When heartburn needs help

For many people suffering from heartburn, watching what they eat, over-the-counter medications, and stress reduction can bring relief. But when symptoms don't improve and start to interfere with sleep or daily life, it is time to get your doctor's help.

Your doctor will ask detailed questions about the nature and pattern of your pain. Is it worse after you eat a heavy meal or eat certain food, such as high-fat foods or dairy products? Does bending over to tie your shoelaces or lying down aggravate the symptoms? Does the pain seem linked to anxiety or stress?

If your symptoms are typical for gastroesophageal reflux (GERD, or simply, reflux), the first step is usually to try a medication such as omeprazole (Prilosec) or lansoprazole (Prevacid). If symptoms improve, you can switch to a less powerful medication. That might be an H2-receptor antagonist (H2 blocker) such as cimetidine (Tagamet), ranitidine (Zantac), or famotidine (Pepcid), or an antacid like Tums.

If, however, medication doesn't seem to help, your doctor might suggest some tests to confirm reflux or rule out other possible causes for your symptoms.

Be aware that reflux symptoms can be similar to heart attack symptoms. If what you feel is more like a constriction or pressure rather than burning, call your doctor. Even if you know you have reflux, always seek medical attention if you experience chest discomfort brought on by exercise. Pay attention to the severity and length of your chest pain. Severe, pressing, or squeezing discomfort, especially if it lasts a while, also warrants a call to your doctor.

For more on diagnosing and treating a sensitive gut, buy The Sensitive Gut, a Special Health Report from Harvard Medical School.