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Heartburn — that burning sensation in your chest that sometimes follows meals — happens when stomach acid escapes the stomach and rises into the esophagus, where it becomes an irritant. While many people experience infrequent bouts of heartburn, extreme heartburn occurs several times a week, if not daily. Extreme heartburn is often accompanied by other problems, including bad breath, trouble swallowing, gas, upset stomach, hoarseness and coughing. Some people may feel as if they are choking, or they may have chest pain that makes them think they're having a heart attack. Having extreme heartburn can affect a person’s entire life, especially sleep and eating habits.
Extreme heartburn, like occasional heartburn, has several potential causes, including a weakening of the stomach valve intended to keep stomach acid from escaping into the esophagus, eating large meals and eating right before bedtime. Peptic ulcers, hiatal hernias, gastroparesis and gastritis also may be to blame. Some foods have been shown to trigger discomfort, and a change in diet may be needed to ease persistent problems. Eliminating greasy and spicy foods can help, as can drinking milk when the symptoms start.
People who experience only occasional heartburn are likely to find it's easily controlled with over-the-counter medications. These come in tablet form that may be swallowed whole, in chewable tablet form, in liquid form, or in a powder that can be mixed into a glass of water. Many people with severe heartburn choose to use liquid heartburn medication because it is easier on a person’s raw throat. Liquid forms also may work more quickly to relieve the symptoms of heartburn, but they may not relieve the heartburn symptoms for as long as some other medications.
While antacids and other over-the-counter medications are short-term solutions for heartburn, extreme heartburn often requires stronger medication that will work for longer periods of time. A visit to a doctor can help identify the problem, its likely causes, and possible treatments, including prescription medications. A doctor can also tell a patient when his symptoms aren't actually heartburn at all; some symptoms, such as weight loss, difficulty swallowing, and the inability to swallow, can be signs of cancer.
A doctor also can tell a patient when his extreme heartburn is an indication of gastroesophageal reflux disease (GERD). Lifestyle changes such as quitting smoking, avoiding trigger foods, wearing loose-fitting clothing, and elevating one's head while sleeping can help, as can a range of prescription medications designed to provide longer-term relief than antacids. Cases of GERD that don't sufficiently respond to such treatments may require surgery. Effective treatment for GERD is important, because long-term, persistent damage to the esophagus can lead to other medical problems.