Heartburn Health (cont.)

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When to Seek Medical Care

Call your health care professional if heartburn continues despite lifestyle modifications and use of antacids or low doses of acid blockers. Call a health care professional if a person has heartburn more than three times a week for over 2 weeks. The health care professional will prescribe medications or make other recommendations to help the pain.

Seek emergency medical care. Chronic heartburn can sometimes lead to serious complications that require immediate medical attention. Go to a hospital's emergency department if you have any of the following symptoms:

  • Throwing up blood or passing blood in the stools
  • Chest pain
  • Severe pain, dizziness, or lightheadedness
  • Difficulty swallowing
  • Shortness of breath
  • Dehydration
  • Unintentional weight loss

NOTE: The pain of heartburn can often be confused with pain that is actually due to more serious heart problems, such as a heart attack. If you or a family member has a history of heart disease, be aware of this possibility. If pain is accompanied by sweating, nausea, vomiting, difficulty breathing, or worsens with activity, you may need your heart evaluated immediately.

Heartburn Diagnosis

Heartburn may be obvious from the symptoms, so the health care professional may not need to perform any tests or do an extensive exam. The patient may be counseled to make lifestyle modifications and dietary changes to begin immediately.

The doctor may order certain procedures if the diagnosis is unclear or if the prescribed medications are not relieving the patient's heartburn.

Exams and Tests

  • The most common procedure is called an gastrointestinal endoscopy (esophagogastroduodenoscopy or EGD). During this procedure the patient is lightly sedated. A special camera is placed through the mouth and into the esophagus and stomach. The doctor can see how much damage has been done to the esophagus from stomach acid. The doctor will be able to determine and possibly treat the complications of heartburn, such as problems swallowing or bleeding. An upper endoscopy assist the doctor in diagnosing other explanations for the pain, such as an infection.
  • The patient may undergo an upper GI series. In this test, the patient drinks a liquid that coats the esophagus and stomach and shows up on X-rays that are taken subsequently.
  • If an upper endoscopy shows everything is normal but the patient continues to have pain, the doctor may do further testing to clarify the diagnosis. This includes a procedure to measure the weakness of the LES muscle, called an esophageal manometry.
  • The 24-hour pH monitoring test measures the strength of stomach acid. A very thin tube is passed through nose into the patient's esophagus. For the next 24 hours, the test measures the amount of acid reflux that occurs while the patient goes about his or her regular activities, including eating.
  • Another test uses a tiny capsule to measure acid reflux levels. The doctor uses an endoscope to attach the bean-sized capsule to the patient's esophagus. It measures pH levels and delivers readings by radio wave to a receiver the patient wears on the belt. After about 48 hours, the capsule detaches and passes through the digestive system and is not recovered.

If the patient's health care professional feels the patient is at risk for heart problems, additional tests may be performed to make sure the patient's heart is healthy.

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