Heartburn, Gastroesophageal reflux disease (GERD)- symptoms, medications

Heartburn is a burning feeling in the chest or throat. It's a key symptom of acid reflux. That's when acids from the stomach "leak" up into the esophagus, the muscular tube that goes from your throat to your stomach. Persistent reflux that occurs more than twice a week may be diagnosed as gastroesophageal reflux disease, or GERD.

Other symptoms of acid reflux may include:
Acid taste in the mouth
Dry cough
A feeling like a lump in the throat
Difficulty swallowing
Sore throat
Hoarseness
Excessive mouth watering
Worsening dental disease

Acid reflux stems from problems with our digestive anatomy and function. One factor could be a poorly working lower esophageal sphincter (LES). The LES is a ring of muscle that acts like a "valve" to keep stomach contents from moving back up into the esophagus. Reflux can occur if the LES either opens when it shouldn't or it doesn't close properly. Another factor could be a slow-moving digestive system. The longer the stomach holds onto food, the more likely it is to cause acid reflux symptoms.

There are several ways to treat GERD, including diet and lifestyle changes, and medication. See the remaining "Next Steps" sections of this report for information about the various treatment approaches.

If left untreated, GERD can cause serious complications. These include:
An inflammation of the lining of the esophagus known as esophagitis
Scarring and narrowing in the esophagus
Ulcers in the esophagus
An increased risk for esophageal cancer due to changes in the cells lining the esophagus

The Asthma Connection
Because you have asthma, you may be interested to know that people with asthma have a higher risk of developing GERD.

Each condition may contribute to the other: When acid reflux irritates the airways and lungs, it may make asthma symptoms worse. And asthma flare-ups may cause the LES to relax, which allows stomach acid to reflux into the esophagus. In addition, some asthma medications, such as theophylline, may make GERD symptoms worse.

The good news? Studies of people with asthma and GERD have shown that those who treat their GERD see an improvement in their asthma symptoms.

If you are concerned that your asthma (or the medications you take for it) may be making your GERD symptoms worse -- or vice-versa -- talk with your health care provider about strategies for managing both conditions.

Is Your Hiatal Hernia Related to Your Symptoms?
You've told us you have a hiatal hernia. This is when the upper part of the stomach and the LES push up through an opening in the diaphragm -- the muscle that keeps the stomach and other abdominal organs separate from the chest. The opening in the diaphragm is called the hiatus; that's where a hiatal hernia gets its name.

While a hiatal hernia usually doesn't cause symptoms, some experts believe people who have one may be more likely to have acid reflux. That is because a hiatal hernia can make it more difficult for the diaphragm to help the LES keep acid in the stomach.

Surgery can help relieve acid reflux in people with large hiatal hernias.

How Extra Weight Can Affect GERD Symptoms
You say you are not at your ideal weight. Did you know that the extra pounds you are carrying could contribute to your GERD symptoms? The bulk of research suggests there is a likely link between the two.

There are several ways that excess weight can contribute to acid reflux. One theory is that carrying too much weight, particularly around the waist, puts increased pressure on the stomach, which leads to acid reflux. Another theory is that the stomachs of people who are overweight may get "stretched," which relaxes the barrier between the stomach and the esophagus.

Losing weight could help you improve your symptoms. To help shed some pounds, you might try moderate exercise, such as a walking program. Slimming down may also help if your clothes are too snug, which could be making your symptoms worse.

Check Your Medications
Several medications and dietary supplements can increase the risk for acid reflux and make GERD symptoms worse. Some of these may cause symptoms by irritating the lining of the esophagus. These types of medicines include:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen
Potassium supplements
Iron supplements
Tetracyclines, which treat infections
Bisphosphonates, used for osteoporosis

Other medicines contribute to acid reflux symptoms by relaxing the LES. These medicines include:
Beta-agonists and theophylline used for asthma
Some medicines for high blood pressure, including calcium channel blockers and alpha-blockers
Nitrates, used for chest pain
Some sedatives, also known as tranquilizers
Hormone replacement such as estrogen and progesterone
Birth control pills
Anticholinergic medicines, which treat a variety of conditions

If you regularly take one of these types of medications or supplements, talk with your healthcare provider about whether it could be contributing to your symptoms.