If you are like most people you occasionally have heartburn, indigestion or some other pain in your gut. In response, you reach for an over the counter antacid. That/s o.k. if the pain is intermittent, but if it happens more than twice a week or is severe enough to make you comfortable only when your upright you may have acid reflux disease. This medical malady (mal, as in bad) is caused when acid that's supposed to stay in your stomach acid makes its way back up into the lower part of your esophagus. It's usually prevented because there is sphincter muscle between your esophagus and your stomach that is supposed to open to let food pass from the esophagus to the stomach then immediately close to prevent anything from coming back up. However, for a number of reasons, the muscle, like elastic, can get loose over time and cause heartburn. Since heartburn is so common, most people don't think it's serious and self-treat or mistreat this symptom of GERD or gastro-esophageal reflux disease, the official name for this chronic disease.

So what is the big deal? It's about the more than sixty million Americans who suffer at least once a month. Many of these take antacids two or more times a week. And some have such regular problems with severe heartburn that it has an impact on more than their physical health. It affects their social health when they can't enjoy meals, their mental health when they don't feel well and can't concentrate, and their emotional health when they get into a cycle where heartburn causes stress which in turn causes heartburn.

Most people aren't aware of this last phenomenon. They aren't aware that there are more neurochemical transmitters in our thirty feet of gut than there are in our brain. It gives new meaning to the words, "trusting your gut" when we don't and later say to ourselves, "I knew that," or "If I'd only..."

If you've progressed from antacids to one of the "H2 blockers" such as Pepcid, Tagamet or Zantec and you still don't have relief you may be a candidate for the newest class of drugs, the proton pump inhibitors. Antacids and acid blockers decrease the action of acid but the proton pump inhibitors prevent the activity of acid producers. Regardless, if you have heartburn on a regular basis you MUST talk to your doctor about this sooner rather than later. Over time, gastric reflux can cause serious damage to the lining of the esophagus and predispose you to cancer. If you've suffered for a long time, your doctor may suggest an endoscope exam so doctors can directly look at or take a clipping of the tender tissue in that area.

Meantime there are a couple of other things you can do including reversing habits that can cause this problem in the first place. This includes eating big meals, having too much of the foods that aggravate GERD (coffee, citrus, tomato, onions, peppermint and, sadly, chocolate), wearing tight clothes (including control top pantyhose), smoking or using potent drugs, including the bisphosphonates, (Fosamax and Actonel) that treat osteoporosis. If heartburn affects you at night you can get some relief by sleeping with your head and upper body slightly elevated. This can prevent the regurgitation.

Regardless, don't ignore this and any other symptom that recurs often. Living long may not be all it's cracked up to be if you aren't living well.