Heartburn Hazards

By Christine Gorman

If the fireworks you experienced last weekend had more to do with the acid in your stomach than the starbursts overhead, you probably blamed it on that one last hot dog you ate before reaching for a bottle of Maalox or a package of Pepcid AC. Most of the time, these and other heartburn remedies are all that are necessary to settle your stomach. But if you suffer from regular bouts of acid indigestion, you may need more than just a drugstore fix; you could have a more serious condition called gastroesophageal reflux disorder, or GERD, which can severely damage the esophagus and even predispose some people to throat cancer.

Nobody knows exactly how many people have GERD. But the latest surveys suggest that at least 15 million Americans experience heartburn, its principal symptom, on a daily basis. And things are only getting worse. "The number of Americans reporting frequent heartburn has grown 10% in the past two years," says Dr. Andrew Dannenberg, chairman of a national heartburn advisory panel and an associate professor at Cornell University Medical College in New York City. Some of that is due to aging. But a lot is caused by such habits as late-night snacking, high-fat eating and a related propensity to obesity.

Heartburn has nothing to do with the heart, of course. It occurs when acidic juices from the stomach gurgle their way past a doughnut-shaped valve and into the esophagus. Unlike the stomach, the esophagus has no protective lining against corrosion. Repeated bouts of reflux eat away at its inner wall, triggering excessive scarring and bleeding. Sometimes the acid reaches the vocal cords, causing hoarseness. Other times it spills over into the lungs, triggering a potentially serious condition that mimics asthma.

Fortunately, GERD has a cure. For years doctors tried to minimize the problem with antacids. Then they turned to drugs like Tagamet and Pepcid to block a biochemical signal that sets off acid production. Neither of these remedies, now available over the counter, can turn off the stomach's acid-making machinery at the source, however. That's where a new group of prescription medications, called proton pump inhibitors, comes in. "You don't just get better on these pills," Dannenberg exults, "you actually return to normal." And because the drugs are activated only in the acid environment of the stomach, they are very safe to use.

Most of the time, a little bit of heartburn is just that: a little bit of heartburn. And a little bit of prevention can keep it at bay. For starters, don't gulp down big meals that are high in fats, chocolate, coffee and alcohol. Small portions eaten over longer periods make it less likely your stomach will back up. In case you needed another reason to quit, cigarette smoking is a potent acid trigger.

Next, make friends with gravity. Don't lie down within three hours of eating a meal. It's too easy for the contents of your stomach to spill upward into your horizontal esophagus. Sleeping with your head slightly elevated can also help.

Whatever you do, don't ignore the acid rising from your stomach. Over-the-counter remedies are fine for occasional upsets. But if you develop heartburn on a regular basis, say twice a week, or if it's keeping you from sleeping at night, then get yourself to a doctor. The problem could be much worse than you realize.

For more information on GERD, see time.com/personal You can e-mail Christine at [email protected]