HeartBurn: Symptom, Causes, Risks and Treatment

Heartburn, also known as acid reflux, is a common condition that affects many individuals. It occurs when the stomach's contents, including acid, come up against the flow into the oesophagus. This backward movement may cause a burning sensation in the thoracic region just behind the breastbone. While occasional heartburn is normal, frequent or persistent episodes of this condition can indicate the presence of an underlying condition. In this blog, we will try to answer a common question, "What causes heartburn every day”?

Symptoms of Heartburn

Heartburn can manifest in various ways, and recognising the signs is crucial for seeking appropriate treatment. The following are some common symptoms:

• Burning in the Chest or Throat Region: This is the most prominent symptom of heartburn. The burning sensation typically starts in the upper abdomen and radiates upward, sometimes reaching the throat. It can worsen after eating, at night, or when lying down or bending over. 
• Sour or Bitter Taste: When stomach acid refluxes into the oesophagus, it can leave a sour or bitter taste in the mouth, often followed by a burning sensation.
• Difficulty Swallowing: In some cases, heartburn can cause discomfort or pain when swallowing, making it challenging to consume food or liquids.
• Regurgitation: Heartburn may cause the stomach's contents to rise back up into the oesophagus, leading to a sensation of regurgitation or vomiting stomach contents.
• Chest Pain: In severe cases, heartburn can mimic the symptoms of a heart attack, with chest pain extending to the arm, neck, or jaw.

Causes of Heartburn

Factors contributing to the heartburn development are:

• Diet: Certain foods & beverages, such as spicy, fried, fatty foods, citrus fruits, tomatoes, coffee, and alcohol, can trigger or worsen heartburn by relaxing the lower oesophageal sphincter (LES) or increasing stomach acid production.
• Obesity: Excess weight, particularly around the waistline, can put pressure on the stomach and contribute to acid reflux.
• Pregnancy: Hormonal changes in a pregnant woman can relax the lower oesophageal sphincter (LES), allowing acid from the stomach to flow back into the oesophagus.
• Medications: Some medicines, such as certain pain relievers, antidepressants, and blood pressure medications, can weaken the LES or increase stomach acid production.
• Hiatal Hernia: This condition develops when a part of the stomach comes out through the diaphragm, allowing stomach contents to reflux more easily into the oesophagus.
• Smoking: Smoking is one of the reasons for heartburn. Nicotine from tobacco can weaken the LES and increase stomach acid production.
• Stress and Anxiety: High levels of continuous stress can cause increased secretion of stomach acid and contribute to heartburn.

Risk Factors

While heartburn can affect anyone, certain factors can increase the possibility of developing this condition, including: 

• Obesity or being overweight
• Pregnancy
• Smoking
• Consuming certain foods and beverages (e.g., spicy, fried, or fatty foods, citrus fruits, tomatoes, coffee, alcohol)
• Chronic stress

How is Heartburn Diagnosed?

In most cases, the diagnosis of heartburn depends on the symptoms reported by the individual. However, a doctor may recommend further testing to rule out other conditions or identify the underlying cause if the symptoms are severe or persistent. Diagnostic tests for heartburn may include:

• Endoscopy: In this procedure, a doctor may insert a thin, flexible catheter with a camera (endoscope) through the mouth into the oesophagus and stomach to examine the lining and check for abnormalities or damage.
• pH Monitoring: This test evaluates the acid level in the oesophagus over a 24-hour period using a small catheter or wireless sensor.
• Barium Swallow: During this test, the individual swallows a barium solution, which coats the oesophagus and stomach, allowing for better visualisation using X-ray imaging.
• Oesophageal Manometry: This test measures the strength and coordination of the oesophageal muscles and the function of the LES.

Treatment for Heartburn

The treatment for heartburn depends on the severity and frequency of symptoms and the underlying cause. Here are some common treatment options:

• Lifestyle Changes: Making dietary modifications, such as avoiding trigger foods, eating smaller portions, and avoiding lying down immediately after eating, can help diminish heartburn symptoms.
• Over-the-counter Medications: Antacids can neutralise stomach acid and provide temporary relief. Histamine-2 receptor antagonists (H2 blockers) and proton pump inhibitors (PPIs) can also reduce stomach acid production.
• Prescription Medicines: In cases of severe or chronic heartburn, doctors may prescribe stronger medicines, such as prescription-strength PPIs or prokinetic agents, which help strengthen the LES and improve gastric emptying.
• Surgery: In some cases, when lifestyle changes and medications are not giving relief, surgery may be recommended to reinforce the LES or repair a hiatal hernia.

When to See a Doctor?

While occasional heartburn is common, you can often manage it with over-the-counter medications and lifestyle changes. It's essential to seek medical attention in certain situations:

• Persistent or Severe Symptoms: If heartburn occurs frequently or is accompanied by intense pain, difficulty swallowing, or weight loss, it may be an indicative sign of a more serious ailment, such as gastroesophageal reflux disease (GERD) or oesophageal cancer.
• Symptoms Lasting More Than Two Weeks: Prolonged heartburn may indicate an underlying ailment that requires medical evaluation.
• Presence of Additional Symptoms: If heartburn accompanies other symptoms, like chest pain, difficulty breathing, or jaw or arm pain, it could be a sign of a heart attack.

Conclusion

Heartburn is a common condition that can be managed through lifestyle changes, over-the-counter medications, and, in some cases, prescription medications or surgery. By understanding the symptoms, reasons, and risk factors associated with heartburn, individuals can take proactive steps to alleviate discomfort and prevent potential complications. If heartburn persists or is accompanied by concerning symptoms, it's crucial to seek medical advice for proper diagnosis and appropriate treatment.

FAQs

1. What reduces heartburn?

Several strategies can help reduce heartburn symptoms:

• Avoid trigger beverages and foods that can worsen heartburn, such as spicy, fried, or fatty foods, citrus fruits, tomatoes, coffee, and alcohol.
• Achieve and maintain an optimal body weight, as excess weight can increase the risk of heartburn.
• Avoid lying down immediately after having food, as this can promote acid reflux.
• Quit smoking, as nicotine can weaken the lower oesophageal sphincter and increase stomach acid production.
• Manage stress and anxiety, as high levels can contribute to heartburn.
• Take over-the-counter antacids or medications as recommended by a doctor.

2. What can I drink if I have heartburn?

When experiencing heartburn, it's best to avoid certain beverages that can potentially aggravate symptoms, such as caffeinated drinks (coffee, tea, sodas), alcoholic beverages, and citrus juices (orange, grapefruit, lemon). Instead, opt for hydrating and non-acidic drinks like:

• Water
• Milk or plant-based milk alternatives
• Herbal teas (e.g., chamomile, ginger, fennel)
• Low-acid fruit juices (e.g. apple, pear, papaya)

3. What food stops heartburn?

While no single food can completely stop heartburn, certain foods may help alleviate symptoms or reduce the risk of acid reflux:

• Low-fat dairy products (milk, yoghurt, cottage cheese)
• Whole grains (oats, brown rice, whole-wheat bread)
• Lean proteins (chicken, turkey, fish)
• Vegetables (leafy greens, broccoli, carrots)
• Fruits (bananas, melons, apples)
• Ginger (fresh or grated)
• Fennel seeds or fennel tea