Heartburn

Encyclopedia of Medicine, Apr 06, 2001 by Lorraine Lica

However, laparoscopy (an examination of the interior of the abdomen by means of the laparoscope) now provides hope for better outcomes. Fundoplication performed with a laparoscope is less invasive. Five small incisions are required instead of one large incision. Patients recover faster, and it is likely that studies will show they suffer from fewer surgical complications.

Prevention, as outlined below, is a primary feature for heartburn management in alternative medicine and traditional medicine. Dietary adjustments can eliminate many causes of heartburn.

Herbal remedies include bananas, aloe vera gel, chamomile (Matricaria recutita), ginger (Zingiber officinale), and citrus juices, but there is little agreement here. For example, ginger, which seems to help some people, is claimed by other practitioners to cause heartburn and is thought to relax the LES. There are also many recommendations to avoid citrus juices, which are themselves acidic. Licorice (Glycyrrhiza uralensis) can help relieve the symptoms of heartburn by reestablishing balance in the acid output of the stomach.

Several homeopathic remedies are useful in treating heartburn symptoms. Among those most often recommended are Nux vomica, Carbo vegetabilis, and Arsenicum album. Acupressure and acupuncture may also be helpful in treating heartburn.

Sodium bicarbonate (baking soda) is an inexpensive alternative to use as an antacid. It reduces esophageal acidity immediately, but its affect is not long-lasting and should not be used by people on sodium-restricted diets.

The prognosis for people who get heartburn only occasionally or people without esophageal damage is excellent. The prognosis for people with esophageal damage who become involved in a treatment program that promotes healing is also excellent. The prognosis for anyone with esophageal cancer is very poor. There is a strong likelihood of a painful illness and a less than 5% chance of surviving more than five years.

Given the lack of completely satisfactory treatments for heart burn or its consequences and the lack of a cure for esophageal cancer, prevention is of the utmost importance. Proponents of traditional and alternative medicine agree that people disposed to heartburn should:

• Avoid eating large meals.
• Avoid alcohol, caffeine, fatty foods, fried foods, hot or spicy foods, chocolate, peppermint, and nicotine.
• Avoid drugs known to contribute to heartburn, such as nitrates (heart medications like Isonate and Nitrocap), calcium channel blockers (e.g., Cardizem and Procardia), and anticholinergic drugs (e.g., Pro-banthine and Bentyl), and check with their doctors about any drugs they are taking.
• Avoid clothing that fits tightly around the abdomen.
• Control body weight.
• Wait about three hours after eating before going to bed or lying down.
• Elevate the head of their bed six to nine inches to alleviate heartburn at night. This can be done with bricks under the bed or with a wedge designed for this purpose.

• Books
• Castell, Donald O. The Esophagus. Boston: Little, Brown, 1995.
• Wolfe, M. Michael, and Thomas Nesi. The Fire Inside: Extinguishing Heartburn and Related Symptoms. New York: Norton, 1996. Periodicals
• "Acid blockers: How You Can Head Off Heartburn Before it Starts." Mayo Clinic Health Letter (November, 1997).
• Mittal, Ravinder K. and David H. Balaban. "Mechanisms of Disease: The Esophagogastric Junction." New England Journal of Medicine 336 (March 27, 1997): 924-932.
• Vaezi, Michael F., and Joel E. Richter. "Gastroesophageal Reflux Disease." Current Opinion in Gastroenterology 13 (July, 1997): 327-332. Organizations
• The American College of Gastroenterology (ACG). P.O. Box 3099, Alexandria, VA 22302. (703) 820-7400; (800) HRT-BURN. http://www.healthtouch.com.
• The American Gastroenterological Association (AGA). 7910 Woodmont Ave., 7th Floor, Bethesda, MD 20814. (310) 654-2055. http://www.gastro.org/index.html. aga001@aol.com.
• American Society for Gastrointestinal Endoscopy. 13 Elm St., Manchester, MA 01944. (508) 526-8330. http://www.asge.org/doc/201.
• National Digestive Diseases Information Clearinghouse. 2 Information Way, Bethesda, MD 20892-3570. (E-mail: nddic@aerie.com) http://www.niddk.nih.gov/Brochures/NDDIC.htm.>

Gale Encyclopedia of Medicine. Gale Research, 1999.