Is heartburn associated with heart attacks?

No. But sometimes pain in the chest may be mistaken for heartburn when it's really a sign of heart disease. If you have any of the symptoms in the box below, call your doctor.

Call your doctor if:

• You have trouble swallowing or pain when swallowing.
• You're vomiting blood.
• Your stools are bloody or black.
• You're short of breath.
• You're dizzy or lightheaded.
• You have pain going into your neck and shoulder.
• You break out in a sweat when you have pain in your chest.
• You have heartburn often (more than 3 times a week) for more than 2 weeks.

What about medicines for heartburn?

Several kinds of medicine can be used to treat heartburn. H2 blockers (some brand names: Pepcid, Tagamet, Zantac) reduce the amount of acid your stomach makes. Several are available without a prescription.

Other medicines, such as omeprazole (brand name: Prilosec) and lansoprazole (brand name: Prevacid), also reduce how much acid the stomach makes. Metoclopramide (brand name: Reglan) reduces acid reflux. To find out what medicine is right for you, talk with your doctor.

What if my symptoms get worse?

If lifestyle changes and antacids don't help your symptoms, talk with your doctor. Your doctor may want you to take prescription medicine or schedule you for some tests.

Tests might include X-rays to check for ulcers, a pH test to check for acid in the esophagus, or an endoscopy to check for other conditions. During an endoscopy, your doctor looks into your stomach through a long, thin tube which is inserted down your esophagus. Your doctor may also check for H. pylori, a bacteria that can cause ulcers.

Will antacids take care of heartburn?

Antacids neutralize the acid that your stomach makes. For most people, antacids that you can get without a prescription (over-the-counter) give fast, short-term relief.

However, if you use antacids too much, they can cause diarrhea or constipation. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide. (One causes constipation while the other causes diarrhea so they counteract each other.) Some brands of antacids include Maalox, Mylanta and Riopan. Follow the directions on the package.

What can I do to feel better?

You might be able to avoid heartburn by making some changes in your lifestyle. The box below lists some tips on how to prevent heartburn.

Tips on preventing heartburn

• Place 6- to 9-inch blocks under the legs at the head of your bed to raise it.
• Try to eat at least 2 to 3 hours before lying down. If you take naps, try sleeping in a chair.
• If you smoke, quit.
• Lose weight if you're overweight.
• Don't overeat.
• Eat high-protein, low-fat meals.
• Avoid tight clothes and tight belts.
• Avoid foods and other things that give you heartburn.

Can heartburn be serious?

If you only have heartburn now and then, it's probably not serious. However, if you have heartburn frequently, it can lead to esophagitis (an inflamed lining of the esophagus). If esophagitis becomes severe, your esophagus might narrow and you might have bleeding or trouble swallowing.

If you get more than occasional heartburn, it may be a symptom of acid reflux disease, gastroesophageal reflux disease (GERD), an inflamed stomach lining (gastritis), hiatal hernia or peptic ulcer.

What factors add to heartburn?

What factors add to heartburn?

Many things can make heartburn worse. Heartburn is most common after overeating, when bending over or when lying down. Pregnancy, stress and certain foods can also make heartburn worse. The box below lists other things that can aggravate heartburn symptoms.

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Things that can make heartburn worse

• Cigarette smoking
• Coffee (both regular and decaffeinated) and other drinks that contain caffeine
• Alcohol
• Carbonated drinks
• Citrus fruits
• Tomato products
• Chocolate, mints or peppermints
• Fatty foods or spicy foods (such as pizza, chili and curry)
• Onions
• Laying down too soon after eating
• Being overweight or obese
• Aspirin or ibuprofen (one brand name: Motrin)
• Certain medicines (such as sedatives and some medicines for high blood pressure)

What is hiatal hernia?

Hiatal hernia is a condition in which part of the stomach is pushed up through the diaphragm (the muscle wall between the stomach and chest) and into the chest. Sometimes this causes heartburn.

What causes heartburn?

What causes heartburn?

When you eat, food passes from your mouth down a tube (about 10 inches long in most people) called the esophagus. To enter the stomach, the food must pass through an opening between the esophagus and stomach. This opening acts like a gate to allow food to pass into the stomach.

Usually, this opening closes as soon as food passes through. But if it doesn't close all the way, acid from your stomach can get through the opening and into your esophagus. This is called reflux. Stomach acid can irritate the esophagus and cause heartburn.d

Heartburn

What is heartburn?

Despite its name, heartburn doesn't affect the heart. Heartburn is a burning feeling in the lower chest, along with a sour or bitter taste in the throat and mouth. It usually occurs after eating a big meal or while lying down. The feeling can last for a few minutes or a few hours.

How can I prevent diverticular disease?

