By Medicover Hospitals / 08 March 2022
Heart Burn
Heartburn is an irritation of the esophagus, the tube that connects the throat and the stomach. It is caused by stomach acid. This causes a burning sensation in the upper abdomen or below the breastbone. You can successfully treat heartburn symptoms at home. However, if frequent heartburn makes eating or swallowing difficult, your symptoms may be a sign of a more serious medical condition. And despite its name, heartburn has nothing to do with the heart. Yet some signs are equivalent to a heart attack or heart failure symptoms.
Causes
Heartburn usually occurs when stomach contents return to the esophagus. The esophagus is a tube that carries food and fluids from the mouth to the stomach. Your esophagus connects to your stomach at a junction known as the cardiac sphincter or lower esophageal sphincter. If the heart sphincter is working properly, it closes when food leaves the esophagus and enters the stomach.
In some people, the heart sphincter does not work properly or becomes weak. This causes stomach contents to leak back into the esophagus. Stomach acids can irritate the esophagus and cause heartburn symptoms. This condition is known as reflux.
Some common foods that we eat and drink stimulate increased stomach acid secretion and set the stage for heartburn. Over-the-counter medications can also precipitate heartburn. Examples of these irritants include:
- Alcohol
- Caffeine
- Aspirin (Bayer, etc.)
- Ibuprofen (Motrin, Advil, Nuprin, etc.)
- Naproxen (Naprosyn, Aleve)
- Carbonated drinks
- Acidic juices (grapefruit, orange, pineapple)
- Acidic foods (tomatoes, grapefruits, and oranges)
- Chocolate
Smoking and eating foods high in fat tend to affect the function of the Lower Esophageal Sphincter (LES), causing it to relax in the stomach and allow acid to flow back into the esophagus.
A hiatal hernia where part of the stomach is inside the chest instead of the abdomen can affect the way the LES works and is a risk factor for reflux. Hiatal hernias alone do not cause symptoms. Only when the LES fails does heartburn occur.
Pregnancy can cause increased pressure within the abdominal cavity and affect the function of the LES and predispose it to reflux.
Obesity can also cause increased pressure in the abdomen and, therefore, reflux in the same way.
The primary diseases of the esophagus can also present with heartburn as a symptom. These include, but are not limited to, scleroderma and sarcoidosis.
Diagnosis
Heartburn is a common complaint, although it can confuse with other chest-related illnesses, including:
Diagnosis begins with a complete history and physical examination. Most times, they provide enough information for the healthcare professional to make the diagnosis and begin a treatment plan. If your heartburn goes on for a long time, it may be a sign of a more serious condition known as gastroesophageal reflux disease (GERD). Your doctor may determine if GERD causes your heartburn from your symptoms. But to find out how severe it is, they can run several tests, including:
- X-Ray
You will drink a solution called barium suspension that lines the lining of your upper GI (gastrointestinal) tract - your esophagus, stomach, and upper small intestine. This coating allows doctors to see defects that could mean a problem with your digestive system.
- Endoscopy
In Endoscopy test, a gastroenterologist uses a flexible endoscope and a fiber optic camera to view the lining of the esophagus and stomach. Inflammation and ulcers can be identified. Biopsies and small pieces of tissue can be obtained to look for cancerous or precancerous cells.
- Outpatient acid probe test (esophageal pH monitoring)
An acid monitor placed on the esophagus and connected to a small computer that you can wear on a belt or shoulder strap. It measures when stomach acid returns to the esophagus and for how long.
- Tests esophageal motility (esophageal manometry)
Less frequently, the use of pressure sensors and acid tests from inside the esophagus can use when traditional treatment has failed to validate the diagnosis or when symptoms are atypical, helps make the diagnosis. A catheter is placed into the esophagus and measures pressure and movement.
Treatment
Depending on your diagnosis, your doctor may provide you with treatment options to help reduce or eliminate your symptoms.
Medications for treating occasional heartburn include antacids, H2-receptor antagonists to reduce stomach acid production, such as Pepcid, and proton pump inhibitors that block acid production, such as:
- Antacids
These medications decrease stomach acid to relieve heartburn pain. Sometimes they can also help with stomach aches, indigestion, and gas.
- Acid blockers and proton pump inhibitors
These drugs decrease the amount of acid your stomach makes. They can also ease the symptoms of acid indigestion.
- H-2 receptor antagonists (H2RA)
which can reduce stomach acid. H2RAs do not work as quickly as antacids, but they can provide longer relief.
Complications
Occasionally heartburn is not dangerous. But GERD can sometimes lead to serious problems, such as:
- A prolonged cough
- Laryngitis
- Inflammation or ulcers of the esophagus
- Trouble swallowing due to a narrow esophagus
- Barrett's esophagus, a condition that can increase your chances of getting cancer of the esophagus
When to visit a Doctor?
Although heartburn is common, it can sometimes lead to more serious health problems. Chronic and severe heartburn has been linked to inflammation and narrowing of the esophagus, breathing problems, chronic cough, GERD, and Barrett's esophagus, which can lead to cancer of the esophagus.
You should contact your doctor if:
- Your heartburn will not go away
- Symptoms of heartburn become more severe or frequent
- It is difficult or painful to swallow
- Your heartburn makes you vomit
- You have had a substantial and unexpected weight loss
- You take over-the-counter antacids for more than two weeks (or longer than recommended on the label) and you still have heartburn symptoms
- You have symptoms of heartburn even after taking prescription drugs
- You have severe hoarseness or wheezing
- Your discomfort interferes with your lifestyle or daily activities
- Severe or crushing chest pain
- Shortness of breath
- Jaw pain
- Arm pain
Prevention
Follow these tips to prevent heartburn:
- Avoid foods or activities that can cause your symptoms
- You can also take over-the-counter medications, such as a chewable antacid tablet, before eating to prevent heartburn before symptoms start
- Ginger snacks or ginger tea are also useful home remedies that you can buy in many stores
- Live a healthy lifestyle and avoid alcohol and tobacco
- Try to avoid snacking late at night. Instead, stop eating at least four hours before bed
- Instead of two or three large meals, eat smaller meals more often to ease the impact on your digestive system
- Eat small meals instead of big ones
- Sitting upright for at least three hours after eating
Home Remedies
If you experience occasional heartburn, there are several home remedies and lifestyle changes that can help ease your symptoms. Changes in your diet, such as keeping a healthy weight, will help reduce your symptoms. You should also avoid:
- lying down after meals
- use tobacco products
- consume chocolate
- to drink alcohol
- consumption of caffeinated beverages
Certain foods can increase your chance of heartburn. These include:
- Carbonated drinks
- Citrus fruits
- Tomatoes
- Mint
- Fried foods
Avoiding these foods can help reduce the frequency of heartburn you experience.
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