Getting the right help for GERD, chronic heartburn and acid reflux

NORRISTOWN, Pennsylvania (WPVI) -- Certain foods are known to trigger heartburn.

But when it seems everything causes that burning pain, it's time for a specialist, not just the antacids.

A local man found he has had conventional and an unconventional factor causing his pain.

The kitchen is Ari's happy place.

"I really love food," says Ari Heitler-Klevans, adding, "Cooking is one of my favorite things to do."

But over the past six years, heartburn turned Ari's joy to pain.

His primary care and a gastroenterologist suggested several moves, starting with dietary changes to reduce the acid and avoid known heartburn triggers.

"I removed chocolate and tomatoes and anything that had mint from my diet," he says.

But it didn't help, and as a vegetarian, he didn't eat bland meat like chicken, which is often recommended.

Medications had mixed results.

"The medication would work for a period of time, and then my body would adapt to it," he recalls.

After no success with multiple medications, Heitler-Klevans' doctor referred him to Temple Health gastroenterologist Mark Malamood, who notes that heartburn is one sign of gastroesophageal reflux, or GERD.

"The contents of the stomach, whether it's food or acid or other stomach chemicals come back up or reflux up into the esophagus and the chest," Dr. Malamood explains.

Regurgitation and chest pain are among the most common signs of GERD.

There are also atypical signs:

"Including a chronic cough, chronic needing to clear your throat, a sense of something sort of being, just kind of stuck right here," the doctor notes.

He adds that those can be confused with other conditions.

To treat GERD, you have to find the cause.

For Heitler-Klevans, an endoscopy and PH test verified reflux.

"They put sort of a monitor down the back of my nose all the way into my stomach that measured pH at multiple locations in my esophagus," he says of the tests,

They are aimed at seeing any weakness in the mechanism at the base of the esophagus that keeps food in the stomach.

Heitler-Klevans also had a hiatal hernia, in which part of the stomach bulges into the chest, and that also allowed food to come into the esophagus.

After surgery to reposition the stomach, Heitler-Klevans' symptoms vanished for a while.

New tests showed the surgical fix for reflux was still intact.

However, his nerves thought there was still a problem, causing a phenomenon called "visceral hypersensitivity."

"They're sending these sorts of distress and pain signals to the brain when only exposed to normal levels of saliva or food," Dr. Malamood explains.

"I am now on a medication that is supposed to help dampen my nerves' responses," Heitler-Klevans says.

He began taking that earlier this summer, so it will be late fall or winter before he and Dr. Malamood can be sure of success.

Dr. Malamood says many reflux symptoms can be resolved with small changes, starting with cutting back on acidic and caffeinated foods like coffee, and not lying down for at least 2 hours after eating.

Ari says another frequent recommendation - elevating the head of the bed by 6 inches - has also helped him.

He is back in the kitchen, having fun.

"I have allowed myself back into the realm of delicious food," he says with a smile.

But he urges anyone experiencing frequent, chronic heartburn to look for solutions, even if it takes time.