up, causing pain and difficulty swallowing. If it’s not treated, scar tissue can build up, causing the esophagus to narrow and lead to a choking risk.
• Barrett's esophagus. If they’re exposed to years of acid reflux, the cells in the esophagus can start to change. This doesn’t cause symptoms but puts its victims at higher risk for esophageal cancer.
• Tooth decay. If acid from the stomach reaches the mouth, it can wear away at teeth. For people who don’t experience pain, tooth decay may be the first symptom of GERD.
• Esophageal cancer. This is among the rarest, but also the most serious threats of long-term heartburn. The American Cancer Society estimates there will be about 17,650 new cases of esophageal cancer diagnosed in the United States in 2019.

To be clear, a few months of heartburn is unlikely to cause cancer. It usually takes many years of damage before cancer is a risk.

But heartburn is a problem that too many people easily dismiss. And, as with many cancers, catching esophageal cancer early is critical. When the cancer is found before it spreads beyond the esophagus, an estimated 43 percent of patients are alive five years later. If it spreads to nearby tissues, that survival rate declines to 23%.

When it spreads to other organs, the survival rate is about 5 percent.

These statistics can be scary, but the good news is that esophageal cancer forms slowly, and we have the tools to stop the acid reflux that causes it.

AdventHealth believes that relieving the pain of heartburn is only part of the solution. Stress and anxiety make heartburn worse, so emotional and spiritual health are important parts of acid reflux treatment.

To learn more about how AdventHealth prioritizes both peace from pain and peace of mind, visit our website..