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Heartburn- Causes, Symptoms, Complications, Diagnosis, and Treatment

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Heartburn is a burning feeling in the chest caused by stomach acid. Read the article below to know about heartburn.

Written by

Dr. P. Saranya

Medically reviewed by

Dr. Jagdish Singh

Published At August 17, 2022
Reviewed AtFebruary 6, 2023

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.

Frequently Asked Questions

1.

How Can Someone Relieve Heartburn?

Several medications are available to relieve heartburn. It includes antacids, proton pump inhibitors, and H2 receptor antagonists. Other than medications, lifestyle changes such as avoiding late meals, maintaining a healthy weight, avoiding alcohol and cigarettes, and certain home remedies can help relieve heartburn.

2.

When Should Someone Worry About Heartburn?

When the pain and discomfort associated with heartburn are not relieved with medication and persist for more than one week, it requires proper medical examination and treatment. Sometimes, the symptoms may develop into severe complications if left unnoticed. Thus heartburn should be treated medically if not responding to treatment with medications.

3.

Why Does a Person Get Heartburn Every Day?

Heartburn may occur due to various factors, including stomach acid backflow into the esophagus (reflux), obesity, overeating, pregnancy, stress, anxiety issues, some medications, smoking, and alcohol. In addition, some individuals have frequent heartburn due to digestive disorders like gastroesophageal reflux disease (GERD). It is a digestive disorder affecting the stomach and esophagus muscles.

4.

Does Drinking Water Help to Relieve Heartburn?

Drinking water helps balance the pH of the stomach fluids, dilutes the acidic stomach secretions, and gives relief. In addition, water aids digestion and improves the motility of food from the stomach into the small intestine, thus helping reduce acid reflux. In general, water consumption lowers acid reflux and helps relieve heartburn symptoms to a certain extent.

5.

Can Heartburn Damage the Heart?

As the name suggests, heartburn is not exactly related to the heart. Acid indigestion or heartburn causes pain or a burning feeling in the chest area that eventually may move up to the throat and neck. Thus heartburn does not cause any direct damage to the heart. However, long-standing heartburn may cause permanent damage to the esophagus (food pipe).

6.

Does Milk Help to Relieve Heartburn?

 
It is believed that drinking milk may help control acid reflux and reduce the symptoms of acid reflux disease and heartburn. Milk aids in buffering the action of stomach acids and relieves acid reflux symptoms. However, drinking small quantities of milk is advised. However high amounts of milk may worsen the symptoms associated with heartburn.

7.

Is Gastroesophageal Reflux Disease a Serious Condition?

Gastroesophageal reflux disease (GERD) is not a dangerous or life-threatening condition. But untreated, long-standing gastroesophageal reflux may cause severe damage to the esophagus and result in Barrett's esophagus. In addition, severe heartburn can lead to inflammation and narrowing of the esophagus, chronic cough, and respiratory problems.

8.

How Can We Treat Gastrointestinal Reflux Disease?

Gastrointestinal reflux disease (GERD) can be managed with medications (antacids, proton pump inhibitors, and H2 blockers)  that help reduce stomach acids. Along with medications, lifestyle modifications such as quitting smoking, caffeine, and alcohol and managing excess weight can also reduce the symptoms.

9.

What Are the Main Causes of Acid Reflux Disease?

 
Acid reflux disease may occur due to stomach abnormalities (hiatal hernia), pregnancy, smoking, acid reflux foods (carbonated beverages, coffee, fried foods, spicy foods, citrus fruits, and mint), alcohol, being overweight, heavy meals, and medications (Aspirin, Ibuprofen, and blood pressure medications).

10.

How Can Someone Get Rid of Heartburn Naturally?

 
Heartburn can be relieved to a certain extent in the initial stages by adapting to a healthy lifestyle, including a nutritious diet, a balanced weight, avoiding late meals, quitting alcohol, avoiding caffeine, eating a low-calorie diet, and sleeping with the head in an elevated position. In addition, having ripe bananas, chewing gums, wearing loose-fitting clothes, and drinking water are considered to be good in reducing heartburn. But there is no scientific evidence for the same.
Dr. Jagdish Singh
Dr. Jagdish Singh

Medical Gastroenterology

Tags:

heartburnacid reflux
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