All You Need To Know About Heartburn: Causes, Symptoms And Treatment

Heartburn is a widespread condition that affects millions of people around the world. Characterised by a burning sensation in the chest, typically occurring after eating, heartburn can be both uncomfortable and distressing. In India alone, a significant portion of the population experiences heartburn regularly due to their dietary habits, lifestyle choices, and varying health conditions. Understanding the causes and recognizing the symptoms of heartburn is essential for managing this common problem effectively. In this article, we will explore the common triggers, symptoms, and available treatments to help those affected find relief and improve their quality of life.

What is Heartburn?

Heartburn is a common condition characterised by a burning sensation in the chest, typically occurring after eating. This discomfort is caused by stomach acid flowing back into the oesophagus, the tube that carries food from the mouth to the stomach. The acid irritates the lining of the oesophagus, leading to a painful, burning feeling behind the breastbone. Heartburn can be triggered by various factors, including certain foods and beverages, sedentary lifestyle habits, and underlying medical conditions. While it is often mild and an occasional issue for many people, frequent or severe heartburn can indicate a more serious problem and may require medical attention

Who Gets Heartburn?

Heartburn can affect people of all ages and backgrounds, though certain factors can increase the likelihood of experiencing it. 

• Adults are more commonly affected than children, and it is especially prevalent among pregnant women due to hormonal changes and pressure on the stomach from the growing baby.
• Individuals who are overweight or obese are also at higher risk, as excess weight can put additional pressure on the abdomen, leading to acid reflux.
• Those who consume a diet high in fatty, spicy, or acidic foods, drink alcohol or caffeinated beverages, smoke, or eat large meals, particularly close to bedtime, are more likely to experience heartburn.
• Additionally, certain medical conditions, such as gastroesophageal reflux disease (GERD), hiatal hernia, and delayed stomach emptying, can contribute to the frequency and severity of heartburn. 

What does Heartburn Feel Like?

Heartburn is typically experienced as a burning sensation in the chest, just behind the breastbone. This discomfort often occurs after eating and can last for a few minutes to several hours. The sensation may also rise into the throat, creating a sour or acidic taste in the mouth. Some people describe the pain as a sharp or pressure-like feeling, which can be severe enough to be mistaken for a heart attack. 

Other symptoms that may accompany heartburn include difficulty swallowing, a persistent cough, and a sensation of food being stuck in the throat. The intensity and frequency of heartburn can vary, but it is generally worse when lying down or bending over.

What Causes Heartburn?

Heartburn is caused by the backflow of stomach acid into the oesophagus, the tube that carries food from the mouth to the stomach. This acid reflux occurs when the lower esophageal sphincter (LES), a ring of muscle that acts as a valve between the oesophagus and the stomach, does not close properly or opens too frequently. Several factors can contribute to this malfunction and subsequently cause heartburn:

• Dietary Choices: Consuming fatty, spicy, or acidic foods, as well as chocolate, caffeine, and carbonated beverages, can trigger heartburn. Large meals or eating close to bedtime can also exacerbate the condition.
• Lifestyle Factors: Smoking, alcohol consumption, and a sedentary lifestyle can weaken the LES, increasing the likelihood of acid reflux.
• Body Weight: Being overweight or obese puts extra pressure on the abdomen, which can push stomach acid into the oesophagus.
• Pregnancy: Hormonal changes and the growing baby pressing against the stomach can cause the LES to relax, leading to heartburn.
• Medical Conditions: Conditions such as gastroesophageal reflux disease (GERD), hiatal hernia, and delayed stomach emptying can increase the risk of heartburn.
• Medications: Certain medications, including aspirin, ibuprofen, certain muscle relaxers, and blood pressure medications, can contribute to heartburn by irritating the oesophagus or relaxing the LES.

How Long does Heartburn Last?

The duration of heartburn can vary widely among individuals. For most people, heartburn typically lasts from a few minutes to a few hours. In mild cases, the burning sensation in the chest may subside on its own or with over-the-counter antacids. However, in more severe cases, particularly those associated with gastroesophageal reflux disease (GERD), heartburn can be more persistent and frequent, lasting several hours or recurring multiple times a week.

Certain factors can influence the duration of heartburn, including the type and quantity of food or drink consumed, body position (such as lying down or bending over), and the effectiveness of any medications taken to relieve the symptoms. If heartburn lasts for an extended period, becomes more frequent, or is accompanied by other symptoms such as difficulty swallowing or unexplained weight loss, it is important to seek medical advice to rule out more serious conditions and receive appropriate treatment.

What are the Other Symptoms of Heartburn?

In addition to the characteristic burning sensation in the chest, heartburn can be accompanied by several other symptoms. These may include:

• Regurgitation: A sour or bitter-tasting acid backing up into the throat or mouth.
• Chest Pain: Discomfort or pain in the chest, especially after eating, which can sometimes be severe enough to be mistaken for a heart attack.
• Difficulty Swallowing (Dysphagia): A sensation of food being stuck in the throat or a feeling of tightness in the throat.
• Chronic Cough: A persistent cough that does not seem to be related to any respiratory condition.
• Hoarseness or Sore Throat: Irritation of the throat caused by acid reflux can lead to a hoarse voice or a sore throat.
• Lump in the Throat: A sensation of having a lump in the throat, which can be uncomfortable and persistent.
• Bloating: A feeling of fullness or bloating in the stomach.
• Nausea: A feeling of sickness that can sometimes accompany heartburn.

