What is heartburn?

Heartburn is a burning pain felt in the throat or lower chest or upper abdomen that occurs when stomach acid or food rises up from the stomach into your food pipe which connects your throat to your stomach. Heartburn is a common symptom of Gastro-Esophageal Reflux Disease (GERD) also called Acid Reflux. The stomach acids flow back can be worse in case of bending or lying down.

Heartburn is generally triggered by your diet and most people experience heartburn frequently. Heavy or fried or fatty or spicy food can cause heartburn or acid reflux. Alcohol, coffee, carbonated drinks, and chocolate can also cause heartburn. Smoking Obesity and medications for hypertension and cancer are the causes of heartburn too. Heartburn is also common in women during pregnancy as the uterus grows to put pressure on the stomach.

Causes of heartburn

Heartburn occurs when stomach acid or food rises up from the stomach into your food pipe (esophagus) which connects your throat to your stomach. When we swallow food, a group of muscle around the bottom of the esophagus (lower esophageal sphincter) relaxes to allow our food and liquid to flow down into the stomach. Then again, the muscle tightens. Stomach acids are released to digest your food. They can flow back (acid reflux) if the lower esophageal sphincter weakens or relaxes abnormally. This causes heartburn. Following are some of the causes for heartburn:

Overeating:   This is one of the leading causes of heartburn. You should take smaller meals a few times per day instead of taking too many meals at a time. You should also avoid late-night meals.

Lifestyle Factors:   There are crucial factors that may increase the risk of heartburn and they include:

   Obesity

   Excess usage of alcohol and smoking

   Stress

   Sleeping on your right side

   Wearing tight fitted belts and clothing

Food Triggers:   Different persons have different effects on foods they take. Foods that may cause heartburn include:

   Fried or spicy or fatty foods

   Chocolate

   Coffee or Tea

   Carbonated Soft drinks

   Onion

   Tomato or tomato ketchup

   Mustard

   Vinegar

   Citrus fruits or juices

   Mints

Pregnancy:   Many women can develop heartburn during the later stages of pregnancy as the growing uterus puts pressure upwards on the stomach.

Hiatus Hernia:   A hiatus hernia is when part of the stomach slides upwards into the chest by pushing itself through a hole (called the hiatus) in the diaphragm muscle (sliding hiatus hernia). The hernia itself rarely causes any symptoms but it does seem to make reflux more likely. For those people who have a large hiatus hernia, surgery may be required.

Symptoms of heartburn

Symptoms are often worse after eating, when lying down and when bending over. The main symptoms of heartburn are:

   Burning sensation in the middle of your chest

   Burning feeling in the throat

   Chest pain behind the breastbone

   Unpleasant sour taste in your mouth due to stomach acid

   Discomfort and agitation in the chest after eating meals

How is heartburn diagnosed?

Initially the GP doctor or Gastroenterologist conducts an external physical examination and enquires about the frequency of heartburn in the patient. In case of frequent heartburn, the doctor conducts the following tests:

X-Ray:   In this scan, the current shape and position of the oesophagus, cardiac sphincter and stomach are examined.

Endoscopy:   In this test, a gastroenterologist uses a flexible endoscope and a fiber optic camera to view the position of the esophagus and stomach as well as to identify Inflammation and ulcers. To identify cancer or precancer cells, a tissue sample (Biopsy) is collected.

Ambulatory Acid Probe Tests:   In this test, an acid monitor is placed on the esophagus and connected to a small computer that you can wear on a belt or shoulder strap. It measures when and how long stomach acid returns to the esophagus.

Esophageal Motility Tests:   In this test, a catheter is placed into the esophagusand measures pressure and movement of the esophagus during the passage of food particles and fluids.

Treatment of heartburn

Heartburn can be treated with medications, diet and lifestyle changes.

Medications:   Antacids, H2 blockers and proton pump inhibitors can be recommended by your doctor in case of occasional heartburn. These drugs include:

Antacids:   These medications help to reduce stomach acid to relieve heartburn pain. They are also helpful to decrease stomach aches, indigestion and gas.

   Calcium Carbonate   ( Antacid, TUMS )

   Mintox   ( Gelusil, Maalox )

H2 blockers:   These medications help to reduce stomach acid and do not work as quickly as antacids but they can provide longer relief.

   Famotidine   ( Pepcid AC )

   Cimetidine   ( Tegamet HB )

Proton Pump:   These medications help to reduce the amount of acid your stomach makes. They are also helpful to ease acid indigestion.

   Prilosec

   Esomeprazole   ( Nexium )

   Lansoprazole   ( Prevacid )

Diet:   Moderate heartburn can typically be avoided by making a few diet and lifestyle modifications. A variety of foods can cause heartburn thus such specific foods should be avoided if you have heartburn after eating them.

Avoid or Reduce:

   Acidic foods and drinks (caffeinated beverages as well as carbonated drinks)

   Chocolates

   Fried foods

   Citrus fruits

   Tomatoes

   Mint

Lifestyle management:   Person with epilepsy can take the following steps to reduce risks related to seizure:

   You should avoid eating at least three hours before bed. You should also avoid late-night meals.

   You should take smaller meals a few times per day instead of taking too many meals at a time.

   You should take your prescribed medications regularly.

   You should maintain your overall health by doing yoga and meditation.

   You should exercise regularly to lose obesity.

   You should avoid or reduce alcohol

   You should avoid or reduce smoking and tobacco products

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