What is Heartburn?
Heartburn is a burning sensation in the chest, just behind the breastbone. This discomfort often rises from the lower chest and can extend to the throat. Despite its name, heartburn has no relation to the heart. It is actually a symptom of acid reflux, a condition where stomach acid flows back up into the esophagus, irritating its lining.
What Causes Heartburn?
Heartburn occurs when the lower esophageal sphincter (LES), a muscle ring that acts as a valve between the esophagus and stomach, doesn't close properly or relaxes inappropriately. This allows stomach acid to escape into the esophagus. Factors contributing to heartburn include:
- Eating large meals
- Lying down after eating
- Obesity
- Pregnancy
- Smoking
- Consuming certain foods and drinks such as spicy foods, alcohol, caffeine, chocolate, and fatty or fried foods.
What are the Symptoms of Heartburn?
The primary symptom of heartburn is a burning sensation in the chest, which may be accompanied by a sour or bitter taste in the mouth. Other symptoms can include difficulty swallowing, regurgitation of food or sour liquid, and a feeling of a lump in the throat. These symptoms often worsen after eating, when lying down, or bending over.
How is Heartburn Diagnosed?
Heartburn is primarily diagnosed based on the description of symptoms. A detailed medical history and physical examination help rule out other conditions. If symptoms are frequent or severe, additional tests such as an endoscopy, esophageal pH monitoring, or esophageal manometry may be recommended to evaluate the esophagus and monitor acid levels.
How is Heartburn Treated?
Treatment for heartburn often begins with lifestyle modifications, such as avoiding trigger foods, eating smaller meals, not lying down immediately after eating, losing weight if necessary, and quitting smoking. Over-the-counter antacids can provide quick relief by neutralizing stomach acid. H2 receptor blockers and proton pump inhibitors (PPIs) reduce acid production and are available over-the-counter or by prescription for more persistent cases. In severe or refractory cases, surgical interventions like fundoplication may be considered to reinforce the LES and prevent acid reflux.
