Heartburn: Symptoms, Causes, Treatment

What are the symptoms of heartburn?

Heartburn, also known as acid reflux, is a common condition in which stomach acid flows back up into the esophagus, causing a burning sensation in the chest and throat. The symptoms of heartburn can vary in severity and frequency, but common symptoms include:

1. Burning sensation in the chest: A sharp, burning pain or discomfort in the chest area that can radiate to the arms, back, or jaw.
2. Pain in the throat: A sore or burning sensation in the throat, often accompanied by a sensation of food or liquid sticking in the throat.
3. Regurgitation of food: Feeling like food is coming back up into the mouth, often accompanied by a sour or bitter taste.
4. Bitter or acidic taste: A sour or acidic taste in the mouth, often accompanied by a feeling of discomfort or burning.
5. Coughing: Coughing can be a symptom of heartburn, especially if the acid that flows up from the stomach irritates the vocal cords.
6. Sour or bitter burps: Burping up sour or bitter-tasting air can be a sign of heartburn.
7. Difficulty swallowing: Difficulty swallowing food or liquids due to inflammation and irritation of the esophagus.
8. Hoarseness: Hoarseness or a hoarse voice can be a symptom of heartburn, especially if the acid that flows up from the stomach irritates the vocal cords.
9. Chest discomfort: Discomfort or pain in the chest area that may be described as pressure, tightness, or heaviness.
10. Nausea and vomiting: In some cases, heartburn can cause nausea and vomiting, especially if the acid that flows up from the stomach irritates the stomach lining.

If you experience any of these symptoms frequently or severely, it’s essential to consult with a healthcare provider to rule out other underlying conditions and develop an appropriate treatment plan.

What are the causes of heartburn?

Heartburn, also known as acid reflux, is a common condition in which stomach acid flows back up into the esophagus, causing a burning sensation in the chest and throat. There are several factors that can contribute to heartburn, including:

1. Overeating: Eating large or heavy meals can put pressure on the lower esophageal sphincter (LES), causing it to relax and allow stomach acid to flow back up into the esophagus.
2. Eating habits: Eating too quickly, not chewing food thoroughly, or eating large amounts of fatty or spicy foods can increase the risk of heartburn.
3. Lying down after eating: Lying down or bending over after eating can cause stomach acid to flow back up into the esophagus, increasing the risk of heartburn.
4. Weight gain: Being overweight or obese can increase the risk of heartburn, as excess weight can put pressure on the LES and cause it to relax.
5. Pregnancy: Hormonal changes during pregnancy can relax the LES, increasing the risk of heartburn.
6. Aging: As people age, the LES becomes less effective at keeping stomach acid from flowing back up into the esophagus, increasing the risk of heartburn.
7. Eating trigger foods: Certain foods and drinks, such as citrus fruits, tomatoes, chocolate, coffee, tea, and spicy or fatty foods, can trigger heartburn in some people.
8. Smoking: Smoking can weaken the LES and increase the risk of heartburn.
9. Hiatal hernia: A hiatal hernia is a condition in which part of the stomach bulges up into the chest cavity through an opening in the diaphragm. This can increase the risk of heartburn.
10. Stress: Stress can relax the LES and increase the risk of heartburn.
11. Certain medications: Certain medications, such as antihistamines, painkillers, and antidepressants, can relax the LES and increase the risk of heartburn.
12. Sleep position: Sleeping with your head elevated or using extra pillows can increase the risk of heartburn by allowing stomach acid to flow back up into the esophagus.

If you experience frequent or severe symptoms of heartburn, it’s essential to consult with a healthcare provider to rule out any underlying conditions and develop an appropriate treatment plan.

How is the diagnosis of heartburn made?

The diagnosis of heartburn, also known as acid reflux, is typically made based on a combination of medical history, physical examination, and diagnostic tests. Here are some of the common methods used to diagnose heartburn:

Medical history: Your doctor will ask you questions about your symptoms, such as when they occur, how often they occur, and any factors that trigger or relieve them.

Physical examination: Your doctor will perform a physical examination to look for signs of heartburn, such as inflammation or irritation of the throat and esophagus.

Symptom questionnaire: Your doctor may ask you to complete a symptom questionnaire to help identify the frequency and severity of your symptoms.

Endoscopy: An endoscopy is a procedure in which a flexible tube with a camera is inserted through your mouth and into your esophagus to visualize the inside of your esophagus and stomach.

Barium swallow: A barium swallow is a test in which you drink a liquid containing barium sulfate, which coats the lining of your esophagus and allows it to be visible on an X-ray.

Ambulatory acid probe test: This test involves inserting a small probe into your esophagus to measure the pH levels in your esophagus and track the flow of stomach acid back up into your esophagus.

24-hour pH monitoring: This test involves wearing a small device on your chest that measures the pH levels in your esophagus over a 24-hour period.

Manometry: Manometry is a test that measures the pressure and movement of muscles in the esophagus to determine if there are any abnormalities that may be contributing to heartburn.

Upper GI series: This test involves drinking a liquid containing barium sulfate and then having an X-ray taken to visualize the movement of food through your esophagus and stomach.

If you experience frequent or severe symptoms of heartburn, it’s essential to consult with a healthcare provider to rule out any underlying conditions and develop an appropriate treatment plan.

What is the treatment for heartburn?

The treatment for heartburn, also known as acid reflux, typically involves a combination of lifestyle changes and medication. Here are some common treatments for heartburn:

Lifestyle changes:

1. Dietary changes: Avoid foods and drinks that trigger heartburn, such as citrus fruits, tomatoes, chocolate, coffee, tea, and spicy or fatty foods.
2. Eating habits: Eat smaller, more frequent meals to reduce pressure on the esophagus.
3. Avoid lying down after eating: Wait at least 2-3 hours after eating before lying down or going to bed.
4. Raise the head of your bed: Elevating the head of your bed by 6-8 inches can help prevent stomach acid from flowing back up into the esophagus.
5. Maintain a healthy weight: Losing weight can help reduce pressure on the esophagus and alleviate heartburn symptoms.

Medications:

1. Antacids: Over-the-counter antacids like Tums, Rolaids, or Mylanta can help neutralize stomach acid and provide quick relief from heartburn symptoms.
2. Histamine-2 (H2) blockers: Prescription medications like ranitidine (Zantac) or famotidine (Pepcid) can reduce acid production in the stomach.
3. Proton pump inhibitors (PPIs): Prescription medications like omeprazole (Prilosec) or lansoprazole (Prevacid) can also reduce acid production in the stomach.
4. Gastrointestinal motility modifiers: Medications like metoclopramide (Reglan) or domperidone (Motilium) can help speed up digestion and reduce symptoms of heartburn.
5. Surgical procedures: In severe cases of heartburn, surgical procedures like fundoplication or laparoscopic antireflux surgery may be necessary to strengthen the lower esophageal sphincter (LES) and prevent acid reflux.

Alternative therapies:

1. Acupuncture: Some studies suggest that acupuncture may help relieve heartburn symptoms by stimulating certain pressure points in the body.
2. Herbal remedies: Certain herbs like chamomile, licorice root, and slippery elm may help soothe the digestive tract and reduce inflammation.
3. Yoga and relaxation techniques: Stress-reducing activities like yoga and meditation may help alleviate heartburn symptoms by reducing stress and promoting relaxation.

It’s essential to work with a healthcare provider to determine the best course of treatment for your specific case of heartburn. They can help you develop a personalized treatment plan that takes into account your medical history, lifestyle, and other health factors.