Introduction
Heartburn, also known as acid reflux, is a common condition characterized by a burning sensation in the chest, often rising up towards the throat. It occurs when stomach acid flows back into the esophagus, the tube that carries food from the mouth to the stomach. Frequent or persistent heartburn can be a symptom of gastroesophageal reflux disease (GERD), a chronic digestive disorder.
Causes
Heartburn and GERD are caused by the backflow of stomach acid into the esophagus. This can happen when the lower esophageal sphincter (LES), a muscular ring that normally prevents stomach contents from flowing back up, weakens or relaxes inappropriately. Factors that can contribute to heartburn and GERD include:
- Hiatal hernia (when part of the stomach protrudes into the chest cavity)
- Obesity
- Pregnancy
- Smoking
- Certain foods and beverages (such as fatty or fried foods, chocolate, caffeine, alcohol, and peppermint)
- Certain medications (such as NSAIDs, aspirin, and some blood pressure medications)
- Lying down soon after eating
Symptoms
Symptoms of heartburn and GERD can include:
- A burning sensation in the chest, often after eating or at night
- Regurgitation of food or sour liquid
- Difficulty swallowing (dysphagia)
- Chronic cough
- Sore throat
- Hoarseness
- Feeling like there’s a lump in your throat
Diagnosis
Diagnosis of heartburn and GERD is usually based on symptoms. If symptoms are frequent or severe, a healthcare provider may recommend:
- Upper endoscopy (EGD) to examine the esophagus and stomach
- Esophageal pH monitoring to measure the amount of acid in the esophagus
- Esophageal manometry to assess the function of the esophagus muscles
Treatment Options
Treatment for heartburn and GERD focuses on reducing acid production and protecting the esophagus:
- Lifestyle modifications:
- Elevating the head of the bed
- Avoiding trigger foods and beverages
- Eating smaller, more frequent meals
- Not lying down for at least 2-3 hours after eating
- Quitting smoking
- Losing weight if overweight or obese
- Over-the-counter medications:
- Antacids to neutralize stomach acid
- H2 blockers to reduce acid production
- Prescription medications:
- Proton pump inhibitors (PPIs) to block acid production
- Prokinetics to speed up gastric emptying
- Surgery:
- In severe cases, surgery to strengthen the LES may be considered
Prevention
Preventing heartburn and GERD involves lifestyle and dietary changes:
- Maintain a healthy weight
- Avoid trigger foods and beverages
- Eat smaller, more frequent meals
- Don’t lie down soon after eating
- Elevate the head of the bed
- Quit smoking
When to Seek Medical Care
Seek medical attention if you experience:
- Frequent or severe heartburn that does not improve with over-the-counter medications
- Difficulty swallowing
- Unexplained weight loss
- Vomiting blood or passing black, tarry stools
- Chest pain, especially if accompanied by shortness of breath or dizziness
Takeaway
Heartburn and GERD are common conditions caused by acid reflux. Lifestyle changes and medications can help manage symptoms and prevent complications. If symptoms are severe or persistent, seek medical care.