Causes, complications, treatments, and prevention for heartburn

Definition

Stomach acid backing up into the esophagus causes heartburn, which is a burning sensation in the chest (food pipe).

The burning typically occurs directly behind the sternum in the middle of the chest (breast bone).

Lying flat or on the right side can make the burning worse or start it. Heartburn frequently gets worse during pregnancy.

Heartburn affects many people, and there are numerous over-the-counter (OTC) drugs and natural therapies that can be used to treat it.

Most of the time, you won't need to see a doctor unless your symptoms are severe, frequent (more than a few times a week), or getting worse.

To differentiate between heartburn and more serious medical disorders like a heart attack, you should consult a doctor if your heartburn is severe or if the pain is accompanied by other symptoms like shortness of breath or radiation into your arms or neck.

Heartburn is the primary symptom of GERD (gastroesophageal reflux disease), which is a chronic and serious form of reflux. However, there may be additional symptoms or no symptoms at all.

To ensure that there are no major issues present, you should consult a healthcare practitioner if your heartburn symptoms occur more than twice a week.

Risk Factors

Risk factors for GERD and heartburn

Include:

Dietary options: fatty or acidic foods, coffee, meals eaten right before bed, and large meals

Abdominal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities)

Obesity

Pregnancy

Scleroderma

Using tobacco or alcohol

Causes of Heartburn

Food and stomach acids "reflux" into the esophagus, the tube connecting the throat to the stomach, causing heartburn.

The term "gastroesophageal reflux" refers to this process.

Typical reasons for reflux include:

The lower esophageal sphincter, also known as the LES, which closes the valve between the esophagus and the stomach partially.

Foods and beverages including chocolate, peppermint, fried, fatty, and sugary foods and beverages, as well as alcohol and carbonated beverages.

After experiencing heartburn, the esophagus may become more sensitive to other foods, including citrus fruits, tomatoes, spicy meals, garlic, and onions due to the backflow of stomach contents.

These foods could make heartburn symptoms worse.

Obesity, frequent bending over and lifting, tight clothing, discomfort during bowel motions, strenuous exercise, and pregnancy all put pressure on the stomach.

Using tobacco goods and smoking.

Medications, both prescribed and over-the-counter, including aspirin, ibuprofen, prednisone, potassium, iron, and antihistamines.

The muscle that divides the lungs from the abdomen, the diaphragm, is breached by a small part of the stomach, resulting in a hiatal hernia.

Stress, which can make your stomach produce more acid and cause it to empty more slowly.

 

The signs of heartburn

The rearward flow of stomach contents into the esophagus, which causes heartburn, can induce a variety of symptoms.

The severity of the symptoms can vary from person to person.

Symptoms of Heartburn

Heartburn symptoms could be present every day or just occasionally.

Any of these typical symptoms can occasionally be severe:

    Abdominal burning

    Abdominal pain

    Burning feeling in the upper chest

    Indigestion

    Pain in the upper chest

Heartburn symptoms might occasionally be an indication of a heart attack or another serious disease.

If you or someone you are with has any of these life-threatening symptoms, including:

Chest discomfort, tightness, pressure, and palpitations

Persistent heartburn symptoms despite taking the prescribed medications

An ache that travels down your arm and shoulder

Wheezing, not breathing, choking, and other respiratory issues include shortness of breath, difficulty breathing, laborious breathing,

Black or bloody stuff in the vomit (resembling coffee grounds).

Heartburn complications

There is no cause for alarm if the aforementioned specific heartburn symptoms gradually go away in a day or two.

Underlying Serious Ailments:

In some cases, the affected person experiences severe chest discomfort, difficulty breathing, difficulty swallowing, persistent nausea, abrupt weight loss, and several recurrent heartburn attacks within a week.

It is then advisable to see a doctor right once to determine the cause of these symptoms.

Gastric esophageal reflux disease (GERD):

GERD develops from chronic heartburn that occurs more than twice a week.

