Understanding Heartburn: Stages, Diagnosis, and Prevention Strategies

Heartburn, commonly associated with acid reflux, is a symptom that many experience periodically. When it occurs more than twice weekly, it is classified as gastroesophageal reflux disease (GERD). According to the National Institute of Diabetes and Digestive and Kidney Diseases, GERD affects up to 20% of the population.

Progression of GERD

GERD is a progressive disorder, with treatment depending on its stage. The severity of reflux into the esophagus determines the stage progression.

The stages are as follows:

Stage I

At this initial stage, symptoms are mild and occur once or twice a month. Management primarily involves lifestyle adjustments and OTC medications.

Stage II

Symptoms become more frequent; patients may need acid-suppressing drugs. Without medication, symptoms can worsen, affecting daily life and possibly causing esophageal inflammation.

Stage III

At this advanced stage, symptoms are unresponsive to standard prescriptions, significantly impacting daily routines. Esophageal inflammation is common, and specialist intervention, such as anti-reflux surgery, may be necessary to improve quality of life.

Stage IV

If GERD remains untreated for years, it can lead to esophageal cancer. About 10% of long-term GERD patients progress to this stage, often developing Barrett’s esophagus—a pre-cancerous condition. Without treatment, the risk of cancer increases.

Diagnosis

To identify GERD, healthcare providers review symptoms and conduct physical exams. Additional tests may include:

Upper endoscopy

Ambulatory acid monitoring

Esophageal motility test

Upper GI X-ray

Prevention Tips

Preventative measures involve lifestyle modifications:

Maintain a healthy weight
Obesity increases pressure on the stomach, pushing gastric juices into the esophagus. Losing weight can reduce GERD symptoms.

Avoid trigger foods

Limit intake of foods and drinks such as:

Spicy dishes

Acidic foods like tomatoes

Mint products

Coffee

Onions

Chocolate