Heartburn
Whenever you eat spicy food or you eat too much food, you may experience heartburn or acidity. It is a burning sensation in the chest that may occur with a bitter taste in your mouth or throat. The pain is often worse after eating a large meal in the evening, or while lying down, or bending over. Usually, heartburn can be managed through home remedies or over-the-counter medications. However, if heartburn is more frequent and symptoms are disturbing your daily life, it may require more advanced medical care.
What are the Symptoms of Heartburn?
It can include:
- A burning sensation or pain in the chest
- Pain that worsens when bending over or lying down
- Bitter taste of acid in the mouth
What are the Causes of Heartburn?
Heartburn occurs when the contents from the stomach flow back into the esophagus (food pipe). The esophagus connects to the stomach at a juncture called cardiac or lower esophageal sphincter. Normally, this sphincter muscle closes when the food leaves the esophagus and enters the stomach. However, in some people, this sphincter doesn’t function properly. It leads to leaking of the contents from the stomach back into the esophagus (acid reflux). The term reflux means that fluid is flowing in an abnormal direction (so, upwards instead of downwards inside the esophagus). Stomach acids irritate the esophagus and cause pain and a burning sensation, which is called heartburn. Around 20% of Americans experience heartburn at least once every week and it is more common among pregnant women.
When to see a Doctor?
You should see a doctor if any of the following apply to you:
- Symptoms occur even after using over-the-counter medications
- Heartburn happens more than twice a week
- You experience nausea and vomiting
- You have progressive difficulty swallowing
- Have poor appetite and difficulty eating
- If any of these symptoms are leading to illness and weight loss
What are the Complications of Heartburn?
If you are frequently experiencing heartburn and it is interfering with your daily routine, then it can be due to Gastroesophageal Reflux Disease or GERD. GERD may also cause changes in the lining of the esophagus that can increase the risk of esophageal cancer (Barrett’s Esophagus changes). GERD treatment can include prescription medications, surgery, or other procedures.
How is Heartburn Diagnosed?
If your heartburn is frequent, your doctor may recommend:
- X-rays with barium
- Endoscopy
- Ambulatory acid probe test
- Esophageal motility testing
What are the Differences and Similarities Between Heartburn and Gastroesophageal Reflux Disease (GERD)?
Heartburn is a common health condition that can range from mild to severe. Heartburn can progress to a more severe and chronic condition called GERD. GERD is diagnosed when acid reflux or heartburn happens more than twice a week or causes inflammation in the esophagus. Symptoms of GERD may not be relieved from over-the-counter medications. Symptoms of GERD may include:
- Chest pain
- Awakening at night with a choking sensation
- Bad breath
- Frequent Heartburn
- Dry cough
- Difficulty swallowing
- Frequent throat clearing
- Regurgitation of sour liquid or food
- Wheezing
What is the Treatment for Heartburn?
Medications for heartburn may include:
Antacids
Provide quick relief by neutralizing stomach acids but cannot heal the damaged esophagus.
H2-Receptor Antagonists
Help to reduce stomach acids and to provide more long-term relief.
Proton Pump Inhibitors
Help to reduce stomach acids
If you have occasional heartburn, lifestyle changes like losing excess weight, eating smaller meals, and avoiding spicy food, alcohol, and caffeine can really help. However, symptoms of GERD are more severe and may hamper your daily life. Medications for GERD aim to reduce acid production in the stomach. But, they may not be effective in every person. Some people may require surgery to get relief from GERD. The most common surgery performed to resolve or improve GERD is a fundoplication procedure. This procedure creates a wrap with the upper stomach around the lower esophagus to strengthen and recreate the lower esophageal sphincter. This is done laparoscopically, through small incisions and can dramatically improve a person’s life.