And three, it's a huge market for a cascade of drugs that work remarkably well and are a big source of drug company profits. Most heartburn can be treated without drugs, if you're willing to rein in your appetite for foods that touch off the pain and take some other precautions. First, understand that GERD is basically a plumbing problem. When you eat and swallow, food entering the stomach is prevented from washing back into the lower esophagus by a muscular valve, or sphincter. When the sphincter isn't tight enough, stomach acids and even bits of food can squirt back into the esophagus and irritate its nerve-filled lining, giving rise to all the discomfort and that bitter taste.
Many factors can cause the sphincter to be too relaxed.
One cause is hiatal hernia - a common congenital abnormality in which the top of the stomach protrudes through an opening where the esophagus passes through the diaphragm. Smoking, obesity, and pregnancy may also be to blame. Doctors recommend trying some lifestyle changes to prevent the condition in the first place. Losing excess weight can also help. Wolfe and other experts say it's fine to take the nonprescription drugs for occasional heartburn symptoms.