Understanding Heartburn

Heartburn, also known as pyrosis, is the burning sensation in your esophagus, just below your breastbone. It is often connected with regurgitation of the gastric acid. The sensation rises in the chest and usually radiates to the throat, neck, or angle of your jaw.

This condition has been found to cause chronic cough, and may imitate asthma. The term "heartburn" is a misnomer as this condition has nothing to do directly with the heart.

What causes heartburn?

Heartburn is a symptom of gastroesophageal reflux disease (GERD) and is primarily caused by acid that refluxes back into your esophagus. People who have high levels of stomach acid secretion are at a higher risk of heartburn.

This increased secretion is triggered by irritants such as caffeine, alcohol, aspirin, carbonated drinks, acidic food and juices, chocolates, and anti-inflammatory medications such as ibuprofen.

Smoking and eating fatty foods cause acid to reflux into your esophagus. Pregnancy, obesity, and hiatal hernia can have a significant effect on LES function and are all risk factors of acid reflux. Major diseases of the esophagus (sarcoidosis and scleroderma, among others) also cause heartburn.

What are the symptoms?

One of the major symptoms of heartburn is the pain often felt as a burning sensation behind the breastbone or sternum, either as a sharp pain or a spasm.

Many people mistake this pain for heart attack. The pain can be concentrated in your lower chest or can radiate to your throat.

In the latter’s case, heartburn may lead to waterbrash or the spontaneous flooding of the mouth with a slightly salty and clear fluid. Hoarseness or a coughing episode may follow if there’s acid reflux near your larynx.

How is heartburn diagnosed?

Heartburn is one of the most common health conditions we experience. However, many people confuse it with other illnesses related to chest, including: pulmonary embolus, chest wall pain, heart attack, and pneumonia. Heartburn diagnosis requires a physical examination and complete history.

In most instances only this examination is needed before performing a treatment plan. In some cases, however, further testing is required. These tests include x-ray endoscopy, and manomentry and pH testing.

How is heartburn treated?

Heartburn can be treated by medication. You may take antacids at bedtime, after meals, or when needed in order to coat your esophagus and to bind the excess acid in your stomach.

Histamine H2 antagonists ( cimetidine, ranitidine, and famotidine) and Proton pump inhibitors (omeprazole, rabeprazole, pantoprazole, lansoprazole, and esomeprazole) can reduce stomach acid.

Heartburn can also be treated by surgery; it’s an option for patients with Barrett’s esophagus, for whom medical therapy doesn’t give adequate relief, and for those with severe reflux.

How can you prevent heartburn?

You can prevent heartburn by changing your lifestyle. Don’t eat before bedtime as much as possible. You have to give up smoking and also avoid alcohol, caffeine, aspirin, and ibuprofen.

You should also eat smaller portion of foods more frequently. Lastly, your head must be slightly elevated when you sleep. Here, the gravity will keep the acid in your stomach and prevent acid reflux.