Heartburn: What's Going On Do... Video Transcript

Participants

James W. Freston MD, PhD, David R. Marks MD, M. Michael Wolfe MD, Stephen Ritz DO

Summary

Most of us know what heartburn is like -- in fact, 60 million Americans feel that sharp, burning sensation in their chest at least once a month. But fewer people know what causes heartburn, or that it can be a symptom of a much more serious condition. Tune in to find out what everyone should know about heartburn.

Webcast Transcript

DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks.

Now, most of us know what heartburn is like. In fact, 60 million Americans feel that sharp, burning sensation in their chest at least once a month. But fewer people know what causes heartburn or that it can be a symptom of a much more serious condition.

Joining me today to discuss what you should know about heartburn is Dr. Jim Freston from the University of Connecticut, welcome. And next to him is Dr. Michael Wolfe, he's here from Boston University School of Medicine. Welcome.

We use this term "heartburn" all the time, but what exactly is it?

JAMES FRESTON, MD, PhD: Heartburn is a sensation of burning, typically behind the breastbone. It migrates up toward the throat. Classically.

What it is is a manifestation of acid coming up from the stomach into the esophagus, where it doesn't belong. And actually causing irritation there. It's one end of the spectrum of a whole bunch of conditions that we call GERD, for gastroesophageal reflux disease. Ranging from simple heartburn clear to cancer of the esophagus.

DAVID R. MARKS, MD: What exactly is it? How does it differ from just regular old heartburn?

MICHAEL WOLFE, MD: Okay, heartburn is a symptom. That is, the burning sensation Jim described behind the breastbone that goes up into the throat. But GERD is actually what's happening. GER, actually. Gastroesophageal reflux. Meaning, you're getting flow of acid from the stomach into the esophagus. So the process is reflux. The end result, most commonly, is heartburn.

DAVID R. MARKS, MD: Can a person's lifestyle affect heartburn?

JAMES FRESTON, MD, PhD: Absolutely. People who overeat. People who are overweight. People who eat large meals before going to bed, leaving no gap between the meal and bedtime or very little. They're all predisposed to getting heartburn.

DAVID R. MARKS, MD: Any other factors?

MICHAEL WOLFE, MD: Well, certain foods are notorious for causing heartburn. But -- then again, causing reflux, I should say. But there are -- we should really recognize that everybody has their own individual trigger. Certain foods relax that valve -- that so-called "sphincter" between the esophagus and stomach, allowing acid to flow backwards, or reflux. Such as coffee of any type, fatty foods, chocolate, peppermint, alcohol. Those are the notorious foods that cause the problems of reflux.

JAMES FRESTON, MD, PhD: We should mention, and a host of medications.

DAVID R. MARKS, MD: What about stress?

JAMES FRESTON, MD, PhD: I think stress is overrated as a cause of heartburn. It can contribute indirectly. For example, uptight people who are rushing through meals and overeating they're so anxious, which is common. Drinking ten cups of coffee, that can contribute. But stress itself, I doubt is directly a cause.

MICHAEL WOLFE, MD: I agree. If you look at just stress by itself, it's very difficult. It's what people do in response to their stress.

DAVID R. MARKS, MD: A lot of people also have heartburn specifically at night. Why is that? What are they doing wrong?

MICHAEL WOLFE, MD: Well, they get heartburn at night because sometimes they're going to bed too soon after eating a meal. Not having given the food a chance to empty the stomach. But additionally, we no longer have gravity on our side. We're lying flat. We don't have the gravity of allowing food to empty the stomach.

Additionally, we're not swallowing as much. Saliva has a natural antiacid bicarbonate within it. So the defense mechanisms just aren't there to help us from getting the reflux, or getting the heartburn to occur.

DAVID R.