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Johns Hopkins Health - Feeling the Burn

Winter 2010
Issue No. 7

Feeling the Burn

Date: January 24, 2010

Occasional heartburn has fazed most of us at some point. But when is it just an annoyance or something more serious?

man with his hand on his chest

What is heartburn?
Heartburn is one of many symptoms associated with gastroesophageal reflux disease, or GERD. It’s characterized by a burning sensation below the sternum that’s worse after meals. About 20 percent of Americans will have reflux symptoms at least once a week, while half will have symptoms once a year. Heartburn is typically the most common symptom associated with GERD, but another common symptom is acid regurgitation.

How do I know when to see a doctor?
The big worry with heartburn is the irritation of the esophagus, strictures or possible Barrett’s esophagus or esophageal cancer, says gastroenterologist John Clarke, M.D. If you are having symptoms more than once a week, it’s worth talking to a doctor. If you’re having frequent heartburn and other symptoms such as weight loss or difficulty swallowing, or you’re older than 50 or have a family history of Barrett’s esophagus or esophageal cancer, you should also talk to a doctor. He or she will want to rule out something more serious.

Should I have an endoscopic screening done?
It’s somewhat controversial to do endoscopic screenings for everyone with reflux. However, if you meet any of the criteria or have had symptoms for more than 10 years, it’s worthwhile to get an endoscopic screening to ensure it’s not Barrett’s esophagus or esophageal cancer.

What treatments are recommended for heartburn?
Dietary and lifestyle modifications are usually the first places to start. If you’re overweight, losing as little as 5 percent of total body weight can be very effective. Other changes such as raising the head of your bed between 4 and 6 inches, avoiding tight clothes and eating at least three hours before lying down can be beneficial, too. Eating smaller quantities of food and eating foods that are low in fat may help. Also, avoiding certain types of foods and beverages that contain caffeine, alcohol, chocolate, peppermint, garlic, onion and citrus may reduce your heartburn. Over-the-counter medications such as antacids that neutralize stomach acid are fine for occasional heartburn. Someone with more frequent or severe heartburn may require more aggressive therapy.

To learn more about heartburn, visit, or for appointments, call 877-546-1872.