Chewing tobacco cessation and heartburn

Dear Ask The Doctor: I quit chewing tobacco about a month ago but now I have really bad heartburn. I had been using chewing tobacco since 2003. I was wondering if they are connected and what I can do other than antacids which tend to make me nauseated. The heartburn began a few days after I quit, some days are worse than others. It happens every time I eat or drink anything. Thank you for your time.

Dear Jen: Your heartburn symptoms are due to reflux of stomach acid into the lower oesophagus. It may be a coincidence that your symptoms of heartburn just appeared when you quit chewing tobacco. Alternatively the excess saliva and secretions, secondary to chewing tobacco, may have neutralized the regurgitant stomach acid. If your symptoms are not relieved by simple antacids, I would advise attending your family physician for a detailed history of your symptoms and clinical examination. You may require further investigation with endoscopy, a camera used to visualize the upper gastrointestinal tract, or treatment to suppress acid production in the stomach with a proton pump inhibitor e.g. Omeprazole.