Skip to main content
ASK AN EXPERT
Got a question about a health story in the news or a health topic? Here's your chance to get an answer. Send us your questions about general health topics, diet and fitness and mental health. If your question is chosen, it could be featured on CNN.com's health page with an answer from one of our health experts, or by a participant in the CNNhealth community.




* CNN encourages you to contribute a question. By submitting a question, you agree to the following terms found below.
You may not post any unlawful, threatening, libelous, defamatory, obscene, pornographic or other material that would violate the law. By submitting your question, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your questions(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. CNN Privacy Statment.
Thank you for your question!

It will be reviewed and considered for posting on CNNHealth.com. Questions and comments are moderated by CNN and will not appear until after they have been reviewed and approved. Unfortunately, because of the voume of questions we receive, not all can be posted.

Submit another question or Go back to CNNHealth.com

Read answers from our experts: Living Well | Diet & Fitness | Mental Health | Conditions

Expert Q&A

What can I do about my heartburn?

Asked by Loretta Torti, Encinitas, California

Open quote
Close quote

I keep having this terrible heartburn. It hurts to elevate my legs. Food feels like it's coming back up, and it burns very badly. Sometimes it makes me cough. What should I do?

Expert Bio Picture

Conditions Expert Dr. Otis Brawley Chief Medical Officer,
American Cancer Society

Expert answer

Acid reflux is when the acidic liquid in the stomach rises up into the esophagus or higher into the throat, nose or mouth. This fluid can burn the esophagus, causing chest pain, which is often referred to as heartburn. Acid reflux occurs in virtually everyone occasionally. People who have it more frequently have what is referred to as gastroesophageal reflux disease, known by the acronym GERD.

When it occurs frequently, acid reflux can actually damage the throat, causing trouble swallowing, change in or loss of voice, as well as the feeling of a lump in the throat. Aspiration or breathing in of the stomach contents can lead to cough and in more serious cases, a burning of the lungs and "aspiration pneumonia." Long-term burning of the esophagus can lead to a condition known as Barrett's esophagus, which can progress on to esophageal cancer.

It is estimated that 10 to 20 percent of adults in the Western world have GERD. It is believed about 5 percent of people in Asia have it. This disease is more common among people who are overweight and sedentary. It can be worsened by certain foods such as chocolate, fatty foods, spicy foods, citrus juices and alcohol. Smoking also worsens reflux. Pregnant women often have it as well.

The initial approach is use of an over-the-counter oral antacid medication such as calcium carbonate or aluminum hydroxide to try to overcome the burning pain. Patients who need further therapy are often given acid-reducing H2 blocker medications such as cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) or ranitidine (Zantac). If symptoms do not improve, patients are given proton pump inhibitors such as omeprazole (Prilosec), lansoprazole (Prevacid), and esomeprazole (Nexium). Some of these drugs are available without prescription. Lifestyle changes such as avoidance of foods that cause symptoms, exercise and weight loss often help. Some people find taking a walk for 20 minutes every day helps.

Many people have worse symptoms when lying down. Raising the head of the bed 6 to 8 inches with blocks can be helpful. Extra pillows to raise the head do not help -- bending in the middle of the torso increases pressure on the stomach and forces stomach fluid up the esophagus, worsening symptoms.

In the past we frequently used drugs to stimulate gastric emptying, such as bethanechol or metoclopramide, but realization that these drugs often cause serious side effects has caused them to be used to treat only extremely severe GERD. Surgery is a treatment of last resort. This procedure, called the Nissen fundoplication, can be done through a scope placed in the chest. The esophageal-gastric junction is modified or reshaped to decrease the tendency of fluid to reflux up into the esophagus.

I should note that a hiatal hernia, which is the top of the stomach being in the chest, above the diaphragm, increases risk of GERD, but occurs more often without GERD than with.

An internist or family physician can treat most patients with reflux, but patients with symptoms that don't respond to treatment should be seen by a gastrointestinal specialist, who may do additional testing such as an upper GI endoscopy. Diseases that occasionally mimic GERD include esophagitis, which can even be caused by pills for other illnesses; peptic ulcer disease; inflammatory diseases; and the Zollinger-Ellison syndrome, which is a rare disease in which gastric acidity is increased because of an endocrine disorder.

More Q&A

  • CNN's Medical UnitCNN's medical unit brings you the best experts available to answer your questions about current events and health issues that matter most to you.
Is secondhand smoke really that risky?asked by: Asked by David; Tampa, Florida
Can a nerve stimulator stop my back pain?asked by: Asked by Larry; New York
Is the inability of cancer patients to eat a concern?asked by: Steve Snodgrass; Bowling Green, Kentucky

CNN Comment Policy: CNN encourages you to add a comment to this discussion. You may not post any unlawful, threatening, defamatory, obscene, pornographic or other material that would violate the law. All comments should be relevant to the topic and remain respectful of other authors and commenters. You are solely responsible for your own comments, the consequences of posting those comments, and the consequences of any reliance by you on the comments of others. By submitting your comment, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your comment(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. CNN Privacy Statement.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.