What is Heartburn?
Heartburn, also known as acid indigestion is a burning sensation in the chest. The pain often rises in the chest and may radiate to the neck, throat, or angle of the jaw.
Have you ever felt an uncomfortable burning or pressure that starts in your upper chest and rises up to your throat? If you feel this type of sensation from time to time, you could be experiencing heartburn. An acidic of bitter taste in your mouth is another symptom that could mean you have heartburn.
Heartburn can be a transient problem (one that comes and goes) or it could be a symptom of a medical problem, such as hiatal hernia or gastroesophageal reflux disease (GERD).
WHAT CAUSES HEARTBURN?
When you eat, food passes from your mouth down a tube (about 10 inches long in most people) called the esophagus. To enter the stomach, the food must pass through an opening between the esophagus and stomach. This opening acts like a gate to allow food to pass into the stomach.
Usually, this opening closes as soon as food passes through. But if it doesn't close all the way, acid from your stomach can get through the opening and into your esophagus. This is called reflux. Stomach acid can irritate the esophagus and cause heartburn.
Common Causes of Heartburn include:
- Drinking alcohol or caffeine
- Being stressed
- Being over 50 years old
- Overeating or eating large meals
- Having more fat around abdomen
- Eating certain foods, such as those that are greasy, spicy or fatty
- Eating just before bedtime or lying down just after eating
- Over eating or eating large meals
- Taking certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids Pregnancy
Foods and drinks that may cause heartburn include alcohol, caffeine, chocolate, citrus fruits, garlic, fatty foods, mints, onions and spices such as chili curry.
Conditions That May Cause Heartburn Include The Following:
- Gastric outlet obstruction: Just as there is a one-way valve between the esophagus and the top of the stomach, there is another at the bottom of the stomach and the small intestine. This valve can get blocked, causing food to back-up into your stomach. .
- Obesity: People who are overweight have extra pressure on the stomach and diaphragm. This can push the food back up and cause acid to back-up in to esophagus. .
- Hiatal hernia: If you have hiatal hernia, a small part of your stomach comes up through an opening in your diaphragm, the muscle that helps you breathe. .
- Gastroparesis: Delays stomach emptying. It takes too long to your stomach to empty, some of the acid may back-up and cause heartburn. The delay can be caused by many things, including other conditions such as diabetes. Delayed stomach emptying is also a side effect of some medications. .
- Medications: Many medications cause heartburn as a side-effect, including, several acid blockers. These include: .
- Acid Blockers: Prevacid, Prilosec, Zantac, etc.
- Asthma inhalers (beclamethasone, flovent, etc.).
- Nonsteroidal anti-inflammatory medications (NSAIDs), such as aspirin, ibuprofen, and naproxen.
- Antianxiety medications, such as diazepam (Valium) and lorazepam (Ativan).
- Osteoporosis drugs such as alendronate (Fosamax).
- Stress: Stress is a small word with big health consequences. Stress can be the sole cause of heartburn, but often it is exacerbating other causes. Regardless, there are nutrients, herbs and therapies that will help you deal with your stress. .
- Smoking: Smoking also causes the lower esophageal sphincter to relax, leading to heartburn. .
- Peptic ulcer:
- Pregnancy: Pregnant women may have heartburn for two reasons: .
- The enlarging uterus can press on stomach and cause back-up of acid
- Hormones released during pregnancy can relax the valve between the esophagus and stomach, allowing acid to back-up
- Connective tissue disorders, such as scleroderma: These diseases or disorders can make it more difficult for the stomach, allowing acid to back-up food and can cause delayed stomach emptying. .
- Zollinger-Ellison syndrome: This is a rare disorder, but one of its complications is the excess amount of acid that is produced in the stomach.
What Are The Symptoms of Heartburn?
Usually, if you have heartburn, youíll know it. However, heartburn can sometimes be mistaken for something more serious, like a heart attack Ė especially women. If you are ever unsure about whether of not you are having heartburn or something else, you should contact your doctor right away.
Common Symptoms of heartburn include:
- Burning pain in the upper chest, behind the breast bone. The pain can be fleeting or can last quite a while. It can be made worse by bending over, lying down or even eating
- A sour, bitter taste in your mouth
Can Children Have Heartburn?
Children can also have heartburn and reflux (bringing the food and acid back up). If your child is experiencing frequently bringing up milk or food after feeding, it would be a good idea to mention this to your childís doctor.
Do not give heartburn medications to a child unless youíve been told to do so by your childís doctor.
How is Heartburn Diagnosed?
Most of the time, if thereís no reason to suspect otherwise, your doctor will make the diagnosis based on your symptoms, how often they occur, how long they last, what you were doing when they began and what helped to relieve them. Your medical history is also important in making the diagnosis.
Sometimes the doctor may want to do some tests to rule out anything more serious than heartburn. These tests could include:
- Barium swallow, also called an upper GI (gastrointestinal) series: you swallow barium as a liquid or very tiny pills, which can be seen by x-ray as it travels through your esophagus, stomach and upper intestines.
- Upper GI endoscopy: Your doctor insets a long tube through your mouth into your esophagus. There is a camera at the end of the tube that allows the doctor to inspect the lining.
- 24 hour pH monitoring: A catheter, a thin tube, is inserted into your nose and advanced to your nose and advanced to your esophagus. There is a probe at the end of the catheter that measures the amount of acid and the activity as you go about your day.
How Are Heartburn Symptoms prevented or managed?
Many times, heartburn can be reduced or relieved by making some changes in your lifestyle:
- Donít overeat at mealtime; consider eating four or five small meals throughout the day rather than three large ones.
- Donít lie down immediately after eating or go to bed within 3 hours of eating.
- Donít exercise immediately after eating.
- Avoid foods that appear to worsen your symptoms.
- Avoid wearing tight clothing especially around the waist
- Maintain a healthy weight
- Stop smoking.
- Limit your intake of caffeine and alcohol.
- If you frequently have symptoms at bedtime, raise the head of your bed.
Over-The Counter Medications
Antacids: Liquid or tablet forms are available and they work by neutralizing the acid. Some people prefer the liquid or quick-dissolving tablets because they may work faster.
Antacids are most effective when they are taken after meals since this is the time the stomach produces the most acid. Follow the dosage instructions on the packaging and be careful not to take them too often or at too high a dose, as they can cause diarrhea.
Be sure to check the ingredients if you are pregnant. Usually, pregnant women can use aluminum-magnesium or calcium antacids, but some antacids medications have not been approved to use in pregnancy.
Alginic acid and alginic-antacid combination products: These are usually chewable tablets that work by combining with saliva to create a foamy layer that floats on the surface of the stomach contents. When the stomach contents are regurgitated, the foamy layer acts as a barrier between the stomach contents and the esophagus.
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