HEARTBURN
Heartburn is a painful burning sensation in the chest, just behind the sternum (breastbone).
- Heartburn is often accompanied with a bitter taste in the mouth or throat.
- The burning may get worse by lying flat, on the right side or after eating a large meal.
- Occasional heartburn is common and often requires no cause for alarm.
- Frequent heartburn that occurs like several times in a week or that interferes with daily routine may be a symptom of a more serious and chronic condition like a heart attack or GERD (Gastroesophageal reflux disease).
- Approximately 17% to 45% of women who become pregnant will suffer from heartburn.
- If neglected over a long period of time it may lead to some serious conditions such as esophageal cancer and Barrett’s esophagus
CAUSES
Heartburn is caused when stomach acid refluxes (flows back) into the tube that connects and carries food from the mouth to the stomach (esophagus). When food is swallowed, a band of muscle located at the junction of the esophagus and stomach, called the lower esophageal sphincter relaxes to push food and fluid towards the stomach in rhythmic waves. After which the muscle tightens. In a case where the lower esophageal sphincter relaxes abnormally or weakens, digestive juices and stomach acid can reflux (flow back) into the esophagus and cause a heartburn.
Some factors that trigger heartburn include:
- Alcohol
- Caffeine
- Aspirin
- Acidic foods such as tomatoes, oranges, pineapple
- Primary diseases of the esophagus
- Obesity
- Pregnancy
- Smoking
- Consumption of high-fat contents
- Spicy foods
- Onions
- Chocolate
SIGN AND SYMPTOMS
A burning sensation in the chest that usually occurs after eating.
A burning sensation in the chest that occurs at night.
Acidic or bitter taste in the mouth or throat.
Pain that worsens when lying down or leaning forward.
Some other symptoms that may accompany heartburn includes:
Difficulty swallowing
A persistent sore throat
A chronic cough
Persistent hoarseness
Stomach pain
If the symptom is accompanied by shortness of breath, pain in the arm or neck and dizziness, seek the attention of your healthcare provider.
DIAGNOSIS AND TREATMENT
DIAGNOSIS
To make a preliminary diagnosis of heartburn, your health care provider may require a thorough medical history and physical examination. To check for damages and the severity of your heartburn, further testing may be required:
- Endoscopy, to examine for abnormalities in your esophagus and stomach.
- X-ray, to see the condition and shape of the stomach and esophagus.
- Esophageal motility testing, to evaluate movement and pressure in the esophagus
- Ambulatory pH testing, to measure and identify when and how long stomach acid refluxes into the esophagus.
TREATMENT
Heartburn can be treated with medications and lifestyle changes. In cases of severe and chronic heartburn e.g. GERD, surgical procedures may be required.
Several lifestyle changes may help in treating and avoiding heartburn.
- Food control such as eating smaller and more frequent meals, avoiding late night eating.
- Weight loss
- Quit smoking
- Avoiding aspirin, ibuprofen, and caffeine
- Elevating the head of the bed to allow avoid acid reflux.
There are many medications available in treating heartburn, they are:
- Antacids provide great relief by neutralizing stomach acid.
- H-2 blockers reduce the production of acids. They relief symptoms faster than antacids.
- Proton Pump Inhibitor blocks acid production and allows healing of the esophagus.
Surgical procedures are usually only chosen if:
- Lifestyle changes and medications do not help.
- Reflux is so severe that it causes pneumonia or hoarseness
- Heartburn has resulted in a more chronic and severe condition such as Barrett’s esophagus
Fundoplication is the standard surgical procedure. In this procedure, the upper part of the stomach is wrapped around the lower esophagus to strengthen the sphincter and prevent acid reflux.