Heartburn: Information on Causes, Diagnosis & Treatments

Burning Sensation Heartburn Heartburn is an acid indigestion problem that causes a painful burning sensation in the middle of the chest or upper portion of the stomach. While the sensation appears to be near the heart, the condition does not affect the heart muscle. However, many of the symptoms associated with heart disease and heart attack are often experienced by individuals suffering from heartburn. During intense bouts of the condition, the pain can spread to other areas of the body including the arms, jaw, and neck, where the achy feeling last for minutes or hours at a time.

Occasional bouts of heartburn are common among both men and women and are not a cause for alarm. Many of these problems associated with the condition can be treated using over-the-counter (OTC) drugs and changes in lifestyle choices. However, when the condition becomes more frequent, more intense, and interferes with daily living, it may be time to seek out medical care to treat the problem.

What Causes Heartburn?

Heartburn is caused by stomach acid that refluxes into the esophagus and causes irritation. The burning discomfort can occur just below the breastbone in the upper abdomen at the lower esophageal sphincter that is malfunctioning and does not tighten.

Most cases of heartburn are as a result of certain excesses where too much pressure has been placed on the stomach through constipation, pregnancy or obesity. The other is consuming too much food that needs to be digested in the stomach including chocolate, onions, garlic, citrus fruits, tomatoes, peppermint, coffee, caffeinated products, and alcohol.

Consuming fatty and oily products can also cause heartburn as can prescription medications and over-the-counter drugs. A lack of sleep and high levels of stress can also increase the body’s acid production that will eventually lead to heartburn. Smokers have an elevated risk of developing high levels of acid production caused by the relaxing of the lower esophageal sphincter and allowing stomach acid to reflux into the esophagus.

Specific factors that trigger heartburn to occur include:

  • Excess consumption of red wine and other alcohol products

  • Over Eating were eating three large meals a day causes acid to build up, compared eating five or six small meals every day.

  • Consuming food before bedtime can trigger heartburn. It is best to allow a minimum of two hours for the food to digest before lying down. Lying in a prone position can make it difficult to digest the food and exacerbate conditions that cause heartburn.

  • Abdominal workout exercises including sit-ups and crunches are known to trigger bouts of heartburn as is any position that involves the need to bend over. This is because pressures put on the abdomen causing stomach acids to thrust or reflux back into the esophagus.

  • Yoga moves and head stands where the stomach is lower than the hips can disrupt the natural flow of the contents in the stomach and produce a reflux action of acids into the esophagus.

  • Taking Prescription Drugs and Over-The-Counter Medications can trigger bouts of heartburn or worsen the condition. These include aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) and Cox-2 inhibitors including Celebrex to treat arthritis are known to produce heartburn.

  • Undergoing Chemotherapy

  • Taking Osteoporosis Drugs

It is important to discuss with the doctor all the medicines you are currently taking to determine if any of them trigger heartburn or make the condition worse. There are usually alternatives to nearly every medication that might reduce the symptoms of heartburn, or eliminate it altogether.

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Common Heartburn Symptoms

Many people misdiagnose acute bouts of heartburn as a heart attack when acid reflux has pumped stomach acid into the esophagus causing many symptoms associated with other hard conditions. The most common heartburn symptoms include:

  • A burning sensation in the chest at the upper portion of the stomach and just below the breastbone. The sensation occurs after consuming a meal and can last a few minutes or many hours.

  • Debilitating chest pain that occurs when lying down, bending over, or eating.

  • Difficulty in swallowing

  • A burning sensation in the throat that has a salty, acidic, sour, or hot taste.

  • Chronic sore throats, coughing, or chronic hoarseness can be an indicator of heartburn

Any individual experiencing one or more of the symptoms listed above should seek medical attention for a diagnosis of heartburn or other condition. Typically, the doctor will perform numerous tests determine the heartburn’s severity and whether the treatment needs to be monitored.

However, there are other conditions that can cause the same types of symptoms including chest pain. Individuals having a gallbladder attack often feel the pain that radiates through the chest and experience intense nausea and a chronic ache in the upper right or upper middle part of the abdomen. These conditions typically occur after consuming a fat meal. It is common for the pain to shift to the arms, neck, or shoulders.

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Diagnosing Heartburn

An accurate and precise diagnosis causing of heartburn usually requires the results of numerous tests to see if some factors are at fault for the condition. The doctor will typically recommend electrocardiogram to rule out any problems associated with heart disease or heart failure. The patient will also undergo a comprehensive physical examination to determine if they have a hiatal hernia or abdominal mass that is causing the pain. Other tests used to determine heartburn include:

  • A check for high blood pressure

  • A comprehensive medical history to see if other drugs being taken are causing the problem

  • Gastric Emptying Study to determine the rate at which consumed food leaves the stomach and how well the esophagus and its associated sphincters function.

  • Upper Endoscopy procedure can allow the doctor to evaluate the condition of the esophagus and look for any abnormality or damage. This procedure requires the insertion of a flexible tube with an attached tiny camera that is placed on the throat of the patient.

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Treating Heartburn

While the doctor will likely treat heartburn using different prescription medications, there are lifestyle changes the patient can make to minimize many of the common symptoms associated with the condition. These include:

Self Help
  • Consume smaller meals more frequently throughout the day

  • Avoid consuming any food prior to bedtime

  • Avoid ibuprofen, aspirin, caffeine, and alcohol

  • Quit smoking

  • Using two or three pillows, elevate the head of the bed to minimize the potential of acid reflux
Common Heartburn Medications

The doctor will likely prescribe one or more medications that diminish acid production in the stomach that can decrease many of the common symptoms associated with heartburn. Effective antacids can be taken after consuming a meal, before bedtime, or when required. Antacids bind excess acid together inside the stomach.

In addition to the patient taking antacids, the doctor might recommend antagonist drugs that block histamine action in the stomach. These include Zantac (ranitidine), Tagamet (cimetidine), and Pepcid (famotidine).

There also surgical procedures to treat heartburn, especially in individuals who cannot find adequate relief from common medical therapies. The reflex action can cause severe damage to the windpipe that results in wheezing, pneumonia, and hoarseness. Based on the patient’s situation, the doctor can offer numerous surgical procedure options that help maximize esophageal sphincter function to minimize the potential of acid levels backing up into the esophagus.

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Sources:

https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults

https://www.cdc.gov/pcd/

https://my.clevelandclinic.org/health/articles/heartburn-symptoms

http://www.mayoclinic.org/diseases-conditions/gerd/basics/definition/con-20025201

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