Heartburn is a condition that almost all people have heard of and one that most people have experienced at least once. It is typically characterized as a burning sensation in the upper abdomen, below the breast bone.
Although the symptoms can seem similar to a heart attack and the name includes the word heart, the condition has nothing to do with one’s heart. It is actually an irritation of the esophagus due to stomach acid.
The lower esophageal sphincter (LES) sits at the bottom of the esophagus, right at the top of the stomach. It is designed to open to allow food to pass through into the stomach and to close to keep stomach acid down.
When the LES does not function properly, such as opening too often or failing to close tightly, stomach acid can travel back up into the esophagus and cause the burning sensation attributed to heartburn.
The American College of Gastroenterology estimates that 15 million Americans experience heartburn.
People can suffer from occasional heartburn, which is not typically dangerous or chronic heartburn, sometimes known as acid reflux, which could be problematic and lead to serious health issues.
Chronic heartburn can lead to numerous other health ailments, including:
- Esophagitis, a condition where the lining of the esophagus becomes inflamed
- Gastroesophageal reflux disease (GERD)
- Gastritis, a condition where the stomach lining is inflamed
- Hiatal hernia
Heartburn is caused when the lower esophageal sphincter does not function properly. However, there are many reasons that can cause the LES to stop working. The main two reasons are if there is too much food in the stomach or too much pressure of the stomach.
An excess of food in the stomach is most often due to overeating. Too much pressure on the stomach can be caused by conditions such as obesity, pregnancy and constipation. Heartburn is actually a very common symptom of pregnancy.
In addition, there are a variety of other conditions that can cause heartburn in an individual. Each person will have different triggers for heartburn so it is important to understand one’s unique triggers. While the causes of heartburn listed below include the majority of causes, each will affect an individual differently.
One of the most common causes of heartburn is eating or drinking certain foods and beverages that are known for being heartburn triggers. The most common trigger foods and beverages include:
- Overly fatty foods
Another cause of heartburn for many individuals is certain medications one may be taking. Certain medications, such as aspirin, sedatives and high blood pressure medications can all have heartburn as a potential side effect. If one believes medication is the reason behind their heartburn, it is important to discuss with a physician the possibility of changing to a different medication.
Other causes of heartburn include:
- Stress, which can increase the severity of heartburn and the production of acid
- Lack of sleep, such also increases the production of acid
- Lying down after a meal
Certain medical conditions can cause heartburn as well, including:
- Hiatal hernia, a condition where the stomach is pushed above the diaphragm and into the chest
Symptoms of Heartburn
The symptom most often associated with heartburn is a burning sensation in the lower chest. Other symptoms can include an acidic taste in one’s mouth as well as pain in the chest area.
Symptoms of heartburn can mimic that of a heart attack. The following symptoms are red flags for a serious medical condition. If one is experiencing heartburn with any of the below symptoms, seek medical attention immediately.
- Trouble swallowing
- Vomiting blood
- Shortness of breath
- Dizzy / Lightheadedness
- Bloody stools
- Pain going into one’s neck, shoulders or back
- Sweating combined with a pain in the chest
- Heartburn occurring 3 or more times per week for 2 weeks or more
Diagnosis of Heartburn
A physician can usually diagnose heartburn based on the patients symptoms, combined with a medical history and physical exam. However, in some cases testing may be required. These testing include:
- X-ray, to check to ulcers
- pH test, to test for acid in the esophagus
- Endoscopy, to check for irritation in the esophagus
- Testing to check for pylori, a bacteria that causes ulcers
Treatment for Heartburn
The first line of treatment for heartburn is to make lifestyle changes. Oftentimes, these changes will relieve heartburn symptoms and prevent future occurrences, therefore eliminating the need for further intervention. The most common lifestyle changes that are recommended include:
- Raising the head of the bed 6 inches
- Not lying down for 3 hours after eating
- Quitting smoking
- Losing weight in overweight or obese
- Eating small meals, slower
- Avoiding tight fitting clothes
- Avoiding foods and beverages that trigger heartburn
If these changes do not work, there are a number of medications that can be used to treat heartburn. The most common medications are antacids, H2 blockers, proton pump inhibitors, foaming agents and prokinetics.
There are also a number of natural remedies for treating heartburn.
For most people, heartburn occurs infrequently and does not pose a dangerous health risk. However, for others it is more prevalent and can become dangerous. If one is experiencing any of the symptoms or believes they have heartburn, one should seek the medical advice of a professional. The information provided here is meant to be informative and does not constitute medical advice. One should never begin a treatment or medication without first discussing it with a physician if pregnant or breastfeeding.