Heartburn That Keeps Coming Back: When an Upper Endoscopy Can Help
Almost everyone has felt heartburn at some point, especially after a large holiday meal. That burning feeling in the middle of the chest usually passes on its own. But when heartburn becomes a regular part of your week, or over-the-counter remedies no longer seem to help, it may be time to find out what is really going on.
At Bedford Ambulatory Surgical Center (BASC) in Bedford, NH, our gastroenterology team performs upper endoscopies, also called EGDs, in a comfortable outpatient setting. Here is what to know about reflux, the symptoms worth a call to your doctor, and what to expect if an EGD is recommended.
Heartburn, Reflux, and GERD: What Is the Difference?
Gastroesophageal reflux happens when stomach contents back up into the esophagus, the tube that carries food from your mouth to your stomach. A ring of muscle at the bottom of the esophagus normally keeps that from happening. Many people have reflux once in a while, and it is usually nothing to worry about.
Gastroesophageal reflux disease, or GERD, is a longer-lasting form of reflux. It can develop when that muscle becomes weak or relaxes when it should not. Common symptoms include:
- Heartburn, a burning feeling in the middle of the chest that can rise toward the throat
- Regurgitation, or tasting food or acid in the back of the throat
- Nausea
- Trouble swallowing or pain when swallowing
- A chronic cough or hoarseness
Not everyone with GERD has classic heartburn, which is one reason it can be easy to overlook.
What Can Make Reflux Worse?
Several things are known to raise the risk of GERD or make symptoms worse, including:
- Carrying extra weight
- Pregnancy
- Smoking or being around secondhand smoke
- A hiatal hernia, where the upper part of the stomach moves up into the chest
- Certain medications, including some pain relievers known as NSAIDs
If you take medications regularly and have reflux, talk with your doctor before making any changes on your own.
When Should You See a Doctor About Heartburn?
Reach out to your primary care provider if you think you may have GERD, or if your symptoms do not improve with over-the-counter medicine or lifestyle changes. Some symptoms need prompt attention because they can point to a complication or another problem:
- Trouble swallowing or pain when swallowing
- Vomiting that does not stop
- Vomit that contains blood or looks like coffee grounds
- Stool that is black and tarry or contains blood
- Weight loss you cannot explain, or loss of appetite
- Chest pain
Chest pain can also be a sign of a heart problem. If you have chest pain along with shortness of breath, or pain that spreads to your arm, neck, or jaw, call 911.
What Is an Upper Endoscopy (EGD)?
An upper endoscopy, or esophagogastroduodenoscopy (EGD), lets a gastroenterologist look directly at the lining of your esophagus, stomach, and the first part of your small intestine. The doctor uses an endoscope, a thin, flexible tube with a camera, which is guided gently through the mouth.
An EGD can help your doctor find the cause of ongoing heartburn, pain, vomiting, or trouble swallowing. It can help identify conditions such as GERD, Barrett’s esophagus, ulcers, and celiac disease. If needed, the doctor can take a small tissue sample (biopsy) during the same procedure.
What to Expect on the Day of Your EGD
- Review your medications. Your doctor will go over the medicines and supplements you take, such as aspirin, NSAIDs, blood thinners, and iron, and let you know if any need to be adjusted beforehand.
- Follow fasting instructions. You will typically be asked not to eat or drink for several hours before the procedure. Follow the exact instructions your care team gives you.
- Arrange a ride. Because you will usually receive sedation, you will need a responsible adult to drive you home.
- The procedure. Most people receive a sedative through an IV and may also get a numbing spray for the throat. The endoscope does not interfere with breathing. The procedure itself typically takes 10 to 20 minutes.
- Recovery. You will rest while the sedation wears off. Some people have mild bloating, nausea, or a sore throat for a short time afterward. If a biopsy was taken, results can take several days.
Before your visit, you can find patient forms on our forms page.
Why Choose BASC for Your Upper Endoscopy?
BASC has provided outpatient surgical care in Bedford since 1993, with three designated GI endoscopy suites. Our gastroenterology physicians perform colonoscopy, EGD, and flexible sigmoidoscopy in a setting focused entirely on outpatient care. Patients choose BASC for:
- A calm, smaller setting designed for outpatient procedures
- Going home the same day to recover in your own space
- Accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC)
- An experienced team that has performed more than 155,000 procedures
Frequently Asked Questions
Is occasional heartburn a reason to get an endoscopy?
Usually not. Occasional heartburn is common. An EGD is typically recommended when symptoms are frequent, do not respond to treatment, or come with warning signs like trouble swallowing or bleeding. Your doctor will help you decide.
Will I be awake during an upper endoscopy?
Most patients receive sedation through an IV, and many fall asleep during the procedure. Your care team will explain the type of sedation planned for you.
How long does an EGD take?
The procedure itself typically takes 10 to 20 minutes. Plan for extra time on the day of your visit for check-in and recovery.
Do I need a referral?
Talk with your primary care provider about your symptoms first. They can refer you to a gastroenterologist, who will decide whether an EGD is the right next step.
Can I drive myself home?
No. Because of the sedation, you will need a responsible adult to drive you home.
Have more questions? Visit our FAQ page.
Take Heartburn Seriously
Heartburn that keeps coming back is more than an inconvenience, and you do not have to keep guessing about the cause. If reflux has become part of your routine, ask your doctor whether a referral to a gastroenterologist is right for you. To learn more about GI care at BASC in Bedford, NH, contact us or call (603) 622-3670.