A Ball of Fire: Heartburn

Shirley Schultz, Roving Reporter

Softball season has us thinking about balls. What may feel like a ball of fire in the chest and throat is actually heartburn or gastroesophageal reflux disease (GERD). It has nothing to do with balls and nothing to do with the heart. It is caused by stomach acid refluxing or flowing back into the esophagus, the tube connecting the mouth to the stomach. A protective mucous barrier protects the stomach lining from the acid, but the esophagus does not have that protection. Chronic heartburn can lead to more serious problems, including esophageal ulcers and an increased risk of esophageal cancer.

Estimates are about 25 to 35 percent of people in the U.S. suffer from GERD, the most common of all gastrointestinal disorders. This means at least 83 million are likely taking over-the-counter and prescription drugs to treat their symptoms. First-line drugs are antacids that neutralize the acid, such as Tums, Rolaids, Maalox, and Gaviscon. Antacids are shortacting and can have side effects if overused. Stomach acid has been described by gastroenterologist Brijen Shah, MD, as “only slightly less powerful than battery acid.” Those with severe and frequent heartburn are likely to be taking a drug to inhibit stomach acid production. One such class of drugs is called histamine H2-receptor antagonists or H2-blockers, and its names include, Famotidine (Pepcid), Cimetidine (Tagamet), and Ranitidine (Zantac). Another class of drugs that inhibit stomach acid production is called proton-pump inhibitors (PPIs), such as Omeprazole (Prilosec), Esomeprazole (Nexium), Lansoprazole (Prevacid), and Pantoprazole (Protonix). Many H2blockers and PPIs are available over the counter and in stronger doses by prescription.

Recent research has raised concerns about the possible association between long-term use of GERD drugs and dementia and other health problems such as increased risk of fractures, kidney failure, and stroke. Those taking these drugs need to work closely with their doctors to determine how long to take them and to weigh the benefit versus risks.

Healthy Years from UCLA Health for April 2024 suggests some natural ways to ease heartburn.

• Take slow, deep breaths to move the diaphragm.

• Avoid large meals.

• Avoid trigger foods, which may include spicy foods, tomatoes, citrus fruits, onions, garlic, chocolate, caffeine, alcohol, and fatty foods.

• Avoid lying down for two to three hours after eating.

Go out and enjoy the softball season without any fireballs.