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Maybe it isn't something you ate

  Heartburn can turn an enjoyable meal into a four-alarm fire down below. Luckily, calling the fire department isn't necessary to extinguish the burning feeling that leaves more than 60 million sufferers feeling uncomfortable, if not downright miserable.

Most people who get heartburn, or its more serious cousin — gastroesophageal reflux disease (GERD) — can ease their symptoms by taking medication and/or making lifestyle changes.

"A lot of patients, actually, when they come to me for the first time, they have not experienced normality for a long time," says Dr. Ashok Kapur, a gastroenterologist at Caritas Medical Center in Louisville, Ky.

Heartburn occurs when the lower esophageal sphincter, a muscle at the junction of the food pipe and the stomach, relaxes inappropriately, allowing acid from the stomach to back up into the esophagus.

But when heartburn occurs more frequently, the person is likely to have GERD.

The problem becomes GERD "when the reflux is bad enough to cause injury to the esophagus or when the reflux is frequent enough or serious enough to cause a lot of symptoms," Nickl says.

Complications of chronic reflux include possible erosion, narrowing and inflammation of the esophagus; Barrett's esophagus, a precancerous condition; and esophageal cancer, which is often detected late, Kapur says.

Diet and lifestyle changes — such as avoiding fatty foods, alcohol, smoking, peppermint, carbonated beverages, chocolate, late-night eating and excessive weight — can be helpful, especially to people who have mild symptoms, Strobel says.

But changing diet and lifestyle can be difficult, Nickl says. Also the modifications don't work for everyone.

"That's quite appropriate to do that if you have an occasional heartburn," Kapur says. But if you have heartburn more than a couple of times a week, then you need to be seen by a physician, Kapur says.

To combat symptoms, doctors often suggest proton pump inhibitors (PPIs), which reduce the production of stomach acid. Those drugs include Prilosec, which last year became the first of its type to be approved for nonprescription use. Nexium is a well-known prescription PPI.

The PPIs "are the most potent medications and generally very effective," Strobel says.

Surgery is another option for people with moderate to severe reflux, but it's not done as often as it once was because today's medications, particularly the PPIs, work so well, Nickl says.

However, there are some people who want an alternative to medication but don't want the trauma of surgery.

One of the more popular endoscopic procedures is Enteryx, a polymer injection approved by the U.S. Food and Drug Administration in 2003.

"It goes in as a liquid and it sets up very quickly as a kind of a spongy gel," Nickl says. It provides a bit of bulking down at the bottom of the esophagus to act as a reflux barrier but doesn't interfere with swallowing, Nickl says.

Endoscopic procedures such as these aren't without risk. Complications range from failure to correct the problem to, in some cases, death, he says.

"Fatal complications (from these procedures) seem to be rare, but on the other hand, it's not unheard of, and that's part of the fact that they're still in development," he says.