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Heartburn

Overview

Heartburn can be explained as a particular burning sensation in the chest and upper abdomen. It is a common issue, affecting approximately 20 to 30% of the US population. This problem also becomes frequent as you age. Heartburn occurs when the acid in your stomach gets backed up in the esophagus, responsible for transferring food from your mouth to your stomach.

You experience this burning sensation when the stomach acid starts leaking up into the esophagus through a flaw in a valve known as the lower esophageal sphincter (LES). This valve is responsible for connecting the esophagus and the stomach. So in case, the LES doesn't close properly or gets weakened, this stomach acid might flow back into the esophagus, causing a burning feeling.

Causes

Heartburn causes vary from person to person. In some people, it develops physiologically, while in some other people, the use of certain foods, drinks, and lifestyle habits lead them to face this problem. Following are some of the causes for heartburn:

Overeating

It is one of the leading causes of heartburn. You should avoid overeating and take smaller meals at intervals throughout the day. Also, never develop a habit of having late-night snacks.

Smoking

Smoking is not only harmful to your lungs; it is also a cause of heartburn. 

Sleeping on Your Right Side

Some research proves that sleeping on your right side could aggravate acid reflux. So if you try to sleep on your left side or raise the head of your bed, you could save yourself from heartburn.

Stress

Stress is not individually responsible for harmful acid production. However, it plays a significant role in disturbing or slowing down the digestive process. This, as a result, increases your sensitivity to acid and leaves you to suffer from the pain caused by heartburn.

Food Triggers

The kind of heartburn is different in each person. Foods that cause heartburn include:

    • Spicy and fried food
    • Chocolate
    • Caffeine
    • Soft drinks
    • Alcohol
    • Coffee
    • Ketchup and mustard
    • Vinegar
    • Tomato and citrus juices
    • Mints
    • Some fruits and juices with acidic nature

Tight Clothes

Wearing tight fitted belts and clothing may put extra pressure on your stomach. So it might cause you to experience heartburn.

Risk Factors and Epidemiology

A risk factor makes the chances of getting a disease or condition higher. Following are some of the risk factors of heartburn:

  • Obesity

Being overweight is a significant risk factor for developing the issue of heartburn. It happens due to some extra which exerts pressure on the stomach. And this load, in turn, causes stomach acid to travel back up your esophagus.

  • Pregnancy

Heartburn is a common issue noticed in pregnant women. During pregnancy, specific bodily changes could lead to the point of heartburn. The growing weight of the fetus results in increased pressure on the stomach, leading stomach contents and acid to go up the esophagus.

  • Genetic Factors

Some research studies have suggested that there is an inherited risk for heartburn. It happens due to inherited muscular or structural problems in the esophagus or stomach.

  • Lower Esophageal Sphincter (LES) Dysfunction

It is also a significant risk factor. It takes place when the lower esophageal sphincter gets weak or loses tone. So the LES could not close properly after food passed into the stomach. In this condition, the stomach acid could back up into the esophagus.

Signs and Symptoms

When you suffer from heartburn, you may also feel the following symptoms:

  • A burning sensation in your chest continues from a few minutes to a couple of hours.
  • Pain in your chest while trying to bend over or lay down.
  • A burning feeling in your throat.
  • A hot, sour, acidic, or salty taste in the back of your throat.
  • Difficulty in swallowing.

Diagnosis

The diagnosis exactly whether your heartburn is a symptom of GERD, your doctor may recommend:

  • X-ray to examine the shape of the esophagus and stomach.
  • Endoscopy to examine your esophagus for any abnormalities. For analysis, a tissue sample (biopsy) may be collected.
  • Ambulatory Acid Probe Tests determine when and how long your stomach acid backs up into your esophagus. It usually involves a tiny computer you wear around your waist or a strap over your shoulder connected to an acid monitor inserted in your esophagus.
  • Esophageal Motility Testing to calculate pressure and movement in the esophagus.

Differential Diagnosis

Heartburn is often associated or misinterpreted as GERD, but it could be the most common symptom of this condition. Besides, GERD is the most common cause of heartburn, but several other disorders contribute to heartburn. It is also linked with

  • Dyspepsia
  • H. Pylori Infection
  • Esophagitis

Treatment

Your doctor may recommend antacids if you have occasional heartburn. More potent drugs, such as H2 blockers and proton pump inhibitors, may be required in some cases, especially if symptoms continue. There are prescription and over-the-counter options. Surgery is only advised in rare instances to avoid reflux and heartburn. The main goal of treatment is to figure out what's causing your heartburn so you can prevent it in the future.

Heartburn that occurs only occasionally or is moderate can typically be avoided by making a few lifestyle modifications. A variety of foods can cause acid reflux and heartburn. Keep a close eye on how you feel after consuming various things. Take precautions to avoid specific foods if you have acid reflux or heartburn after eating them.

Medications

Certain over-the-counter and prescription medications are available that help relieves heartburn. These fall into these categories:

 Antacids: Antacids are medications that help neutralize the acid in the stomach. Antacids can help you feel better quickly. However, they can’t heal an esophagus that has been injured by stomach acid. They contain ingredients like calcium, magnesium, aluminum, and sodium bicarbonate which act as alkalis (bases).

  • H-2-Receptor Antagonists (H2RAs): They can help to lower gastric acid. H2RAs don't work as rapidly as antacids, but they may last longer, such as cimetidine, famotidine, nizatidine, and ranitidine
  • Proton Pump Inhibitors (PPIs): They help to reduce gastric acid. They include Omeprazole and lansoprazole.

Antacids, proton pump inhibitors (PPIs), and H2 blockers are all medicines that can help with heartburn symptoms. It's essential to remember that PPIs work better than H2 blockers to heal the esophageal lining and treat symptoms. Furthermore, H2 blockers can cause various side effects, including diarrhea, constipation, stomach distress, and headaches.

Prevention

There are several ways to prevent and avoid heartburn with lifestyle changes.

  • Take more minor, more frequent meals
  • Do not eat before bedtime
  •  Be careful to take alcohol, aspirin, ibuprofen, and caffeine
  • Avoid smoking and consuming alcohol
  • Maintain a healthy weight
  • Avoid wearing tight-fitting clothes
  • Elevate the head of the bed to enable gravity to hold acid in the stomach.

Bringing changes to lifestyle and behavior can help you prevent or improve heartburn symptoms rapidly. Staying away from acidic foods and drinks also prevents developing this disorder.

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