If these symptoms are frequent or severe, it is important to seek medical advice to rule out more serious conditions and receive appropriate treatment.

Does Acid Reflux Always Cause Heartburn?

No, acid reflux does not always cause heartburn. While heartburn is a common symptom of acid reflux, not everyone who experiences acid reflux will feel the characteristic burning sensation in the chest. Some people with acid reflux may experience other symptoms, such as regurgitation, where stomach acid backs up into the throat or mouth, causing a sour or bitter taste.

Is Heartburn Serious?

Heartburn is usually not serious and can often be managed with lifestyle changes and over-the-counter medications. However, frequent or severe heartburn can be a sign of a more serious condition, such as gastroesophageal reflux disease (GERD). If left untreated, GERD can lead to complications like oesophagitis (inflammation of the oesophagus), strictures (narrowing of the oesophagus), or Barrett's oesophagus, which can increase the risk of oesophageal cancer.

Persistent heartburn that interferes with daily activities or does not respond to standard treatments should be evaluated by a healthcare professional. Additionally, heartburn accompanied by symptoms such as difficulty swallowing, unexplained weight loss, chest pain, or vomiting blood requires immediate medical attention, as these could indicate more severe health issues.

How is Heartburn Diagnosed?

Heartburn is diagnosed through a combination of patient history, physical examination, and sometimes diagnostic tests to determine the underlying cause. Here are the common steps involved in diagnosing heartburn:

Patient History

The healthcare provider will ask about your symptoms, including their frequency, severity, and any triggers you have noticed. They will also inquire about your diet, lifestyle, and any medications you are taking.

Physical Examination

A physical examination will be conducted to check for any signs of complications or underlying conditions that could be causing your heartburn.

Diagnostic Tests

• Endoscopy: A thin, flexible tube with a camera (endoscope) is inserted through the mouth to examine the oesophagus, stomach, and duodenum. This helps to identify inflammation, ulcers, or other abnormalities.
• pH Monitoring: A probe is placed in the oesophagus to measure the frequency and duration of acid reflux episodes over 24 to 48 hours.
• Barium Swallow: You will drink a barium solution, and X-rays will be taken to look for any abnormalities in the oesophagus, such as a hiatal hernia or strictures.
• Esophageal Manometry: This test measures the rhythmic muscle contractions of the oesophagus when you swallow, as well as the coordination and force exerted by the esophageal muscles.

These diagnostic methods help healthcare providers determine the cause of heartburn and develop an appropriate treatment plan.

What is the Treatment for Heartburn?

The treatment for heartburn typically involves a combination of lifestyle changes, over-the-counter medications, and prescription medications. In some cases, surgical interventions may be necessary. Here are the common treatments for heartburn:

Lifestyle Changes

• Dietary Modifications: Avoiding foods and drinks that trigger heartburn, such as fatty, spicy, or acidic foods, caffeine, and alcohol. Eating smaller, more frequent meals and not eating close to bedtime can also help.
• Weight Management: Losing weight if you are overweight or obese can reduce pressure on the stomach and lower the risk of acid reflux.
• Elevating the Head of the Bed: Raising the head of your bed by about 15-20 centimetres can help prevent acid from flowing back into the oesophagus while you sleep.
• Avoiding Smoking: Smoking can weaken the lower esophageal sphincter, so quitting smoking can help reduce heartburn symptoms.

Over-the-Counter Medications

• Antacids: These provide quick relief by neutralising stomach acid. Common antacids include calcium carbonate (Tums) and magnesium hydroxide (Milk of Magnesia).
• H2 Receptor Blockers: These reduce the production of stomach acid and provide longer relief than antacids. Examples include ranitidine (Zantac) and famotidine (Pepcid).
• Proton Pump Inhibitors (PPIs): These are stronger acid reducers that help heal the oesophagus. Over-the-counter PPIs include omeprazole (Prilosec) and lansoprazole (Prevacid).

Prescription Medications

• Stronger H2 Receptor Blockers and PPIs: If over-the-counter options are not effective, your doctor may prescribe higher doses or different medications.
• Prokinetics: These medications help strengthen the lower esophageal sphincter and improve stomach emptying. Examples include metoclopramide (Reglan) and domperidone (Motilium).

Surgical Interventions

• Fundoplication: This procedure involves wrapping the top of the stomach around the lower oesophagus to strengthen the lower esophageal sphincter and prevent acid reflux.
• Linx Device: A ring of magnetic beads is placed around the junction of the stomach and oesophagus to keep the lower esophageal sphincter closed when not swallowing.

By following these treatments, most people can manage and reduce their heartburn symptoms effectively.

Final Word

Heartburn, while often manageable with lifestyle changes and over-the-counter treatments, can sometimes indicate more serious underlying conditions. Persistent or severe heartburn requires proper medical attention to prevent complications and improve quality of life. At Max Hospitals, our team of experienced healthcare professionals is dedicated to providing comprehensive care for digestive health issues, including heartburn. If you are struggling with persistent heartburn or related symptoms, do not hesitate to seek expert advice. Schedule an appointment with Max Hospitals today to receive personalised treatment and take the first step towards better digestive health and overall well-being.