A high-fiber diet is the best way to prevent diverticular disease. You can increase the amount of fiber you eat by including more fruits, vegetables and whole-grain foods in your diet. Also be sure to drink plenty of fluids and exercise regularly.

How is diverticular disease treated?

For diverticulosis, your doctor may suggest that you eat more fiber, drink plenty of fluids and exercise regularly to help prevent the pouches from becoming infected or inflamed.

For mild cases of diverticulitis, your doctor may prescribe antibiotics. He or she may also suggest that you eat more fiber, drink plenty of fluids and exercise regularly to help prevent future problems.

For severe cases of diverticulitis or diverticular bleeding, your may need surgery to remove the pouches and the diseased parts of your

How can my doctor tell if I have diverticular disease?

Your doctor may check your abdomen for tenderness and ask you about your bowel habits, diet and medications. Your doctor may also want to do some tests to screen for diverticular disease:

• Barium Enema. For this test, you are given an enema (injection of fluid into the rectum) with a liquid that makes your colon show up on an X-ray.
• Flexible sigmoidoscopy. In this test, your doctor puts a thin, flexible, hollow tube with a light on the end into your rectum. The tube is connected to a tiny video camera, which allows your doctor to see the rectum and the last part of your colon.
• Colonoscopy. Before you have this test, you are given a medicine to make you relaxed and sleepy. A thin, flexible tube connected to a video camera is put into your rectum, which allows your doctor to see your whole colon. A colonoscopy may be uncomfortable, but it is usually not painful.
• CT Scan. This test is a type of X-ray that allows your doctor to see the pouches in your digestive tract that are inflamed or infected.

Sometimes, diverticular disease is found when tests are ordered for a different reason, such as routine screening that checks for colorectal cancer or other digestive problems.

Who gets this disease and why?

Diverticular disease affects both men and women and is most common in people older than 40. Diverticular disease may be caused by not eating enough fiber. When you don't eat enough fiber, you may get constipated and your stools may not be as soft. Constipation and hard stools increase the pressure in the bowel walls. This pressure may cause the diverticular pouches to form.

Diverticular Disease

What is diverticular disease?

Diverticular (say: die-ver-tick-yoo-ler) disease affects the lining of the bowel (in your large intestine). It is caused by small pouches (called diverticula) that can form anywhere in your digestive tract, but usually form in the last part of the large intestine (called the colon).

The most common types of diverticular disease are:

• Diverticulosis. People with diverticulosis have pouches in the large intestine. Most people with diverticulosis don't have any symptoms and may not even know they have it.
• Diverticulitis. This occurs when the pouches become infected and inflamed. Symptoms of diverticulitis can include severe abdominal pain, fever, nausea, constipation or diarrhea. Less common symptoms include vomiting and frequent and painful urination. Pain is most often located on the lower left side of the abdomen. Complications of diverticulitis can include intestinal blockages and openings in the bowel wall.
• Diverticular bleeding. Diverticular bleeding occurs when a blood vessel next to the pouches bursts. You may find blood in a bowel movement or in the toilet. If you notice blood coming from your rectum, you should call your doctor immediately.

What are the complications of gastroparesis?

• Weight loss, malnutrition and dehydration. If you’re not able to eat enough food, or if you vomit up a lot of what you eat, you may not get enough nutrition. Following the suggestions listed above may help with this problem.
• Bezoars. A bezoar (say: “bee-zore”) is a solid mass of food that your stomach is not able to digest. Bezoars can cause nausea and vomiting. In severe cases, they may block other food from entering the small intestine. This situation can be life-threatening, and the bezoar may have to be removed by surgery.
• Bacterial infections. When food stays too long in your stomach, bacteria can grow out of control, which can lead to infection.
• Problems controlling blood sugar. When you have gastroparesis, your timing for digesting food doesn’t follow normal patterns. For this reason, people who have diabetes and gastroparesis often have a lot of trouble controlling their blood sugar levels.

How is gastroparesis treated?

There is no cure for gastroparesis. Treatment will focus on treating any underlying problem that is causing the gastroparesis and controlling your symptoms. For example, your doctor may ask you to stop taking any drugs that can affect the digestive system. Don’t stop any medicine without first talking to your doctor. Your doctor also may want to treat any eating disorders, infections or other issues that could be causing gastroparesis.

Your doctor might also recommend one or more of the following:

Dietary changes. Since you might not be able to eat normally, it’s very important to make sure you’re getting enough nutrients. You may need to:

• Eat several smaller meals each day instead of 2 or 3 large ones.
• Eat softer foods, such as vegetables or pasta that are cooked thoroughly.
• Limit fat (which can slow digestion) and fiber (which can be hard to digest).
• Supplement your diet with nutrition drinks (such as Ensure or Boost) or solid food that you’ve pureed in a blender.

