Frequent heartburn, indigestion can signal serious problem

DEAR SAVVY SENIOR: Is regular heartburn or indigestion anything to worry about?

My 60-year-old husband eats a lot of Tums or Rolaids throughout the day to help him manage it, but it keeps him up at night, too.

What can you tell us?

— Inquiring Spouse

DEAR INQUIRING: Almost everyone experiences heartburn or acid indigestion from time to time, but frequent episodes can signal a much more serious problem.

Here’s what you should know, along with some tips and treatments to help relieve your husband’s symptoms.

It’s estimated that more than 60 million Americans experience heartburn at least once a month, with about 15 million people who suffer from it daily. If your husband is plagued by heartburn two or more times a week, and it’s not responding well to over-the-counter antacids, he needs to see a doctor. Frequent bouts could mean he has gastroesophageal reflux disease, which can severely irritate and damage the lining of his esophagus, putting him at risk of Barrett’s esophagus and esophageal cancer if it’s not treated.

LIFESTYLE ADJUSTMENTS

Depending on the frequency and severity of his heartburn, there are a number of lifestyle adjustments he can make that can help provide relief.

>> Avoid problem foods: Certain foods can trigger heartburn symptoms: citrus fruit, tomatoes, fatty food, chocolate, garlic, onions, spicy food, mints, alcohol, coffee and soda. Your husband should keep a food diary to track which foods cause him the most problems and avoid them.

>> Eat smaller, slower and earlier: Smaller portions at mealtime and eating slower can help reduce heartburn symptoms. He should also wait at least three hours after eating before lying down or going to bed.

>> Lose weight: Having excess weight around the midsection puts pressure on the abdomen, pushing up the stomach and causing acid to back up into the esophagus.

>> Quit smoking: Smoking can increase stomach acid and weaken the valve that prevents acid from entering the esophagus. If your husband smokes, the National Cancer Institute offers a number of smoking cessation resources at SmokeFree.gov, or call 800-QUIT-NOW.

>> Sleep elevated: To help keep the acid down while sleeping, get your husband a wedge-shaped pillow to prop him up a few inches. Sleeping on his left side might also help keep the acid down.

TREATMENT OPTIONS

If the lifestyle adjustments don’t solve the problem, or if antacids aren’t doing the trick, there are a variety of over-the-counter and prescription medications that can help, or there are surgical options.

>> H-2 blockers: Available as both over-the-counter and prescription strength, these drugs (Pepcid, Tagamet, Axid and Zantac) reduce how much acid your stomach makes but might not be strong enough for serious symptoms.

>> Proton-pump inhibitors (PPI): If you have frequent and severe heartburn symptoms, PPIs are long-acting prescription medications that block acid production and allow time for damaged esophageal tissue to heal. They include Nexium, Prevacid, Prilosec, Zegerid, Protonix, Aciphex and Dexilant. Prevacid 24 HR, Prilosec and Zegerid OTC are also available over the counter. Long-term use of PPIs can increase your risk for osteoporosis and chronic kidney disease.

>> Surgery: If the medications don’t do the trick, there are also surgical procedures that can tighten or strengthen the lower esophageal sphincter so gastric fluids can’t wash back up into the esophagus.

Jim Miller is a contributor to NBC-TV’s “Today” program and author of “The Savvy Senior.” Send your questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070; or visit savvysenior.org.