HEARTBURN (Esophageal Reflux) |
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HEARTBURN (Esophageal Reflux)
DESCRIPTION
Heartburn is discomfort in the upper digestive tract. Heartburn is a symptom--not a disease -- and has nothing to do with the heart. The stomach and lower esophagus are involved. Heartburn is more common in adults, but it does occur in children and adolescents.
Appropriate health care includes:
Self-care.
Physician's monitoring of general condition and medications.
Hospitalization for special studies or surgery (rarely).
SIGNS & SYMPTOMS
The following signs are worse at night:
Belching or slight regurgitation of stomach contents into the mouth, producing an acid taste.
Heavy, uncomfortable sensation in the chest.
Swallowing difficulty.
Mild abdominal pain.
Vomiting (rarely).
RISK FACTORS
Stress.
Improper diet.
Obesity.
Smoking.
Excess alcohol consumption.
Use of drugs, such as aspirin, arthritis medicine, or cortisone.
PREVENTING COMPLICATIONS OR RECURRENCENo specific preventive measures. Consider lifestyle changes (see Appendices 19 and 48).
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies, such as blood studies, EKG (See Glossary) to exclude chance of heart disease, esophagoscopy (See Glossary), or gastroscopy (See Glossary).
X-rays of the upper digestive tract (sometimes).
POSSIBLE COMPLICATIONS
Misdiagnosis of a heart attack with symptoms similar to heartburn (rare).
If heartburn is caused by a large hiatal hernia, surgery may be necessary to repair the hernia (rare).
If heartburn is caused by ulcers in the esophagus, surgery may be necessary to remove scar tissue. Scar tissue forms with repeated ulceration and healing and may interfere with swallowing.
PROBABLE OUTCOME
Symptoms can be controlled with treatment, but recurrence is common.
TREATMENT
HOME CAREInstructions for your child:
Elevate the head of the bed 4 to 6 inches with blocks.
Don't smoke.
Lose weight if you are overweight.
Don't bend over, lie down, or exercise immediately after eating.
Don't wear tight pantyhose, girdles, belts, or pants.
MEDICATION
For minor discomfort, give the child non-prescription liquid antacids. These preparations coat the inside of the child's esophagus and neutralize stomach acid. Follow instructions on the bottle. The usual dose is 1 tablespoon taken 1 hour after meals and at bedtime.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Your child can resume normal activities as soon as symptoms subside.
DIET & FLUIDS
Your child should avoid foods and beverages that stimulate heavy stomach-acid secretion, such as spicy dishes, coffee, acid fruit juice, or alcohol. Urge the child to avoid chocolate and reduce consumption of fatty foods.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Swallowing becomes more difficult for your child.
Your child regurgitates blood with the heartburn.
The following symptoms accompany the child's heartburn:
-- Shortness of breath.
-- Sweating.
-- Pain in the jaw, neck, and arm.
-- Nausea.
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