In order to treat the damaged oesophagus, restore its normal functioning, and stop precancerous changes termed Barrett's oesophagus from forming in the body, this illness necessitates prescription medications and occasionally even surgery.

Diagnosis and Test

Long-lasting heartburn may be an indication of gastroesophageal reflux disease, a more dangerous ailment (GERD).

Your doctor might be able to determine from your symptoms whether GERD is the root of your heartburn.

However, they may do a number of tests, including:

 

A barium suspension, which coats the lining of your esophagus, stomach, and upper small intestine, will be given to you to consume before the x-ray.

This coating enables medical professionals to spot flaws that can indicate a digestive system issue.

Endoscopy: This procedure allows a glimpse of your upper GI tract by inserting a small camera on a flexible tube down your throat.

Ambulatory acid probe test (esophageal pH monitoring): A small computer that can be worn on a belt or shoulder strap is connected to an acid monitor that is inserted into your esophagus.

It monitors the duration and frequency of stomach acid reflux into the esophagus.

Esophageal motility testing, also known as esophageal manometry, involves inserting a catheter into the esophagus to gauge pressure and movement.

Treatment and Medications

Heartburn Treatment Without Surgery

Most people can control their heartburn's discomfort with dietary adjustments, weight loss, and drugs like proton pump inhibitors, or PPIs.

PPIs lower the amount of stomach acid produced by glands in the stomach lining.

They consist of omeprazole as well as over-the-counter drugs.

These drugs carry some danger even though they are widely used.

Headache, diarrhoea, constipation, and abdominal pain can all be side effects of brief use.

Recent research indicates long-term consequences, including a higher risk of pneumonia and bone fractures.

 

Surgical Heartburn Treatment

To treat symptoms, surgery may occasionally be required.

Patients at Summa Health have access to the most recent medical equipment and surgical methods should surgery be necessary.

the following surgical options:

Nissen Fundoplication through Laparoscopy

The surgeon wraps the lower esophagus over the top of the stomach during a Nissen fundoplication.

By strengthening the lower esophageal muscle or sphincter, acid reflux into the esophagus is less likely as a result.

Usually, the treatment takes up to an hour and a half.

The following morning, patients are started on clear liquids, and they are released in the late afternoon.

Reflux management system LINX

A small, flexible ring of magnets called LINX opens to let food and liquids down while remaining closed to keep stomach contents from rising.

In contrast to other operations, LINX doesn't involve changing the stomach, lowers gas and bloating, and keeps the capacity to belch and throw up intact.

LINX can be removed with a minimally invasive operation that typically takes less than an hour, despite being intended to be a lifelong therapy.

Additionally, it doesn't restrict your alternatives for further treatment.

 

Heartburn can be treated with a number of over-the-counter drugs, including:

Antacids - By neutralizing stomach acid, antacids may offer rapid relief.

However, they don't deal with the underlying causes of heartburn or repair a damaged esophagus.

H2RAs—These drugs work similarly to antacids in that they lessen stomach acid. However, they do not offer relief as soon. However, they can offer comfort for a longer period of time.

Additionally, proton pump inhibitors like Prilosec OTC, Nexium 24HR, and Prevacid 24HR help lower stomach acid.

Rarely, when all other therapies have failed to relieve symptoms, surgery may be considered.

Heartburn Prevention

You can prevent heartburn by making the modifications listed below to your lifestyle:

Weight loss or maintaining a healthy weight

The pressure from being overweight causes stomach acid to reflux into the oesophagus.

Stop smoking because it interferes with the oesophageal sphincter's ability to function normally.

Eat less and cut back on the foods that give you heartburn as part of a healthy diet.

After eating, do not lie down.

After eating, wait at least three hours before lying down or going to bed.

Place blocks under the feet of your bed to raise the head of the bed, or place a wedge between your mattress and the base of the bed to elevate your body from the waist up.