Definition. Gastroephagheal reflux disease (GERD), also referred to as 
heartburn or acid indigestion, is a burning sensation that occurs in the chest. Heartburn generally worsens when lying down or bending over. In most cases, heartburn can be managed with simple lifestyle modifications and occasional use of over-the-counter medications.
Causes. Heartburn occurs when stomach acid backs up into your esophagus, the muscular tube that connects the throat to the stomach.
Identifying triggers. Certain foods that may trigger heartburn include alcohol, black pepper, chocolate, caffeine, fatty or fried foods, ketchup, mustard, onions, orange juice, carbonated/fizzy drinks, tomato sauce, peppermint, and vinegar. If experiencing frequent heartburn, you may consider starting a food diary. Begin keeping a log of the foods and beverages that you eat/drink, and document which food(s) cause acid reflux. Then make an effort to decrease your intake of those foods and drinks.
Complications. Potential complications of heartburn include chest pain, chronic cough, sore throat, laryngitis, and abnormal growths on the vocal cords. Additionally, acid reflux may worsen pre-existing asthma in some patients.
When to see your doctor. Severe heartburn that interferes with your daily activities warrants a visit to your doctor. Examples include heartburn that occurs more than twice weekly; symptoms that persist despite using OTC medications; and experiencing difficulty swallowing.
Lifestyle modifications. You can make small changes to find relief by:
- maintaining a health weight
- avoiding tight-fitting clothing
- avoiding foods that trigger heartburn
- eating smaller meals
- not lying down immediately after a meal
- elevating the head of your bed
- avoiding tobacco
OTC pharmacological treatment.
- Antacids. Maalox, Mylanta, Rolaids, Tums, etc are antacids that neutralize stomach acid. In general, antacids work quickly, but can only be used once heartburn is already occurring. Additionally, they may not provide relief for long.
- H-2 receptor blockers. Tagamet, Pepcid, Axid, and Zantac help to reduce acid production. These medications don’t work as quickly as antacids, but do provide longer relief. Stronger versions are also available by prescription.
- Proton pump inhibitors. Nexium, Aciphex, Protonix, Prevacid and Prilosec block acid production, and allow time for damaged esophageal tissue to heal. Though PPIs are used commonly, ideally they should be used for the shorted duration possible. Chronic use may result in decreased calcium or magnesium levels, certain infections including pneumonia, and bone fractures.
