Heartburn - Diagnosis and Treatment
Last Updated on Monday, 19 October 2009 10:47
Diagnosis & Treatment of Heartburn
Diagnosis of heartburnÂ
A description of your symptoms is sufficient for your doctor to diagnose heartburn. If your symptoms are severe and you do not respond to initial treatment, your doctor may suspect GERD or some other medical condition, and recommend the following tests
Barium X-ray: These X-rays can reveal the presence of hiatal hernia, oesophageal narrowing or stricture, or a growth or protrusion, which may cause difficulty in swallowing.
Endoscopy: This is a more direct test for diagnosing the cause of heartburn. The test is also known as upper gastrointestinal (GI) endoscopy or oesophagogastroduodenoscopy. It helps to rule out any underlying conditions such as a peptic ulcer or Barrett's oesophagus (cancer of oesophagus).
Ambulatory acid (pH) probe tests: These tests use an acid-measuring (pH) probe that helps to understand when and for how long stomach acid regurgitates into your oesophagus. A more comfortable test called a Bravo pH probe is also available.
Oesophageal impedance: This test measures gas or liquid reflux into your oesophagus.
Complications of Heartburn
Most heartburn is only occasional. If your heartburn is severe or chronic, it may suggest you have GERD. Complications of GERD include the following
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Oesophagitis – Irritation and inflammation of your oesophagus.
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Narrowing or stricture of your oesophagus.
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Increased risk of oesophageal cancer called Barrett’s oesophagus.
Treatment for Heartburn
In the case of a mild heartburn, over-the-counter medication and self-care measures provide adequate relief. GERD usually requires prescription-strength medication or medical treatment and sometimes even surgical intervention.
Antacid Treatments for heartburn: Antacids neutralize stomach acid. They can provide quick relief but are not healing agents for an inflamed or damaged oesophagus. Overuse of some antacids can cause side effects such as diarrhoea or constipation.
H-2-receptor blockers: Over-the-counter H-2-receptor blockers are available at half the strength of their prescription versions. These treatments reduce the production of stomach acid. They are not as quick as antacids but provide relief for a longer time. You need to take these medications before a meal as these take about 30 minutes to have any effect. These are also effective in reducing reflux at night if taken just before bedtime. Some known but infrequent side effects include dizziness, diarrhoea, headache, kidney problems and temporary breast enlargement in men. In rare instances, antacids can also react dangerously with other medications. You should consult your doctor before resorting to antacids for relief from heartburn.
Proton pump inhibitors: These medications block acid production and allow time for damaged oesophageal tissue to heal.
Surgery: Surgery is a simple procedure and is called fundoplication. Its purpose is to tighten the lower oesophageal sphincter muscle. This surgery is known to be successful in more than 85% of the cases.
