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Heartburn, also medically refered to as pyrosis, is a painful burning sensation in the esophagus, just below the breastbone. The pain often rises in the chest and may radiate to the neck or throat.

Most people have experienced occasional heartburn. However, frequent, ongoing heartburn, may indicate the more serious condition of gastroesophageal reflux disease (GERD).

Common causes

Normally, when food or liquid enters the stomach, a band of muscle at the end of your esophagus (called the lower esophageal sphincter or LES) closes off the esophagus. If this muscle fails to close tightly enough, stomach contents can back up (reflux) into the esophagus. This partially digested material is usually acidic and can irritate the esophagus, causing heartburn and other symptoms.

Sometimes GERD is related to a hiatal hernia. This is when part of the stomach protrudes upward through a hole in the diaphragm, putting pressure on the LES. Heartburn can also be a side effect of many different medications. Heartburn can also be caused by esophageal spasm.

Drugs implicated in heartburn include:

• Calcium channel blockers for high blood pressure
• Bisphosphonates for osteoporosis
• Progestin for abnormal menstrual bleeding or birth control
• Anticholinergics (e.g., for sea sickness)
• Aspirin or ibuprofen
• Certain bronchodilators for asthma
• Tricyclic antidepressants
• Dopamine for Parkinson's disease
• Sedatives for insomnia or anxiety
• Beta blockers for high blood pressure or heart disease

A peson should always doctor before changing medication.

Treatment

Homecare

It is best to treat heartburn promptly, especially if the symptoms occur often. Over time, on going heartburn caused by acid reflux can damage the lining of the esophagus and cause serious problems.

Avoid foods and beverages that can trigger reflux, such as:

• Alcohol
• Caffeine, carbonated beverages
• Chocolate
• Citrus fruits and juices
• Tomatoes and tomato sauces
• Spicy or fatty foods, full-fat dairy products
• Peppermint and spearmint

Next, try changing eating habits:

• Eat smaller meals. A full stomach puts extra pressure on the lower esophageal sphincter (LES), increasing the chance that food will reflux.
• Avoid eating or lying down within 2-3 hours of bedtime. Lying down with a full stomach results in stomach contents pressing harder against the LES.
• Avoid bending over or exercising just after eating.
• Drink plenty of fluids, especially when taking medications.

Make other lifestyle changes as needed:

• Lose weight if you are overweight. Obesity increases abdominal pressure, which can push stomach contents up into the esophagus. In some cases, GERD symptoms disappear completely after an overweight person loses 10-15 pounds.
• Stop smoking. Chemicals in cigarette smoke weaken the LES.
• Sleep with your head raised about 6 inches. Sleeping with the head higher than the stomach reduces the likelihood that partially digested food will reflux into the esophagus. Place books, bricks, or blocks securely under the legs at the head of your bed. Or use a wedge-shaped pillow under your mattress. Sleeping on extra pillows does NOT work well for relieving heartburn.
• Avoid tight-fitting belts or garments around the waist. They squeeze the stomach, and may force food to reflux.
• Reduce stress. Try yoga, tai chi, or meditation.

Over-the-counter medications

• Antacids, like Maalox or Mylanta, work by neutralizing stomach acid.
• H2 blockers, like Pepcid AC, Tagamet, and Zantac, reduce stomach acid production.
• Proton pump inhibitors, like Prilosec OTC, nearly stop all stomach acid production.

External links

National institutes of health's Library of medicine article: Heartburn

Sources

Part of this article is adapted from the American National institutes of health's Library of medicine which is in the public domain as seen here.