When is it Time to Take that Trip to the Doc?
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Todays newsletter is an email consultation from Hank of Michigan. Hank has had what appears to be chronic heartburn for the last 3 years. He's not too sure if this his case is serious enough to seek medical advice, or if this is just an annoyance that he has to put up with.
Thank you for your letter. I think you're taking a positive step by paying attention to your heartburn.
Even though I take your reference to a heart attack as figurative, let me preface my response by saying that a heart attack is sometimes confused with an acute case of heartburn, because both involve severe pain in the chest. There are some ways to differentiate between the two; for instance, heartburn pain is usually more localized than heart attack pain, and can often be located with single fingers.
In any case, if you do have severe chest pain and you are not sure what the source is, then, by all means Hank, get to the doctor. The worst thing that can happen is mild case of embarrassment.
Heartburn is what can be called a "subjective symptom," which means that there is no real way to test for it. Doctors must rely on the personal reports of patients to diagnose the problem. For this reason, it is really helpful to establish a self monitoring routine. This is a way for you to "log" the condition and determine whether to make a doctor's appointment. You should record:
There are some guidelines to determine more serious heartburn conditions, such as those associated with GERD. Ask yourself:
Do you experience heartburn symptoms two or more times a week?
Do you find that you take antacid medication more than twice a week?
Do you have any trouble swallowing or a frequently sore or raspy throat, especially in the morning?
Do you regularly cough or wheeze without other symptoms?
Are your symptoms worse after eating?
If you answer yes to any of these questions, you should consider making an appointment. Your regular physician will then decide whether to refer you to a gastroenterologist, who will make a comprehensive diagnosis and rule out more serious problems.
All the best,
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