Introduction:
Heartburn is a burning pain in the chest just below the chest bone or upper belly. The pain is worse after eating, or while lying down or bending over. The irritation of the food pipe (esophagus) connects the throat and the stomach. Occasional heartburn is common, but there may be an associated medical condition if it is more frequent. Heartburn is caused by stomach acid. It is also called pyrosis or acid indigestion. Heartburn does not affect the heart. Heartburn worsens with an increase in age.
What Is the Cause of Heartburn?
Heartburn occurs when stomach acid flows back into the esophagus (the tube that carries food from the mouth to the stomach). Usually, during swallowing, the lower esophageal sphincter muscle around the bottom of the esophagus relaxes to allow food and liquid into the stomach. Then the muscle tightens. If the lower esophageal muscle weakens or relaxes abnormally, stomach acid can flow back into the esophagus (acid reflux) and cause heartburn.
Overeating, obesity, pregnancy, and constipation put too much pressure on the stomach, causing the stomach acid to backflow resulting in heartburn. People with hiatus hernia, in which a part of the stomach pushes up into the chest, also experience heartburn.
What Are the Symptoms of Heartburn?
Symptoms of Heartburn include:
-
Burning pain in the chest area after eating especially at night.
-
Pain that gets worse when lying down or bending over.
-
Bitter or acidic taste in the mouth.
-
Difficulty in swallowing.
-
Hoarse voice.
How Long Does Heartburn Last?
Heartburn occurs about once a week in 20 % of Americans and is common in pregnant women. Heartburn can last from just a few minutes to several hours. It can vary from person to person.
What Are the Risk Factors of Heartburn?
Certain foods and drinks can cause heartburn, including:
-
Spicy foods.
-
Onions.
-
Citrus fruits.
-
Tomato products, such as ketchup.
-
Peppermint.
-
Fatty or fried foods.
-
Chocolates.
-
Alcohol, carbonated beverages.
-
Coffee or other caffeinated beverages.
-
Fatty meals.
Certain medications such as Aspirin, Ibuprofen, and some blood pressure medications increase the risk of heartburn. In addition, stress and anxiety can cause heartburn. Being obese and pregnant also increases the risk of heartburn.
What Are the Complications of Heartburn?
Heartburn that often occurs and more frequently disturbing the routine is considered gastrointestinal reflux disease (GERD). Prolonged and untreated GERD can severely damage the esophagus or cause precancerous changes in the esophagus called Barrett's esophagus. Severe chronic heartburn can lead to narrowing and inflammation of the esophagus (esophagitis), respiratory problems, and chronic cough.
How Can We Diagnose Heartburn?
The following tests are done to determine if heartburn is a symptom of GERD in the patients:
X-ray: Drinking a solution with barium lines the digestive tract, including the esophagus, stomach, and the upper part of the intestine. This test helps to view the condition and shape of the esophagus and stomach.
Endoscopy: In this procedure, a thin, flexible tube called an endoscope is inserted with a camera to view abnormalities in the esophagus. A tissue sample for biopsy is also taken if needed during this procedure.
Ambulatory Acid Probe Tests: This test determines when and for how long stomach acid backs up into the esophagus. An acid monitor is put into the esophagus and connected to a small computer that is worn on a belt or shoulder strap. A new technique called bravo allows measuring 48-hour acid levels. This technique is done using wireless ph sensors, which eliminate tube insertion.
Esophageal Motility Testing: To measure the movement and pressure of the esophagus.
What Is the Treatment for Heartburn?
Many over-the-counter medications are available which relieve heartburn. They include:
Antacids: They help in neutralizing stomach acid. Antacids provide quick relief. If the esophagus is damaged by stomach acid, antacids can not heal the damage. Instead, they provide fast short-term relief. Antacids are available in liquid, tablet, or gummy form. They are not intended for daily use.
H2 Receptor Antagonists: They reduce stomach acids. They do not act quickly as antacids but provide more extended relief.
Proton Pump Inhibitors: Such as Lansoprazole and Omeprazole can reduce stomach acid.
A gastroscopy test checks if the medications do not relieve the symptoms. In this procedure, a small tube with a camera is passed down the throat to find out the cause of heartburn.
In more severe cases, a surgery named laparoscopic fundoplication is done to stop the acid reflux from the stomach.
What Are the Lifestyle Changes and Home Remedies to Be Done for Heartburn?
Many simple lifestyle and dietary changes can help in relieving heartburn. They include:
-
Maintain a Healthy Weight: Excess weight puts pressure on the abdomen, pushing up the stomach and resulting in the stomach acid flowing back into the esophagus.
-
Avoid Late Meals: Eat at least three to four hours before bed. This gives enough time for stomach emptying and reduces the chance of heartburn overnight.
-
Avoid Large Meals: Eat many small meals throughout the day.
-
Slow Eating: Eating slowly can prevent heartburn.
-
Wearing Loose-Fitting Clothes: Belts and tight clothing can sometimes cause heartburn.
-
Elevate the Head of the Bed: If heartburn occurs in the night during sleep, elevating the upper body can help reduce heartburn.
-
Avoid Smoking and Alcohol: Nicotine can weaken the lower esophageal sphincter and cause backflow of acid.
-
Stand Up Straight: The body's posture can also lead to heartburn. If you are sitting or lying down, standing up can provide relief.
-
Relaxation Techniques: Try meditation or yoga to reduce stress.
-
Avoid foods that trigger heartburn.
-
Avoid lying down after a meal.
-
Sleeping on the left side may help digestion and remove acid from the stomach and esophagus.
Conclusion:
Heartburn is a common symptom of acid reflux that feels like burning in the chest. Heartburn is not a severe condition. With medications and lifestyle changes it can be controlled to a great extent.
