Heartburn: Causes, Symptoms, Diagnosis, Treatment and Complications

Heartburn is a burning sensation that occurs in your chest just behind the breastbone. The soreness is typically stronger after meals, at night, when lying on one's stomach, or when bending over.

Heartburn is a common occurrence but poses no significant health risks. With lifestyle changes and over-the-counter medications, the majority of people can manage their heartburn problems.

A more serious issue that requires medical treatment may be indicated by persistent heartburn or heartburn that interferes with your daily activities.

Causes Of Heartburn

Heartburn happens when stomach acid reflexes back into the esophagus. Food is delivered from your lips to your stomach through this tube.

Normally, when food is consumed, the lower esophageal sphincter, a muscle band at the base of the esophagus, relaxes, enabling food and liquid to enter the stomach. After that, the muscle contracts once more.

If the lower esophageal sphincter isn't working properly, acid reflux, or stomach acid running back up into the esophagus, can happen and cause heartburn. If you're hunched over or lying down, you risk getting a worse acid backup.

Some people may have heartburn after consuming particular foods and beverages, such as:

• Warm foods
• Citrus-based products
• Onions
• Items made with tomatoes, such as ketchup
• Fried or fatty foods
• Peppermint
• Alcohol, caffeine, chocolate, fizzy drinks, or other stimulants
• Fatty or substantial meals
• Being overweight or pregnant may also raise your risk of experiencing heartburn.

Symptoms Of Heartburn

It could be challenging to distinguish between heartburn and other kinds of chest pain. It's always a good idea to talk with a healthcare professional if you're unsure of the type of pain you're experiencing. Concentrating on any additional symptoms you might experience may also be helpful. 

You can differentiate heartburn from other esophageal illnesses and heart attacks using these comorbid symptoms.

If you have acid reflux disease and have heartburn:

• Burping.
• A sour taste in the mouth.
• Nausea.
• Regurgitation Of Food

Other uncommon signs of acid reflux include:

• Overfullness and stomach bloating.
• Hiccups.
• Persistent cough.
• Asthma getting worse.
• Sore throat.
• Laryngitis.
• Swallowing difficulties or a lump at the back of the throat.
• Chest pain similar to angina

Diagnosis Of Heartburn

The following tests may be recommended by your doctor to determine whether your heartburn is an indication of gastroesophageal reflux disease (GERD):

• X-ray to determine the size, shape, and functionality of your stomach and esophagus.
• During an endoscopy, a tiny camera is used to examine your esophagus to check for any anomalies. A tissue sample (biopsy) may be taken for examination.
• Esophageal reflux disease frequency and duration can be assessed with ambulatory acid probe tests. An acid monitor is inserted into your esophagus and is connected to a little computer that you wear on a strap around your waist or over your shoulder. To assess the pressure and movement in the esophagus, esophageal motility testing is done. 

Treatment Of Heartburn

OTC drugs and lifestyle modifications can be used to manage occasional heartburn at home. But you might require prescription medication if you get heartburn frequently. Drugs lessen the amount of stomach acid that enters your esophagus. However, they don't address the underlying cause of your lower esophageal sphincter dysfunction. You could require additional treatment if drugs don't help.

Heartburn medications include:

• Antacids: The stomach acid is neutralized with antacids (such as Tums® and Rolaids®) so that when reflux occurs, your esophagus won't be harmed. They frequently contain substances that might also alleviate other problems. For instance, magnesium can treat minor constipation, and simethicone can aid with gas. If you experience occasional heartburn, antacids are excellent, but if you use them frequently, they can cause negative effects.
• Alginates: Alginates are organic sugars that come from seaweed. They function as a physical barrier between the acid and your esophagus, preventing acid reflux by floating on top of the acid. If an underlying medical condition prevents you from taking antacids, you can acquire alginates on your own. Additionally, you can purchase antacids that include alginates to boost their effectiveness.
• H2 blockers, or histamine receptor antagonists: These inhibit the chemical (histamines) that instruct your body to make stomach acid, hence reducing its production. H2 blockers come in both over-the-counter (OTC) and prescription forms. Although they can be used more frequently than antacids, they are not usually effective over the long term. Your body may grow accustomed to them and they may no longer be as effective.
• PPIs, or proton pump inhibitors. These are more potent acid blockers that also aid in tissue recovery. If your heartburn is moderately severe or you show evidence of tissue damage in your esophagus, your doctor might advise you to take them as a first line of treatment. They reduce acid reflux 90% of the time. They are the only medication that can help repair esophageal ulcers.

The following additional remedies for heartburn could be used:

• Antiviral drugs or antibiotics to treat an infection.
• Dupilumab or topical steroids are used to treat inflammation directly.
• Adjunctive treatments and low-dose neuromodulators for functional heartburn.
• Surgery to repair a hernia if a hiatal hernia is the root of your heartburn.

Your doctor might recommend a procedure, such as:

• Nissen fundoplication: During this quick operation, the connection between your stomach and esophagus will be strengthened. GERD and its symptoms can be effectively treated with it. without making an oral cut, a fundoplication. With the use of an endoscope, the same procedure is performed without surgery.
• LINX device: The LINX device, a ring of tiny magnets used in yet another minimally invasive treatment, is implanted during this surgery to assist in keeping the junction between the stomach and esophagus closed against reflux.

Complications Of Heartburn

Constant heartburn (also known as gastroesophageal reflux disease or GERD) interferes with your regular activities. Prescription medicines, occasionally surgery, or other treatments are possible for gastroesophageal reflux disease (GERD). Major esophageal damage or Barrett's esophagus, a precancerous condition that damages the esophagus, can result from GERD.

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