Heartburn is in reality, a symptom of gastroesophageal reflux disease GERD. It is caused by acid refluxing back into the esophagus. The esophagus is a tube that connects the mouth to the stomach and is made of muscles that work to push food toward the stomach in rhythmic impressions.
Once the food is in the stomach, it is prevented from moving back into the esophagus (refluxing) by the lower esophageal sphincter.
The stomach combines food, acids, and enzymes together to begin digestion, and there are special protective cells that line the stomach to prevent the acid from causing inflammation.
The esophagus does not have this same protection, and if stomach acid and digestive juices move back into the esophagus, they can result in inflammation and damage to its unprotected lining.
Heartburn is a burning pain in your chest, and the pain is often worse after eating, in the evening, or when lying down or bending over. Risk factors include increased production of acid in the stomach, as well as structural problems that allow acid reflux into the esophagus.
Most of the times, heartburn is common and no cause for alarm, as most people can manage the discomfort of heartburn on their own with lifestyle changes and over-the-counter medications.
However, heartburn that is more frequent or interferes with your daily routine may be a symptom of a more serious medical condition that requires medicinal care.
Symptoms of Heartburn
Symptoms of heartburn include:
- Burning pain in the chest (usually occurs after eating or at night)
- A burning sting that worsens when lying down or bending over
- Acidic taste in the mouth
Causes of Heartburn
Heartburn occurs when stomach acid backs up into the esophagus, and several factors may lead to heartburn or make it feel worse. Such factors include:
- Unhealthy eating habits like eating large food portions
- Eating certain foods such as onions, high-fat foods, citrus fruits, spicy foods, etc
- Drinking alcohol, caffeinated beverages, and carbonated beverages
- Eating shortly before time to turn in
- Lifestyle habits like smoking
- Wearing tight clothes or belts
- Medical causes like Pregnancy: Pregnancy can cause increased pressure within the abdominal cavity and affect LES function, predisposing it to reflux.
- Being overweight: this may cause increased pressure in the abdomen, and thus reflux.
- A hiatal hernia: where a portion of the stomach lies within the chest instead of the in the abdomen, can affect the way the lower esophageal sphincter (LES) works and is a risk factor for reflux. When the LES fails that heartburn occurs.
- Gastroesophageal reflux disease (GERD): Some diseases of the esophagus, like scleroderma and sarcoidosis, can also present with heartburn as a symptom.
- Use of certain medicines, like anti-inflammatory drugs and aspirin
Some common foods that we eat and drink stimulate increased stomach acid secretion. This can set the stage for heartburn. Also, over-the-counter medications may cause heartburn.
Examples of these irritants (foods and drugs) include:
- carbonated beverages,
- acidic juices like grapefruit, orange, pineapple etc
- acidic foods and
Experts believed that smoking and the consumption of high-fat content foods tend to affect the function of the lower esophageal sphincter, causing it to relax from the stomach and allow acid to flow back into the esophagus.
Treatment or therapies to limit the amount of stomach acid production include lifestyle changes like avoiding certain foods, alcohol, anti-inflammatory medications, and quitting or not smoking.
Other lifestyle changes include:
- Eating smaller, more frequent meals
- Avoiding eating before bedtime
- Avoid alcohol,
- Avoiding anti-inflammatory drugs like aspirin, ibuprofen, and caffeine
- Stop smoking
- When you sleep, you can elevate the head of the bed or use two pillows to allow gravity to keep acid in the stomach to avoid acid reflux.
- Antacids: to bind excess acid in the stomach and to coat the esophagus.
- Histamine H2: blocks the action of histamine. Histamine is a chemical that stimulates stomach cells to produce acid. This decreases acid production and decreases symptoms too.
Heartburn Surgery becomes an option for those patients whom intensive medical therapy does not provide adequate relief or those with Barrett’s esophagus. Surgery also becomes an option with reflux that is so severe that it causes hoarseness, pneumonia, or gasping.
Different surgical approaches to esophageal reflux are available, and you should talk to your doctor to find out the most suitable for you.
In summary, heartburn is a symptom of a common medical condition (GERD). It affects up to 20% of the population, but medications can be helpful in controlling its symptoms.
Also, losing weight may help decrease heartburn symptoms by decreasing intra-abdominal pressure.
Heartburn is not a non-threatening condition, but if neglected over long periods of time, may lead to other more serious conditions such as esophageal cancer.