GERD Watch

Tips for Taking AntacidsWhereas an OTC antacid can help relieve mild cases of heartburn and acid reflux, the American Academy of Family Physicians recommends that individuals understand what they are taking and offers the following tips:

• Talk with your clinician before taking an antacid because many types of antacids work in different ways.
• If more calcium is needed to strengthen bones, consider an antacid with calcium carbonate.
• Antacids may have minor side effects such as nausea, headache, diarrhea, or constipation.
• Read the label carefully to make sure you are not allergic to any of the ingredients.
• Individuals with kidney disease may not be able to take all types of antacids. Consult with your physician or pharmacist about what may be safe for your condition.
• Antacids may interact with other medications. Talk with your physician or pharmacist about all the medications you take to avoid any potential drug interactions with an antacid.

Is It Heartburn or a Heart Attack?Individuals who experience a sharp, burning sensation in the chest, near the breastbone or ribs, may attribute the pain to heartburn. It is not always the case, however. Cardiologist Ravi Dave, MD, said that it also may be a heart attack and it is often hard for individuals to tell the difference.

Clinicians advise that even individuals without a diagnosis of heart disease who experience heartburn should not always take an OTC antacid. Health care experts recommend that patients:

• Pay attention to the pattern of heartburn. If patients experience heartburn on a regular basis after eating certain foods, often the food is the cause, according to Dr. Dave.
• Pay attention to when heartburn occurs. Patients usually experience heartburn 30 to 45 minutes after a meal, said gastroenterologist Ronnie Fass, MD. "If [patients] have heartburn, and it is associated with symptoms such as pain during swallowing, difficulty swallowing, loss of appetite, or throwing up blood, then they have to see a doctor right away, within the next 24 to 48 hours," he said.
• See a physician if heartburn is severe and begins to affect quality of life.

Acid Reflux Linked withDental Health ProblemsThe first study to assess the relationship between acid reflux and dental health in pediatric patients found that children who have symptoms of chronic acid reflux are considerably more likely to have dental erosions.

The study included 60 patients with symptoms of gastroesophageal reflux disease (GERD) and 20 healthy participants who had no GERD symptoms. All of the participants were evaluated for GERD and had a comprehensive dental examination. The researchers found that the children with GERD were nearly 6 times more likely to have substantially eroded teeth, compared with the healthy group.

"Having shown that there is a positive correlation between GERD and dental erosions, we must now try to determine exactly what causes children with reflux to develop these erosions," said study coauthor Ann Clark, BS, who presented the findings May 4, 2009, at the Pediatric Academic Societies annual meeting.

Consider EE As an Alternative Diagnosis to GERDEosinophilic esophagitis (EE) is a diagnosis that should be factored in for patients experiencing gastroesophageal reflux disease (GERD) who do not respond to proton pump inhibitors or other medications. EE is becoming more frequently recognized as the source of symptoms such as regurgitation, chest pain, vomiting, heartburn, and dysphagia.

Health care experts attribute the condition to an allergic reaction to food, while pollen is another possibility. The allergens prompt inflammation in the wall of the esophagus causing difficulty swallowing. The prominent marker of the disease is the presence of large numbers of eosinophils in the esophagus.

Chris A. Liacouras, MD, professor of pediatrics at the University of Pennsylvania School of Medicine and the Children's Hospital of Philadelphia, said that clinicians need to think of EE as a possible diagnosis if patients have difficulty swallowing, have had food caught in their esophagus, or are experiencing little, if any, relief from heartburn treatments. He said that milk, eggs, soy, wheat, nuts, and fish are the foods most likely to pose problems.

FAST FACT: Children and teens with asthma are more likely to have GERD.