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Heartburn

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Heartburn or 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.

Pathophysiology

It is caused by the failure to close the lower esophageal sphincter (LES) at the top of the stomach. This allows stomach contents, now mixed with gastric acid, to return into the esophagus. This return is also known as reflux, and may progress to gastroesophageal reflux disease (GERD) if it occurs frequently. Peristalsis, the rhythmic wave of muscular contraction in the esophagus, normally moves food down and past the LES.

Causes

Foods that may cause Heartburn:

  • Alcohol
  • Coffee, tea, cola, and other caffeinated and carbonated beverages
  • Chocolate
  • Citrus fruits and juices
  • Tomatoes and tomato sauces (such as pizza and pasta sauce)
  • Spicy foods and fatty foods (including full-fat dairy products)
  • Peppermint and spearmint

Treatment

If heartburn occurs when lying down, raising the head with pillows or sitting up frequently provides relief – although care must be taken to avoid placing continuous strain on the neck. Avoidance of certain foods shortly before bedtime is frequently advised to avoid future attacks.

Antacids, H2-receptor antagonists and proton pump inhibitors are used (in that order) to treat heartburn.

See also

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