What is Heartburn?

This common symptom has nothing to do with the heart

Double decker turkey sandwich
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Despite the name, heartburn has nothing to do with the heart. It's a digestive problem that occurs when stomach acid comes into contact with the lining of the esophagus, causing irritation.

Most people experience heartburn occasionally, often after a large or spicy meal. It begins as a burning sensation in the upper abdomen behind the breastbone. The pain may travel from the diaphragm to the back of the throat and is often accompanied by a sour taste in the mouth.

 

If you have heartburn once a month, it's considered mild. If you have heartburn once a week, it's moderate. It's when your heartburn occurs daily that it's considered to be severe. Since chronic heartburn is a symptom of an underlying digestive disorder, the course of treatment will vary. But there is relief available if you're one of the many people who have frequent heartburn. 

What Causes Heartburn?

Gastroesophageal Reflux Disease (GERD) is the main cause for the symptom of heartburn. It's caused when stomach acid refluxes (or backs up) into the esophagus, which produces the burning sensation of heartburn. Here are a few of the underlying causes of heartburn:

  • When the lower esophageal sphincter (LES), the valve that keeps stomach acid in the stomach, is weakened or relaxed and doesn't do its job properly. This is the most common symptom of GERD.
  • Certain foods, such as chocolate, fried and fatty foods, peppermint, coffee, alcohol, and sugars can weaken or relax the LES.
  • Eating large meals or eating shortly before bedtime, smoking, and stress are all known triggers for heartburn.
  • hiatal hernia, which occurs when the upper part of the stomach, known as the esophageal or diaphragmatic hiatus, pushes through an opening in the diaphragm and up into the chest. 
  • Pressure on the stomach, including frequent bending over, tight clothes, lifting, and obesity are also known to cause heartburn symptoms.
  • Certain medications can cause heartburn symptoms as well, including some anti-anxiety medications, narcotics, steroids, antibiotics, and even aspirin. 

How Serious is Heartburn?

If you suffer from mild heartburn, it tends to be more of a nuisance than a condition that can cause any serious complications. But chronic heartburn, which includes episodes that occur several times a week or several times a day, can lead to complications if left untreated.

Chronic heartburn can cause scarring of the esophagus, which narrows the esophagus and makes it difficult to swallow. It can also lead to Barrett's esophagus, a condition where cells similar to those of the stomach lining develop in the lower esophagus. This severe damage to the esophagus increases your risk of developing cancer of the esophagus

For most people who develop chronic heartburn, it's the first sign of a larger problem. If you find your heartburn persisting more frequently than a few times a week, it's probably a good idea to contact your healthcare provider. There's no reason to suffer unnecessarily, and there are several good prescription medications that can make heartburn tolerable and reduce its effects. 

Managing Your Mild Heartburn

If you're dealing with mild or moderate heartburn, you may be able to make some diet and lifestyle changes to keep it from recurring.

About 20 percent of all adults will experience symptoms of heartburn at least once a month.

Here are a few suggestions to keep mild or moderate heartburn under control

  • Eat frequent smaller meals instead of three larger ones
    This will help prevent excessive production of stomach acid.
  • Eat slowly
    One way to help you slow down while eating is to put your fork or spoon down between bites.
  • Don't go to bed with a full stomach
    Stay up at least three hours after eating your last meal or large snack before going to bed. This gives acid levels a chance to decrease before your body is in a position where heartburn is more likely to occur.
  • Raise the head of your bed several inches
    Having your head elevated will help prevent reflux during the night.
  • Avoid heartburn triggers
    Examples of foods and beverages that can trigger heartburn are coffee (including decaf), alcohol, fatty foods, caffeinated beverages and foods, onions, peppermint, chocolate, citrus fruits or juices, and tomatoes. If you aren't sure what your heartburn triggers are, keep a food diary for a week or two and see when you're most likely to have heartburn. 
  • Stop smoking
    Nicotine can weaken the lower esophageal sphincter, the muscle that controls the opening between the esophagus and stomach and prevents the acid-containing contents of the stomach from entering the esophagus.
  • Wear loose-fitting clothes
    Tight clothing squeezes the midsection and tends to push stomach contents upward.
  • Lose weight
    There are plenty of health-related reasons to try to shed a few pounds, and losing weight can help relieve your heartburn symptoms.
  • Chew gum
    As funny as this might sound, chewing gum can provide short-term heartburn relief by stimulating the production of saliva, which dilutes and flushes out stomach acid.
  • Drink warm liquids
    Drinking a glass of lukewarm water or herbal tea after a meal can dilute and flush out stomach acid.

Sources:

Herbella, F., and Patti, M., "Gastroesophageal reflux disease: From pathophysiology to treatment." World Journal of Gastroenterology,  Aug. 2010; 16(30): 3745–3749

Badillo, R., Francis, D., "Diagnosis and treatment of gastroesophageal reflux disease." Journal of Gastrointestinal Pharmacology and Therapeutics,  Aug. 2014; 5(3): 105–112.

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