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

But many people fail to seek help for persistent symptoms, thinking the problem is just something they have to endure.

"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 in private practice 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.

Normally, the muscle "relaxes after you swallow and then will tighten up after the food has passed into the stomach," says Dr. James Strobel, a gastroenterologist at Clark Memorial Hospital in Jeffersonville, Ind. But "for unclear reasons, some people have abnormal or too frequent relaxation of that sphincter muscle, which allows reflux" of stomach contents.

Occasional heartburn symptoms are normal.

"Everybody gets a little bit of acid reflux that occurs, particularly after meals," says Dr. Nicholas Nickl, a professor of medicine and chief of endoscopy at University of Kentucky Chandler Medical Center.

But when heartburn occurs more frequently, the person is likely to have gastroesophageal reflux disease, also known as 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 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.

When symptoms strike, the first instinct is often to reach for an over-the-counter antacid, such as Mylanta, or drugstore H2 blockers, including Pepcid AC, Tagamet HB and Zantac 75.

"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, 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 medication.

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.