Heartburn: What's Going On Do... Video Transcript

Webcast Transcript

MARKS, MD: Most people think of heartburn as just being kind of a minor problem. But there are some serious potential manifestations down the road from heartburn.

JAMES FRESTON, MD, PhD: Absolutely. Heartburn's not trivial. An interesting study was done of factory workers who were taking lots of over-the-counter medications. And they were studied. And about 40% of them had severe disease. That should have been handled better. It's not a trivial condition.

I mentioned earlier that some people have simple heartburn, other people have chronic cough, laryngitis, even asthma symptoms. And then some -- a small percent, but a growing percent -- get cancer of the esophagus.

DAVID R. MARKS, MD: You say "a growing percent," why is that? With all the medications out there, that are even available over the counter, why would more people be having cancer from this problem?

JAMES FRESTON, MD, PhD: We're having an epidemic of GERD. And it's dragging cancer with it. Cancer of the esophagus related to heartburn and GERD is the most rapidly increasing cancer in western countries. We're not sure why there's such an epidemic of GERD and bringing cancer with it.

Being overweight, as a society. Probably eating more fatty foods. And, undoubtedly, other factors are playing a role.

MICHAEL WOLFE, MD: I agree. There are many factors that are implicated in this so-called epidemic, but we shouldn't alarm people. It's still a small number.

DAVID R. MARKS, MD: Small number. Some people may think they're even having a heart attack with these symptoms. That's a common complaint in emergency rooms. So the symptoms can be very severe.

MICHAEL WOLFE, MD: And similar. But remember, we have to first exclude the more serious disorder. So, if someone thinks, "Well, I'm just having a little bit of heartburn, and I'm not going to worry about it." That's a serious mistake. Because the first thing we must do is exclude the possibility that this is, indeed, a heart attack. Or angina.

So, first rule out the more life-threatening condition before just saying, "Yes, this is reflux." Yes, reflux is bad. But it will not kill you instantly. Whereas a heart attack may.

DAVID R. MARKS, MD: And, of course, that entails a doctor's evaluation. So when should a patient with heartburn see a doctor.

JAMES FRESTON, MD, PhD: I think if you've had heartburn for a minimum -of four or five years or more. And if you're having it three times a week, you certainly should see a doctor.

MICHAEL WOLFE, MD: I agree completely. And I think if you've had heartburn for five years, I think it's incumbent upon your primary physician to refer you to a gastroenterologist for an endoscopy in order to obtain a tissue sample to make sure you don't have a pre-malignant condition. Which tends to occur the longer you've had heartburn.

DAVID R. MARKS, MD: You mean something that can turn into cancer down the road.

MICHAEL WOLFE, MD: Yes.

JAMES FRESTON, MD, PhD: I would add another thing. If a person is taking a lot of antacids, that's reason enough to come in, because there's a better way. And that can be explained to people.

DAVID R. MARKS, MD: Thank you very much for being here. Thank you for joining our webcast. I'm Dr. David Marks, goodbye.

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