Heartburn Health Article

What to expect at your health care provider's office

Heartburn is usually easy to diagnose from the symptoms you describe to your doctor. Sometimes, heartburn can be confused with another stomach problem called dyspepsia. If the diagnosis is unclear, then you may be sent to a gastroenterologist for further testing.

First, your doctor will perform a physical examination and ask questions about your heartburn, such as:

• When did it begin?
• How long does each episode last?
• Is this the first time you have had heartburn?
• What do you usually eat at each meal? Before you feel heartburn, have you eaten a spicy or fatty meal?
• Do you drink a lot of coffee, other caffeinated beverages, or alcohol? Do you smoke?
• Do you wear clothing that is tight in the chest or abdomen?
• Does the pain also appear in the chest, jaw, arm, or elsewhere?
• What medications are you taking?
• Are you vomiting blood or black material?
• Do you have blood in your stools?
• Do you have black tarry stools?
• Are there other symptoms accompanying your heartburn?

The following tests may be performed:

• Upper GI series
• Esophageal motility to measure the pressure of your LES
• Upper endoscopy to look at the inside lining of your esophagus and stomach

If self care has not been successful, your doctor may consider prescribing you medications to reduce acid secretion. These are stronger than the medications available over the counter. Any sign of bleeding will require a more complicated treatment plan.

References

DeVault KR, Castell DO. Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2005;100:190-200.

Smith L. Updated ACG Guidelines for Diagnosis and Treatment of GERD. Am Fam Physician. 2005; 71(12): 2376-2382.

Fass R. Predictors of heartburn during sleep in a large prospective cohort study. Chest. 2005; 127(5): 1658-1666.

McCarthy D. Living with chronic heartburn: insights into its debilitating effects. Gastroenterol Clin North Am. 2003; 32(3 Suppl): S1-S9.