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Heartburn Is More Than Just A Nuisance


By Gail Benner

If Thanksgiving makes you wince in pain at the thought of impending heartburn, you are probably not alone. But if you experience heartburn more than twice a week despite over-the-counter treatments, a Jefferson expert wants you to check with your doctor. Gastroesophageal Reflux Disease (GERD) Awareness Week is observed each year during the week of Thanksgiving, a fitting time as Americans prepare to indulge in the holiday season.

Robert Coben, M.D., FACP, is an associate professor of medicine in the Sidney Kimmel Medical College at Thomas Jefferson University and a board-certified gastroenterologist at Jefferson.

"Gastroesophageal Reflux Disease, or GERD, is a chronic condition in which a person experiences heartburn several times a week," Dr. Coben said. "If your heartburn persists despite over-the-counter treatment, you should see your physician."

Other symptoms, identified as "alarm symptoms," that require further evaluation include: trouble swallowing, weight loss, nausea or vomiting, poor appetite and regurgitation.

"GERD can be more than just a nuisance," said Dr. Coben. "If left untreated, it can lead to chronic acid exposure in the esophagus which can lead to inflammation, GI bleeding, scarring and potentially cancer."

GERD can also cause regurgitation of stomach acid into the esophagus with additional potential unusual complications which include asthma, laryngitis, chronic cough, dental damage, sinus problems, pneumonia, chronic hoarseness and laryngeal cancer.

"Most importantly, patients should know that severe, chronic GERD can lead to Barrett's esophagus and the risk of developing esophageal cancer," said Dr. Coben. "Although Barrett's esophagus is rare, approximately 7-10 percent of patients with chronic symptoms of reflux develop Barrett's and patients who are diagnosed with Barrett’s esophagus have a 30-40 times increased risk of esophageal cancer."

Luckily, effective treatments are available.

"The mainstay of treatment is lifestyle modifications which could include avoiding tight-fitting clothing, foods triggering heartburn, lying down after meals, late meals and smoking," said Dr. Coben. "In addition, some patients benefit from losing extra weight and elevating the head of the bed."

Beyond lifestyle changes, over-the-counter and prescription medications are available, as well as endoscopic and surgical therapies.

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