Medicine. Anti-nausea medicines called antiemetics can help with nausea and vomiting. Some other medicines, such as metoclopramide and erythromycin, can stimulate stomach muscle contractions. Each of these drugs has some drawbacks, including potentially serious side effects. You and your doctor need to discuss whether the benefits of taking these medicines outweigh the risks.

Feeding tube. If your gastroparesis is severe, you may need a feeding tube. This tube will be inserted through your skin into your small intestine. Or, it may be passed into your intestines through your nose or mouth. The tube allows nutrients to be delivered directly to your bloodstream. A feeding tube can also help when gastroparesis causes unstable blood sugar levels in people who have diabetes.

How do doctors diagnose gastroparesis?

How do doctors diagnose gastroparesis?

Your doctor will start by examining you and asking you about your medical history. Be sure to tell your doctor about any prescription or over-the-counter medicines you are taking. You may have blood tests to check the quality of your blood and measure some chemical levels.

Your doctor might want to do some other tests to make sure you don’t have a blockage or another medical problem. These tests may include:

• Upper endoscopy. Your doctor uses a flexible tube with a light at the end to look inside your throat, your esophagus and into your stomach. You will probably be given a sedative drug to make you more relaxed and comfortable during this test. Your throat will also be numbed, so you shouldn’t feel any pain.
• Gastric emptying ultrasound. This test uses sound waves to look at the organs in your abdomen (your gallbladder, liver and pancreas) so your doctor can check for signs of problems.
• Barium X-ray. When your stomach is mostly empty, you drink a liquid that contains a small amount of barium. The doctor can watch the barium liquid travel through your body on an X-ray machine, in order to figure out where the problem is occurring.
• Gastric emptying studies. For these studies, you’ll eat or drink something that contains a small amount of radioactive material. A scanner is able to pick up signals from the radioactive material. This scanner keeps track of how long it takes your stomach to empty completely. Or, your breath may be tested for the radioactive material to measure how fast your stomach is emptying.
• Gastrointestinal (GI) monitoring capsule. For this test, you swallow a small capsule (or “pill”) that collects information as it moves through your digestive system. The pill sends this information to a small computer you wear around your waist or neck. After a few days, you will pass the capsule in your stool, and your doctor will study the information it collected.

Who is at risk of gastroparesis?

People who have diabetes are most at risk for gastroparesis because high blood sugar levels can damage the vagus (say: “vay-gus”) nerve. The vagus nerve tells your stomach muscles when to contract. Damage to this nerve is one of the most common causes of gastroparesis. Diabetes can also damage the blood vessels that carry oxygen and nutrients to the vagus nerve.

Other things that can lead to gastroparesis include:

• Some medicines, such as certain pain medicines, antidepressants and others
• Surgery on the esophagus (the tube the runs from the mouth to the stomach), the stomach or the upper small intestine
• Radiation of the chest or stomach area for cancer treatment
• Eating disorders, such as anorexia nervosa and bulimia
• Gastroesophageal reflux disease (GERD)
• Other disorders, including hypothyroidism, scleroderma, Parkinson’s disease and some autoimmune disorders
• Rarely, viral infections such as the flu

Gastroparesis

What is gastroparesis?

Gastroparesis (say: “gast-roe-par-EE-sus”) is a disorder that happens when your stomach muscles don’t work properly. It is sometimes called “delayed gastric emptying.” Normally, after you swallow food, your stomach muscles begin squeezing and tightening. (These movements are called contractions.) This crushes the food and moves it into the small intestine to continue the digestive process. If you have gastroparesis, your stomach muscles don’t contract properly. This can delay or prevent the process of crushing the food and sending it to the small intestine.

What are the symptoms of gastroparesis?

Symptoms of gastroparesis can be mild or severe, and may include:

• Heartburn or stomach pain
• Nausea
• Vomiting, especially vomiting pieces of undigested food
• Feeling full after only a few bites of food
• Bloating
• Lack of appetite
• Unintended weight loss
• Unstable blood sugar levels (in people who have diabetes)

These symptoms can suggest a lot of different problems and disorders. This can make gastroparesis hard to diagnose.

What is an ulcer?

Ulcers: What You Can Do to Heal Your Ulcer

 

What is an ulcer?

Ulcers are sores on the lining of your digestive tract. Your digestive tract consists of the esophagus, stomach, duodenum (the first part of the intestines) and intestines. Most ulcers are located in the duodenum. These ulcers are called duodenal ulcers. Ulcers located in the stomach are called gastric ulcers. Ulcers in the esophagus are called esophageal ulcers.

What causes ulcers?

