Doctors’ Notes
Real stories by real family physicians
Don’t assume you’re fine if something doesn’t seem quite right. The earlier your family doctor can address health problems, the better the outcomes usually are!
As a family doctor, I have the benefit of getting to know my patients well over time. I make sure they understand how important it is for them to pay attention to “red flags.” They know that I will take their concerns seriously when they come in for an office visit. This is especially true when I see someone like my patient Leslie (not her real name). Except for her annual well-woman visit, she rarely schedules an appointment. When she comes in, I know something must be really bothering her.
Leslie has had gastroesophageal reflux disease (GERD) for most of her adult life. GERD is sometimes called acid reflux. Reflux occurs when the acid from the food and liquid in your stomach backs up into your throat (esophagus). This can cause symptoms such as an acid taste in your mouth or a burning feeling in the back of the throat, in the middle of the chest, or behind the breastbone. (Learn more about symptoms of reflux.)
Over the years, I have recommended lifestyle changes to reduce Leslie’s reflux. We have also talked about the pros and cons of different medicines and treatments for GERD. For the past several years, she has been taking a combination of over-the-counter (OTC) and prescribed medicines to manage her condition.
Leslie came in to see me because she felt like her GERD symptoms were getting worse in spite of her usual treatment. She told me her medicines just didn’t seem to be working as well anymore. She was having heartburn pretty regularly after meals and in the middle of the night. That seemed like a “red flag” to her. Leslie asked if I thought her medicines needed to be adjusted. Also, she admitted that she was worried something more serious might be going on.
After listening carefully to Leslie’s concerns, I asked about any changes in her daily routine or activities that might have affected her reflux. She told me her diet hadn’t changed. She wasn’t consuming more alcohol or taking any OTC supplements that could cause reflux. Fortunately, she hadn’t experienced any unexplained weight gain or loss. Leslie said that she had some nausea from time to time when her heartburn was bad. But she had no vomiting, no chest pain, and no change in her bowel habits. These were all reassuring signs.
I decided to increase the dosage of Leslie’s prescription medicines to get her GERD symptoms under control quickly. But we also need to find out what is making her reflux worse. I arranged for Leslie to see one of our specialists to have an EGD (esophagogastroduodenoscopy). This procedure examines the lining of the esophagus, stomach, and upper small intestine. It will help us see if anything else might be going on or if her worsening reflux is causing any complications. She is scheduled to have the EGD in a few weeks. In the meantime, her adjusted medicine dosages seem to be working well and her condition has improved.
Leslie could have continued to suffer with worsening reflux symptoms. She could have assumed that there weren’t any other options to evaluate or treat her GERD. But she trusted me—her family doctor— to take her concerns seriously and help her feel better.
Quick Tip
It’s normal to have some reflux occasionally. For example, having greasy or spicy foods, drinking alcohol, or eating a large meal can trigger heartburn. In most cases, reflux symptoms go away pretty quickly on their own or after you take an OTC antacid or acid reducer. But if you have symptoms more than twice a week, it’s time to talk to your family doctor about evaluation and treatment.
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This article was contributed by familydoctor.org editorial staff.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
