How To-70: "How to Question Your Doctor About Heartburn"

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Occasional heartburn is common, but heartburn symptoms that are more frequent could mean something more serious such as GERD (gastroesophageal reflux disease). If you have heartburn symptoms, here are some things you should address at your appointment.


  1. Determine if your case is relatively mild or severe. A heartburn severity scale is a way for people to measure their pain so that health professionals can help plan how best to control it. Mild symptoms are defined as symptoms that are hardly perceivable with only a slight impairment of general well-being; moderate symptoms are defined as clearly noticeable symptoms, but tolerable without immediate relief; and severe symptoms are defined as overwhelming discomfort with an urgent desire for immediate relief.
  2. Find out about recommended lifestyle changes. There are a lot of things you can do to avoid heartburn in the first place. They all mostly get down to what you put in your mouth. You want to avoid those foods that stimulate the prodcuction of acid in your stomach, avoid smoking, and limit your drinking of alcoholic beverages.
  3. Inquire about over-the-counter medicines. If your heartburn is mild and infrequent you can usually manage it temporarily by avoiding certain foods or activities that cause symptoms or with over-the-counter treatments like antacids or H2-antagonists, also known as H2-blockers. Antacids neutralize the stomach acid already present and provide quick but short-term relief of heartburn symptoms. H2 blockers partially block the production of stomach acid. H2 blockers can be effective depending on the specific product or brand used and typically one dose can last from 6 to 12 hours.
  4. Consider prescription medicine. Medicines that reduce the amount of acid that your stomach releases are commonly referred to as PPIs or proton-pump inhibitors. PPIs effect both the symptoms of heartburn and help heal the damage that GERD does to the esophagus. They are often recommended for people whose symptoms are not relieved by H2 blockers or who already have some damage to the lining of their esophagus.
    • Ask about side effects. Individual results vary but you may experience side effects like abdominal pain, constipation, diarrhea, nausea, dizziness, and/or headache.

  5. Discuss alternative if the medicine doesn’t help. There are other medicines that address heartburn from different angles, for example there are medicines that makes you feel full sooner.
  6. Figure out if you show any signs of esophagitis or Barrett’s esophagus You should ask your doctor about this if swallowing causes pain when food reaches part of your esophagus or if food sticks in this area, or if you experience bleeding. Anemia (low red-blood cell count), black stools, and vomiting of blood (obviously) are signs of bleeding.
  7. Ask about an examination for esophageal cancer. Humphrey Bogart died of esophageal cancer at the age of 57. Since the signs of esophagitis can be the same as for esophageal cancer it is a good topic to bring up with your doctor.
  8. Set up future examinations if necessary. Ongoing symptoms require ongoing exams if only to compare your current situation against your first visits.
  9. Accept that surgery may be a possibility. Surgery is occasionally required to treat esophagitis, especially if a hiatus hernia is present and when the above steps have been ineffective. Newer laparoscopic surgery has simplified this procedure.

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