Savvy Living

Is regular heartburn or acid reflux anything to worry about? I take antacids throughout the day to help manage my symptoms, but the reflux has gotten worse and keeps me awake at night. Should I be concerned?

Almost everyone experiences heartburn or acid reflux from time to time, but frequent episodes can signal a more serious problem. It is estimated that more than 60 million Americans experience heartburn at least once a month and around 15 million Americans suffer from it daily.

Heartburn symptoms show up in a variety of ways such as a burning pain behind the breastbone, indigestion or a sour or burning taste in the back of the throat. Other symptoms may include chest pain, difficulty swallowing, a chronic cough, a sore throat or hoarseness.

If you are plagued by heartburn more than twice a week and find little relief from over-the-counter antacids, you should make an appointment to see your health care provider. If your provider suspects you have a chronic condition, he or she may refer you to a gastroenterologist. Frequent bouts may mean you have gastroesophageal reflux disease (GERD). GERD can severely irritate and potentially damage the lining of your esophagus and may also increase your risk of Barrett's esophagus and esophageal cancer if it is not treated properly.

Lifestyle Adjustments

Depending on the severity of your heartburn, various lifestyle adjustments that can provide relief and prevent more serious problems down the road, such as:

• Avoid trigger foods: Avoid foods that trigger heartburn symptoms like citrus fruits, tomatoes, fatty foods, chocolate, garlic, onions, spicy foods, mints, alcohol, coffee and sodas. Keep a food diary to track which foods cause you the most problems and avoid those foods.
• Eat smaller, slower and earlier: Eating smaller portions at mealtimes and eating more slowly can help reduce heartburn symptoms. You should also wait at least three hours after eating before lying down or going to bed.
• Manage weight: Excess weight around the midsection puts pressure on the abdomen, pushing up the stomach and causing acid to back up into the esophagus.
• Quit smoking: Smoking can increase stomach acid and weaken the valve that prevents acid from entering the esophagus.
• Sleep elevated: To help keep the acid down while sleeping, you may want to adjust your sleeping position. Get a wedge-shaped pillow to prop yourself up a few inches. You may also elevate the head of your bed six to eight inches by placing blocks under the bedposts or insert a wedge between your mattress and box spring. Wedges are available at drugstores and medical supply stores. Studies have also shown that sleeping on your left side may also keep the acid down.

Treatment Options

If lifestyle adjustments do not resolve the symptoms and over-the-counter antacids are not helping, there are a variety of other medications that can help.

Histamine-2 Blockers: Available in both over-the-counter and prescription strength, these drugs reduce how much acid your stomach makes but may not be strong enough for serious symptoms.

Proton-Pump Inhibitors (PPI): If you have frequent and severe heartburn symptoms, PPIs are long-acting prescription medications that block acid production and allow time for damaged esophageal tissue to heal. Some PPIs are also available over-the-counter. Keep in mind that long-term use of PPIs may increase your risk for osteoporosis and chronic kidney disease.

If the medications do not resolve your symptoms, your provider may recommend a surgical procedure that can tighten or strengthen the lower esophageal sphincter and help prevent reflux.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.