What Is Heartburn?
Heartburn is
an irritation of the esophagus --
the tube that connects your throat and stomach.
It's caused by stomach acid. This leads to a burning discomfort in your upper
belly or below your breastbone.
Despite its name, heartburn has nothing to do with the heart. But some of
the symptoms are similar to those of a heart
attack or heart disease.
Heartburn Symptoms
Heartburn feels
just like its name: a burning sensation behind your sternum, or breastbone, in
the middle of your chest. You might also feel it in your throat. You may also:
Feel pain in your
chest when you bend over or lie down
Have a hot, acidic, bitter, or salty taste in the back of
your throat
Find it hard to swallow
How long does heartburn last?
It can vary. For some folks, it can last just a few minutes.
Sometimes it can last for several hours.
Heartburn happens about once a week for up to 20% of
Americans and is common in pregnant women.
Heartburn Causes and Risk Factors
Heartburn
symptoms can start up because of a problem with a muscular valve
called the lower esophageal sphincter (LES). It's located where the esophagus
meets the stomach --
below the rib cage and slightly left of center.
Normally, with the help of gravity, the LES keeps stomach
acid right where it should be -- in your stomach. When it's working right, the
LES opens to allow food into your stomach or to let you belch, then closes
again. But if the LES opens too often or doesn't close tightly enough, stomach
acid can seep into the esophagus and cause a burning sensation.
If your LES doesn't tighten as it should, there are often two
things that contribute to the problem. One is overeating, which puts too much
food in your stomach. Another is too much pressure on your stomach, often due
to obesity,
pregnancy, or constipation.
Certain foods can relax your LES or increase stomach acid,
including:
Tomatoes
Citrus fruits
Garlic and onions
Chocolate
Coffee or
caffeinated products
Alcohol
Peppermint
Meals high in fats
and oils (animal or vegetable) often lead to heartburn, as do
certain medications. Stress and
lack of sleep can
raise how much acid your stomach makes and can cause
heartburn.
If you're pregnant, the hormone progesterone can relax your
LES and lead to heartburn. Smoking also
relaxes the LES and increases stomach acid.
Heartburn Diagnosis
If your heartburn goes on for a long time, it may be a sign
of a more serious condition known as gastroesophageal reflux disease (GERD).
Your doctor may be able to tell if GERD is the cause of your heartburn from
your symptoms. But to tell how serious it is, they may do several tests,
including:
X-ray: You’ll drink a solution called a barium
suspension that coats the lining of your upper GI (gastrointestinal)
tract -- your esophagus, stomach, and upper small intestine. This coating lets
doctors see defects that could mean a problem in your digestive
system.
Endoscopy: A
small camera on a flexible tube is put down your throat to give a view of your
upper GI tract.
Ambulatory acid probe test (esophageal pH monitoring): An
acid monitor is put into your esophagus and connected to a small computer that
you can wear on a belt or shoulder strap.
It measures when stomach acid backs up into your esophagus and for how long.
Esophageal motility testing (esophageal manometry): A
catheter is put into your esophagus and measures pressure and movement.
Heartburn Treatment
Usually, you can treat heartburn with over-the-counter
medicines, including:
Antacids: These medications lessen the acid in your
stomach to ease heartburn pain. They can also sometimes help with stomach
pains, indigestion,
and gas.
Acid blockers and proton pump inhibitors: These drugs
lessen the amount of acid your stomach makes. They can also calm symptoms of
acid indigestion.
If OTC medicines don’t work for you, your doctor may give you
a prescription version of these types of medicines.
Heartburn Complications
Occasional heartburn isn't dangerous. But GERD can sometimes
lead to serious problems, such as:
A long-term cough
Laryngitis
Inflammation or ulcers of
the esophagus
Problems swallowing because of a narrow esophagus
Barrett's
esophagus, a condition that can make it more likely to get esophageal cancer
