The burning sensation in the chest due to acid regurgitating into the esophagus is called heartburn. Learn the causes, treatment, and prevention of heartburn.
Usually at night, we may feel a sour liquid in our throat coming from beneath or burning sensation in our upper tummy. The pain goes up through our chest to the throat. Sometimes we fear it as a heart attack. This is called heartburn or gastroesophageal reflux disease (GERD) in medical terms.
The food we eat starts getting digested right from the mouth up to the large bowel. Food passes through the mouth to the throat and then food pipe, stomach, small and large bowels, rectum and at last excreted as feces. Every part of the digestive system plays its role in digesting food. Stomach is unique from other parts as it has acid in it. Yes, stomach produces hydrochloric acid (HCl). This helps in digestion and also kills germs that may be present in unhygienic food.
The hydrochloric acid is present only in the stomach. A functional valve at the lower end of the food pipe called the lower esophageal sphincter preventes the reflux of acid back into the food pipe. It remains closed most of the time and opens for a short time while we swallow food or liquid and then closes again. Sometimes, it opens for short times even without food, to eliminate the air that is swallowed or gas that is produced by some chemical reactions in the stomach. These transient openings are for very short periods. In some individuals, the openings of this valve are recurrent or for longer duration. In that case acid may come back into the lower part of the food pipe and cause burning of walls of the pipe. This causes pain or burning sensation and it is due to acid reflux.
Some common risk factors of acid reflux are as follows:
Heartburn is very common. Most of us experience it three to four times per month. Unless you do not have danger symptoms, this condition is of no concern. Danger symptoms or red flags are weight loss, persistent vomiting, blood vomiting, black colored feces and difficulty in swallowing. If you experience these danger symptoms, then go straight to your doctor without delay.
Usually no investigations are required, but sometimes when the diagnosis cannot be made, few investigations are done to check acid reflux.
1. Esophageal Manometry:
In this, a probe is inserted into food pipe’s lower end, which measures its pressure. If it is decreased, then it causes acid to reflux back.
2. Monitoring Ph:
In this also, a pH probe is inserted into the food pipe through mouth to measure pH of the food pipe continuously for 24 to 48 hours. If it is less than 4, then it gives clue to acid reflux. Normal pH is around 6. This test is also called Bravo test.
In this test a flexible probe is passed through the mouth to the stomach, which has a camera to view inside the food pipe and stomach. It is also used to remove a small piece of tissue from there to test, which is known as biopsy.
4. Acid Suppressing Medicines:
Sometimes a medicine that suppresses acid production is given and if there is symptomatic improvement, then the treatment will be continued.
If you suffer from recurrent heartburn, then the following steps may be taken to decrease or prevent further episodes.
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Lack of sleep and high stress can increase the stomach's acid levels, thus leading to heartburn symptoms. For pregnant women, progesterone might relax the muscles of the esophagus and lead to heartburn. In addition to these conditions, smoking can also increase stomach acid levels, thereby causing heartburn.
Drinking water will aid in the process of digestion. It will also help in the hydration of the body. Frequent consumption of water can relieve the symptoms caused by gastroesophageal reflux disease. You can also try drinking ginger tea for heartburn.
- Drinks and foods that commonly boost heartburn are:
- Alcohol. Red wine triggers heartburn when compared to other alcoholic drinks.
- Garlic, raw onions, black pepper, and other spicy foods.
- Citrus fruits and products like oranges, orange juice, and lemons.
- Coffee and caffeinated drinks like soda and tea.
You can follow the below tips to overcome heartburn.
- Stand up straight when you have heartburn. Laying down will increase the intensity of the condition.
- Wear loose clothing.
- Drinking a mixture of baking soda with water.
- Chewing gums can help in diluting the acid.
- Keeping your upper body in an elevated position.
- Consumption of licorice supplements.
- Eat ginger.
- Drinking apple cider vinegar.
The following drinks can help in relieving heartburn.
- Plant-based milk.
- Low-fat milk.
- Fruit juice.
- Coconut water.
Sudden heartburn might be a sign of the following conditions.
- Hiatus hernia.
- Acid reflux.
- Stomach ulcer.
- Gastrointestinal disease.
In addition to these conditions, sudden heartburn can occur due to overeating, alcohol, tight clothing, and spicy food.
Milk might not be a good option for heartburn in some patients. Some medical researchers suggest that milk can relieve heartburn, but milk is known to stimulate the production of acids in the stomach in practical cases. So, milk is not a recommended option for all types of patients. You should get recommendations from the doctor before consumption of milk.
While sleeping with heartburn, make sure you keep your body elevated. You can sleep on a wedge-shaped pillow. It has to have a minimum thickness of 6 to 10 inches at one end. You can also sleep on your left side to relieve the symptoms of heartburn.
All cases of heartburn are not serious conditions. Sometimes, it can happen due to excessive vomiting in pregnancy. In such cases, the patient need not worry about heartburn. But, if the heartburn occurs more than two times a week, it is necessary to immediately consult a doctor. If the patient has gastroesophageal reflux disease, then they might experience heartburn a minimum of three times a week. In such conditions also it is necessary to consult a doctor.
Banana is a fruit that contains low levels of acid. The high fiber content in bananas can boost the process of digestion. Many indigestion problems can be overcome by eating bananas. So, bananas are really good for heartburn. All the fruits that are having low acid content can be consumed for heartburn.
The following medications can relieve the symptoms of heartburn,
- Pantoprazole sodium
Heartburn occurs when the lower part of the esophagus relaxes at the wrong time. This will result in the backflow of the acid into the esophagus. This will cause heartburn throughout the day. The patient will feel severe discomfort and difficulty in eating.
Chest pain can happen anytime due to the underlying condition. But, heartburn can happen only after the meals because it is mostly a gastrointestinal problem. The symptoms of chest pain are usually seen, along with other symptoms like breathlessness. This does not happen in the case of heartburn.
The symptoms of heartburn can last for two or more hours. In case the heartburn is very mild due to the consumption of spicy foods, then the heartburn will stop after the consumed foods have been digested. There are possibilities for the heartburn to reoccur if the person lies down immediately after eating.
Severe heartburn causes pain and discomfort for the patients. The digestive acids that move through the digestive tract can cause uneasiness in an individual. Typical heartburn will start in the upper part of the abdomen and gradually move to the chest. You should consult your doctor if you are facing severe symptoms of heartburn, consult your doctor immediately.
Last reviewed at:
14 Oct 2019 - 4 min read
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