Reflux Esophagitis: One of the more frequent and persistent problems I treat is Reflux Esophagitis. This is an recurrent irritation of the esophagus from acid washing up from the stomach into the esophagus. Patients experience a burning chest discomfort and occasionally severe pain in the mid chest and even into the mid back. Trouble swallowing with discomfort 9 seconds after swallowing can occur. Anything that increases acid in the stomach can loosen the "gastro-esophageal sphincter" and cause the reflux. Eating too close to bedtime, especially with fatty foods can cause it.  Stress, alcohol, nicotine, spicy foods and red gravy, caffeine, citrus juices can produce it.  Aspirin and Advil like drugs can worsen it.  Just one cup of coffee can double the acid in the stomach for the next three hours.  Acid reflux can cause the esophagus to ulcerate, stricture, bleed, and even change its inner membrane to a precancerous state called Barrett's Esophagitis.  Eleven percent of all gastrointestinal bleeding comes from esophagitis. Head of bed elevation (not with pillows), Proton-pump inhibitor (PPI) drugs, H-2 blockers (zantac, pepcid) , antacids (milk of magnesia) help. Chewing gum can help as saliva is alkaline.  EGD (looking with a scope directly at the stomach and esophagus is important to see, for sure, what is going on and rule out Barrett's. We only feel ten percent of the true severity of the symptoms, so EGD and staying on your medication despite minimal symptoms is important. You can tell if your symptoms are from esophagitis if antacids or belching help immediately or chew five Altoid Peppermints and see if there is immediate relief. If these measures don't work, never try to convince yourself it is not a heart attack and go to the nearest Emergency Room.