Doctors used to think ulcers were caused by stress or by eating food with too much acid in it. We now know this isn’t true. Most ulcers are caused by an infection. The infection is caused by a bacteria (germ) called Helicobacter pylori (say: hell-ee-ko-back-ter pie-lore-ee”), or H. pylori for short. Acid and other juices made by the stomach can contribute to ulcers by burning the lining of your digestive tract. This can happen if your body makes too much acid or if the lining of your digestive tract is damaged in some way. Physical or emotional stress may not necessarily cause an ulcer, but it can aggravate an ulcer if you have one.

Ulcers can also be caused by anti-inflammatory medicines. Although most people take these medicines without problems, long-term use may damage the stomach lining and cause ulcers. Anti-inflammatory drugs include aspirin, ibuprofen (one brand name: Motrin), naproxen (brand name: Aleve), ketoprofen (brand names: Actron, Orudis KT) and some prescription drugs for arthritis.

How can my doctor tell if I have an ulcer?

Your doctor will ask about your symptoms and may start you on some medicine before doing tests. This is because ulcers usually feel better within a week or so of treatment. You may not need tests if you're getting better.

If you don't get better, your doctor may do an endoscopy or a special X-ray to study your digestive tract. During an endoscopy, your doctor looks into your stomach through a thin tube. He or she may take a biopsy (a sample of the stomach lining) to test for H. pylori. Blood and breath tests can also be used to test for H. pylori.

Possible signs of an ulcer

• Feel better when you eat or drink and then worse 1 or 2 hours later (duodenal ulcer)
• Feel worse when you eat or drink (gastric ulcer)
• Stomach pain that wakes you up at night
• Feel full fast
• Heavy feeling, bloating, burning or dull pain in your stomach
• Vomiting
• Unexpected weight loss

How can ulcers be treated?

One way to treat ulcers is to get rid of the H. pylori bacteria. Treatment may also be aimed at lowering the amount of acid that your stomach makes, neutralizing the acid and protecting the injured area so it can heal. It's also very important to stop doing things, such as smoking and drinking alcohol, that damage the lining of your digestive tract.

What is triple therapy?

Triple therapy is a treatment to eliminate H. pylori. It is a combination of 2 antibiotics and bismuth subsalicylate (one brand name: Pepto-Bismol). Other combinations may also be effective. This treatment may be used with medicine that reduces the amount of acid your stomach makes.

What about other medicines?

Several other medicines can be used to help treat ulcers. Two types of medicines (H2 blockers and proton pump inhibitors) reduce the amount of acid that your stomach makes. They usually help people start to feel better within 3 days.

Antacids neutralize acid that the stomach makes. A medicine called sucralfate coats the ulcer to protect it from the acid so it has time to heal.

Another medicine, misoprostol, reduces the amount of acid and protects the lining of the stomach. It is usually used to prevent gastric ulcers in people who need to take anti-inflammatory drugs and who have had stomach irritation or ulcers in the past.

How long will I have to take medicine?

Treatment to get rid of H. pylori usually takes about 2 to 3 weeks. Your doctor may want you to take medicine that lowers the stomach acid for up to 8 weeks. Most ulcers heal within this time.

If your symptoms come back after you stop taking medicine, your doctor may want you to take a different medicine or take a low dose of medicine even when you're not having symptoms to keep the ulcer from coming back.

Tips on healing your ulcer

• Don't smoke.
• Avoid anti-inflammatory drugs such as aspirin and ibuprofen.
• Avoid caffeine and alcohol (or have them only in small amounts and on a full stomach).
• Avoid spicy foods if they cause heartburn.

Does what I eat affect my ulcer?

It may. But this isn't true for everyone. Certain foods and drinks may be more likely to make your pain worse. These include both regular and decaffeinated coffee, tea, chocolate, meat extracts, alcohol, black pepper, chili powder, mustard seed and nutmeg. You may want to avoid these things if they bother you. But keep your diet balanced. Try eating small, frequent meals when you're having pain.

Are ulcers serious?

Most people with ulcers just have stomach pain. Some people don’t have any symptoms at all. But ulcers may cause other health problems. Sometimes they bleed. If the ulcers become too deep, they can break through the stomach. This is called perforation. Ulcers can block food from going through the stomach (called obstruction). This causes nausea, vomiting and weight loss. Get help right away if you have any of the warning signs in the box below.

Warning signs that your ulcer is getting worse

• You vomit blood.
• You vomit food eaten hours or days before.
• You feel cold or clammy.
• You feel unusually weak or dizzy.
• You have blood in your stools (blood may make your stools look black or like tar).
• You have ongoing nausea or repeated vomiting.
• You have sudden, severe pain.
• You keep losing weight.
• Your pain doesn't go away when you take your medicine.
• Your pain reaches to your back.