Kenny Rogers shared a painful duet with heartburn.

After selling over 100 million albums, packing concert halls and winning four Grammys, it wasn't boredom or retirement that nearly kept Kenny Rogers from performing. It was heartburn.

"When my heartburn was at its peak, there were times when I almost didn't go on and that I almost canceled a couple of shows," says Rogers, who starred in the hit television movie The Gambler. "Performing should be a creative process and that's difficult to do when I am worried more about pain and discomfort than performing."

Like millions of Americans, Rogers suffered with heartburn for years without knowing what was really wrong. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), more than 60 million American adults experience heartburn at least once a month. As many as 25 million suffer daily. Men and women are affected almost equally, but incidence increases after age 40.

 "I've probably had this most of my life but about seven or eight years ago it just got worse," Rogers states. "I mean really bad to the point where the burn and the pain in my chest was very painful. It became so frequent that it no longer was something coincidental; it was an issue in my life."

Now Rogers is making heartburn awareness an issue in other people's lives. The country music legend has teamed up with Proctor & Gamble, marketers of Prilosec OTC, to teach people how to recognize their heartburn and find relief.

"It's called the BurnTown Challenge and when I was asked to participate, I wanted to help," Rogers explains. "I know what frequent heartburn is and I understand what people are going through. Plus I thought the Challenge was pretty great - the town that responds the most to the survey gets $25,000 for their fire department."

Heartburn is a pain or discomfort, usually under the breast bone, that people describe as a burning sensation. It typically arises from below the breast bone and migrates upwards and is associated with the reflux of acid.

"Normally the valve between the esophagus and the stomach - called the lower esophageal sphincter - prevents things from moving north," says David A. Peura, professor of medicine at the University of Virginia in Charlottesville. "If the valve is improperly working, relaxing when it's not supposed to or if it's weak, things will regurgitate back and cause irritation."

There are three categories of heartburn:

• Episodic heartburn - people have a problem only when eating certain foods that they infrequently eat. They can self medicate before or treat themselves after.
• Frequent heartburn - two or more times a week. 
• GERD - gastroesophageal reflux disease - this is frequent heartburn that is not getting better with over-the-counter medications

Burning man

Rogers says his doctor was thorough and ordered several medical tests to determine what kind of heartburn he had.

"He wanted to make sure I didn't have GERD which is different and more serious," Rogers explains. "And he wanted to know that it wasn't heart problems and other things that can be misdiagnosed when you have heartburn."

"There's a 'heart' in heartburn," Peura stresses. "We need to make sure that people are not having a heart attack. Heartburn symptoms can sometimes have similar characteristics to heart pain or angina. If people are the right age and if they have risks factors like family history, being overweight, and high cholesterol, we can't just assume it is heartburn."

Another thing Peura says is important to remember is that most people's heartburn is a symptom that is not going to be progressive. But if left untreated, it could become a "major problem and can have a significant impact on people's quality of life."

Rogers knows exactly what that means.

"Once I had the debate about whether I was going to walk out on stage or not, I knew I had to go see what was going on," Rogers says. "When it starts interfering with your work, then it's a whole different thing than being inconvenienced. And frankly, not knowing what it was -- I was concerned it might be something more serious."

Without treatment, heartburn and the associated acid reflux can cause esophagitis, an inflammation of the esophagus. This condition can cause scar tissue which results in strictures that prevent or make swallowing difficult.

"In the rare patient the esophagus can heal with an abnormal lining - more of a stomach type lining," says Peura, who is also associate chief of gastroenterology and hepatology at UVA. "In a small percentage of people this can be a pre-malignant condition called Barrett's Esophagus. But that's more the exception than the rule."

These more serious stages of disease are typically diagnosed using an endoscope, a flexible tube with a tiny camera and light that is inserted down the esophagus so the doctor can determine if there is any acid damage. For a small subgroup of GERD patients who do not respond to medication, surgery to reconstruct the lower esophageal sphincter is recommended.

"I've had the endoscopic exam and it is not pleasant," Rogers reveals. "They looked down there and there were no lesions or damage."

After discussing the frequency that Rogers was experiencing heartburn and what the common denominators were, his family doctor prescribed the medication Prilosec, a proton pump inhibitor that shuts down acid production.

Rogers says the medication 'changed his life' and wants people to know the remedy will soon be available over-the-counter as Prilosec OTC.

'Fire' prevention

And the silver-haired performer admits that if he made additional lifestyle changes he'd probably be doing even better.

"The best choice would be not to eat things that hurt my stomach, but when you're on the road like I am, you tend to eat junk," Rogers jokes. "And if you try to take my pizza and Buffalo wings away from me, you're going to have a fight on your hands."

"I think my problem was less what I was eating as my eating habits," Rogers adds. "I'd finish a show late and then eat at 11 o'clock at night and that would come back to haunt me big time."

"Eating late at night is particularly important to avoid because if the esophageal sphincter relaxes and you're in a recumbent position things can come up more easily," Peura warns. "The worst thing you can do is lie down after a big meal and go to sleep."

Some other tips to help avoid heartburn include:

• Avoiding certain foods - spicy or concentrated foods, orange juice, tomato-type products, caffeine, chocolate, spearmint, peppermint and alcohol.
• Don't smoke.
• Eat in a leisurely fashion.
• Avoid huge meals.
• Lose weight.
• A good walk after dinner is helpful.

"What I have noticed now when I do have a flare up is if I do change my eating cycles and the foods I eat and take my medication, I can control it," Rogers says. "That's all I really ask."

The key according to Peura is not accepting heartburn as a way of life.

"Almost 40% of people with frequent heartburn are taking daily treatment and are not satisfied with their medication," Peura states. "People need to be educated that with appropriate treatment they can find relief and not suffer."

"I would strongly recommend that anyone who frequent heartburn to get checked," urges Rogers, who will release a new album titled Back to the Well in September, featuring duets with Dolly Parton as well as Tim McGraw. "If you have it once in a while you can go buy an antacid and be fine. But if you have it twice a week or more you really need to go see your doctor."

Click here for more information on heartburn.

• National Heartburn Alliance

• National Institute of Diabetes and Digestive and Kidney Diseases

• American Gastroenterological Association

• BurnTown Challenge

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 8/24/2003  -  Donnica Moore, M.D.