Heartburn and acid reflux (GERD): what helps, and when it may not be heartburn

• Heartburn: a burning feeling in the chest, often after eating or when lying down
• A sour or bitter taste, or food or liquid coming back up into the mouth

Chest pain or pressure can be a heart attack. Never assume it is heartburn. Call 911 for chest pain or pressure, most of all if it comes with activity, spreads to the arm, neck or jaw, or comes with sweating or shortness of breath.

• Avoid foods and drinks that set off your symptoms, as well as alcohol and tobacco.
• Lose weight if you are overweight.
• Eat dinner 2 to 3 hours before bed, and do not eat after dinner.
• Raise the head of your bed if your symptoms are worse at night.
• For pain, acetaminophen is a better choice than ibuprofen, naproxen or aspirin you buy yourself. But never stop a medicine a doctor prescribed, like a daily aspirin, without talking to your doctor first.

Medicines can help too. Antacids work fast, but the relief may not last long. Acid reducers, like famotidine, and proton pump inhibitors (PPIs), like omeprazole or pantoprazole, work more slowly but last longer.

Get emergency care for throwing up blood or something that looks like coffee grounds, or for black, tarry stool. These can be signs of bleeding.

See a doctor in person for:

• Trouble swallowing, pain when you swallow, or food that feels stuck
• Weight loss you cannot explain
• Throwing up that does not stop
• Low iron (iron-deficiency anemia)
• Heartburn that starts for the first time at age 60 or older
• A family history of cancer of the esophagus or stomach
• Symptoms that last after 8 weeks of medicine, or any of these signs after you start treatment

If you are in Virginia or West Virginia, you can start a visit online at any time. It is for adults 18 and older with typical heartburn or acid reflux and no chest pain or pressure.

A board-certified physician reviews your answers. If it is right for you, the doctor can prescribe a PPI, like omeprazole or pantoprazole, for 4 to 8 weeks, or famotidine, and then help you step down to the lowest dose that works.

It is not for anyone with chest pain or pressure, or any of the signs above.

Visits start at $59. You see the price before you pay, and you do not need insurance.