Poor dietary and lifestyle habits are the main reasons why most people get heartburn. Making changes in diet and lifestyle are the first steps to reducing the frequency and severity of heartburn. These steps include:

• Controlling or losing weight (if necessary).
• Eating small, well-balanced meals on a regular schedule, and taking time to relax and enjoy them.
• Avoiding snacking and certain foods (including chocolate, fried or fatty foods, mint, alcoholic beverages and drinks containing caffeine). Also avoid citrus juices and other acidic foods, as well as excessive amounts of milk.
• Adopting a regular program of mild to moderate exercise.
• Stopping smoking.
• Avoiding constrictive clothing (especially around the waistline) and reclining for at least two hours after eating.
• Practicing good posture.
• Developing effective ways to deal with stress.

A variety of tests may be carried out to determine if you have heartburn. Which tests are ordered depends on a number of factors, including your age, medical history and any medications you may be taking. Tests used to diagnose the presence of GERD (Gastroesophageal Reflux Disease) are:

Upper GI (Gastrointestinal) Series, or Barium-Swallow Radiograph: This test involves taking an x-ray of the esophagus, stomach and duodenum. Prior to the test, patients need to drink a substance called barium, which enables the x-ray to show an ulcer. (Click here to learn more.)

Endoscopy : More accurate than the barium x-ray, endoscopy can be performed in the hospital or doctor's office. The patient is given a local anesthetic and sometimes an intravenous sedative; the doctor then gently inserts an endoscope (a small, flexible device with a camera on the end) through the mouth, down the esophagus into the stomach and duodenum. The patient may experience slight discomfort during the procedure. Performing an endoscopy enables the doctor to diagnose problems, take photographs and retrieve tissue samples (or biopsy) for further analysis. (Click here to learn more.)

pH Testing : If diagnosis is uncertain, doctors may use this test to measure and monitor the level of acid in the esophagus during meals, rest and periods of activity. A tubular probe is inserted through the nose into the esophagus, where it remains for 24 hours while the patient engages in regular day-to-day activities. This procedure measures the amount of acid backing up in the esophagus.

Manometry: A test that measures internal pressure exerted by the lower esophagus sphincter muscles, manometry can help determine whether patients require surgery to correct this disorder. The purpose of this test is to assess whether or not the relaxed muscle needs to be corrected.

Bernstein Test: This test involves dripping mild hydrochloric acid and a neutral solution separately into the esophagus, but is rarely used as a method of diagnosing GERD.


GERD is effectively treated using a variety of medications:

Proton pump inhibitors (PPIs) 
The most potent and effective acid-suppressing drugs.  PPIs work by blocking the acid pump in the stomach, which shuts down acid production. These include medications such as pantoprazole, omeprazole, lansoprazole, esameprazole and raberprazole.

H2-Blockers
These drugs inhibit histamine (a substance released by the stomach lining) induced acid production in cells. H2 blockers include medications such as ranitidine, cimetidine, famotidine and nizatidine.

Antacids
The active ingredients in antacids are able to bind excess stomach acid, alleviating symptoms of heartburn temporarily by acting as a neutralizer. Long-term use of these products, however, may increase magnesium levels in the body (leading to serious consequences for those with kidney disease), alter calcium synthesis or cause diarrhea.

Anticholinergics
Substances that suppress the effects of acetylcholine, which stimulates acid production in the stomach, anticholinergics cause side effects such as dry mouth and visual disturbances.

Sucralfate
Sucralfate binds to proteins on the surface of ulcers, forming a protective layer and neutralizing the harmful acids that aggravate ulcers and heartburn.

Bismuth
Similar in action to antacids, bismuth was often used as a medication for stomach disorders in the past and is effective against Helicobacter pylori, (H.pylori) if used in combination with specific antibiotics.

Antibiotics
Used to eliminate the H. pylori bacteria, antibiotics are most effective when used with acid-reducing medications (such as proton pump inhibitors).

Cytoprotectives
Cytoprotectives are anti-ulcer drugs that increase production of protective mucus and bicarbonate in the stomach. Side effects such as diarrhea, cramping in the gastrointestinal tract, nausea, headache and drowsiness may occur in patients taking this medication.

Certain medications, including anti-inflammatory drugs used to treat arthritis and related conditions, antidepressants and hormone replacement therapy can aggravate heartburn. If you are taking any prescription medication and experience symptoms of heartburn, talk to your doctor. Check the patient information on any over-the-counter (OTC) medication you may be taking, or speak with your pharmacist.