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Heartburn
Description
Heartburn is a burning sensation in your chest and throat due to regurgitation of stomach acid. It is very common and almost everyone experiences it as some point in their lives. If reflux of stomach acid occurs more than twice a week, it is called GERD (gastroesophageal reflux disease). Stomach lining is protected from acid therefore it doesn’t cause inflammation but acid in the esophagus may cause damage and inflammation. Heartburn is also associated with a bitter or acidic taste in mouth. Despite the name, heartburn has nothing to do with the heart.
Causes
Heartburn is basically due to acid reflux from the stomach, it can happen when there is increased production of acid or abnormal activity of gastroesophageal sphincter (valve that stops acid from entering the esophagus). Some of the common causes of heartburn are:
- Diet: Most people complain about feeling heartburn after eating some specific food. Some foods that commonly cause heartburn include
Spices, high fat foods, citrus fruits, onion, coffee, and milk.
- Obesity: Fat patients have increased abdominal pressure, leading to acid reflux.
- Medicines: Aspirin, naproxen, and ibuprofen can cause heartburn.
- Smoking: Smoking causes decreased function of the sphincter that stops the stomach acid from entering the esophagus.
Risk factors
Certain factors may increase your risk of getting heartburn, some of them are:
- Increased weight
- Hiatus hernia
- Pregnancy
- Lying down after eating
- Eating large at meals late night.
Symptoms
Patients having heartburn may commonly experience:
- Burning sensation in chest and throat
- Acidic taste in mouth
- Worsening of pain on bending or lying down
- Bad breath
- Cough
- Hoarseness
- Tooth erosions.
Diagnosis
To reach a diagnosis, your doctor will ask for your complete medical history and perform a simple physical exam. Your doctor may ask you to get tested further for confirming the diagnosis. These tests include:
- X-ray of the esophagus and stomach.
- Endoscopy (procedure to look inside the body by entering a thin tube, directly)
- Acid monitoring may also be helpful in reaching a diagnosis
Management
The goal of management is to alleviate the symptoms of heartburn, it includes:
- Lifestyle modification:
To reduce the symptoms, you should avoid food that triggers heartburn, avoid eating large meals, avoid alcohol and smoking, reduce weight, avoid lying down after eating, and avoid late night meals.
- Heartburn medicines:
Antacids, proton-pump inhibitors, and Histamine H2 agonists are commonly used for the treatment of heartburn.
- Heartburn surgery:
Fundoplication is a surgery that wraps a part of stomach around the esophagus to make it work as a valve to stop acid reflux.
When to consult a doctor?
A doctor should be consulted if:
- There is no improvement even after taking the prescribed medication.
- The disease has progressed to the extent where there is severe inflammation in the food pipe, or difficulty swallowing (dysphagia)
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