Heartburn: What Does It Mean?

Heartburn is an awful burning sensation in your chest. The pain is often worse after eating, in the evening, or when lying down or bending. Heartburn, if it is occasional, is common and causes no harm, which can be managed with OTC drugs or home remedies. But if it occurs frequently and interferes with your daily routine, then it requires attention.

What causes heartburn?

There are various reasons for heartburn:

Heartburn can be a symptom of gastroesophageal reflux disease (GERD), a condition that occurs when acid or other contents in the stomach “back up” into the esophagus (a tube that carries food from mouth to stomach). A muscle called the lower esophageal sphincter (LES) guides the food between the stomach and esophagus. Once the food is in the stomach, LES prevents it from refluxing back into the esophagus. But if the LES relaxes abnormally or weakens, stomach acid can flow back into the esophagus and cause heartburn.

What are the Risk Factors of GERD?

  1. Increased production of acid in the stomach, and structural problems, allowing acid reflux into the esophagus.

  2. Certain foods stimulate increased stomach acid secretion that leads to heartburn. Examples of such foods include spicy foods, onions, citrus foods, fried foods, alcohol or carbonated beverages, large or fatty meals.

  3. Pregnancy and obesity increase the pressure in the abdomen and thus reflux in the same way.

  4. Certain OTC medications precipitate heartburn-aspirin, ibuprofen, naproxen.

  5. Certain diseases like scleroderma and sarcoidosis present with heartburn as a symptom.

Want to know if it’s heartburn or your heart?

To figure out if it’s just heartburn from GERD which by itself is rarely life-threatening, pay attention to any other symptoms like sudden, excess sweating, irregular heartbeat, shortness of breath, etc. in case these symptoms are present, the underlying heart-related condition can be suspected.

Are Heartburn and Acidity the same?

Acid reflux is a common condition that can range in severity from mild to serious. GERD is a chronic, more severe form of acid reflux. Heartburn is a symptom of acid reflux and GERD.

What happens if heartburn is ignored?

Recurrent irritation and inflammation of the esophagus can lead to ulcers, which indicates tissue breakdown. This can cause severe bleeding. Changes in the cell lining of the esophagus cause a condition called Barrett’s esophagus, which is associated with an increased risk of esophageal cancer.

Diagnosis

Heartburn is a common complaint that can be confused with other chest-related conditions like pulmonary embolus, pneumonia, chest wall pain. After taking details of the patient history and performing a physical examination, the doctors might recommend-

X-ray-to determine if the esophagus is working properly in a rhythmic fashion to push the food into the stomach

Endoscopy-determines inflammation and ulcers in the stomach and esophageal lining.

Manometry and pH testing-when conventional therapy has failed to confirm the diagnosis, and when the symptoms are atypical, these tests might help in diagnosing the underlying condition.

Can heartburn be treated?

Of course yes, by making simple lifestyle changes.

  1. Eating smaller, more frequent meals

  2. Avoiding eating before bedtime

  3. Avoiding alcohol, caffeine, overuse of OTC medications like aspirin, ibuprofen, and caffeine

  4. Quit smoking

  5. Elevate the head of the bed or use more pillows to allow gravity to keep acid in the stomach and avoid acid reflux.

 Medications – Antacids are usually prescribed to treat heartburn-these bind excess acids in the stomach and coat the esophagus. Medications that block histamine (a chemical that stimulates stomach cells to produce acid) such as cimetidine, ranitidine are prescribed.

Proton pump inhibitors – Another class of drugs that block acid production in the stomach help in treating heartburn.examples- Omeprazole, rabeprazole, pantoprazole.

Surgery – This option is considered for the patients with Barrett’s syndrome; severe reflux that causes pneumonia, wheezing, or hoarseness.

Source

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