Heartburn

Heartburn
Synonyms	Pyrosis, acid indigestion
Pronounce	N/A
Specialty	N/A
Symptoms	Burning sensation in the chest, sour taste in the mouth, difficulty swallowing
Complications	Esophagitis, Barrett's esophagus, esophageal cancer
Onset	Can occur at any age
Duration	Minutes to hours
Types	N/A
Causes	Gastroesophageal reflux disease (GERD), hiatal hernia, pregnancy, certain foods and medications
Risks	Obesity, smoking, alcohol consumption, dietary habits
Diagnosis	Based on symptoms, endoscopy, pH monitoring
Differential diagnosis	Angina, esophageal spasm, peptic ulcer disease
Prevention	Lifestyle changes, avoiding trigger foods, weight loss
Treatment	Antacids, H2 receptor antagonists, proton pump inhibitors
Medication	N/A
Prognosis	N/A
Frequency	Common
Deaths	N/A

Heartburn, medically known as acid reflux, is a common condition characterized by a burning sensation in the chest, abdomen, or throat. This discomfort arises when stomach acid regurgitates into the esophagus, the muscular tube that connects the mouth to the stomach.

Causes and Risk Factors

Heartburn is often linked to specific triggers, which include: Gastroesophageal Reflux Disease (GERD): This chronic digestive disease occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). While a person can experience GERD without heartburn, frequent heartburn can be a sign of GERD.

• Diet: Certain foods and beverages, such as spicy foods, onions, citrus products, tomato products, chocolate, peppermint, and fatty or fried foods, can contribute to heartburn. Alcoholic beverages and caffeinated drinks like coffee and soda can also trigger symptoms.
• Lifestyle Factors: Being overweight or obese can increase the risk of heartburn, as can smoking.
• Pregnancy: Hormonal changes and physical pressure from the growing fetus can lead to heartburn during pregnancy.
• Medications: Some drugs, including certain anti-inflammatory medicines and antibiotics, can cause heartburn.

Symptoms

The main symptom of heartburn is a burning sensation in the chest, usually after eating, which might be worse at night. This pain can sometimes be mistaken for the pain of a heart condition, particularly if it's new or intense.

Diagnosis and Treatment

Diagnosis of heartburn often relies on the patient's symptoms and response to treatment. If symptoms persist despite over-the-counter treatments, a healthcare provider may recommend endoscopy to visualize the esophagus and check for any damage. Treatment for heartburn often involves lifestyle modifications and medications:

• Lifestyle changes: These may include weight loss if overweight, avoiding trigger foods, eating smaller meals, not lying down soon after eating, and raising the head of the bed.
• Medications: Over-the-counter antacids, proton pump inhibitors, and H2 blockers can help reduce stomach acid and manage heartburn. For more severe or persistent cases, a healthcare provider may prescribe stronger versions of these medications.
• Surgery: In severe cases, when medication and lifestyle changes do not alleviate symptoms, surgical procedures may be considered.

Complications

Untreated heartburn, particularly if it's due to GERD, can lead to complications such as inflammation, ulcers, or scarring of the esophagus. In rare cases, long-term GERD can lead to Barrett's esophagus, a condition that increases the risk of esophageal cancer.

Warning Signs

If heartburn is accompanied by other symptoms such as intense chest pain, shortness of breath, jaw or arm pain, or if it does not respond to over-the-counter medications, it could signal a more serious condition like a heart attack. Immediate medical attention should be sought.

History

The concept of heartburn has been described since ancient times, with early civilizations attributing this condition to spiritual and supernatural causes. As the field of medicine evolved, the understanding of heartburn has improved dramatically, leading to the modern perception of this condition as a physiological issue rather than a spiritual affliction. Today, heartburn is well-recognized as a symptom of several gastrointestinal conditions, most notably GERD, and is treatable with a combination of lifestyle modifications and medications.

See Also

• GERD
• Peptic ulcer disease
• Barrett's esophagus

References

• Mayo Clinic. Heartburn. Retrieved from: https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223
• American College of Gastroenterology. Acid Reflux. Retrieved from: https://www.gi.org/topics/acid-reflux/
• NHS. Heartburn and acid reflux. Retrieved from: https://www.nhs.uk/conditions/heartburn-and-acid-reflux/
• Cleveland Clinic. GERD (Gastro-Esophageal Acid Reflux) in Adults. Retrieved from: https://my.clevelandclinic.org/health/diseases/17019-gerd-or-acid-reflux-or-heartburn-overview

Further Reading

• Kahrilas PJ. Clinical practice. Gastroesophageal reflux disease. N Engl J Med. 2008;359(16):1700-7.
• Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308-28.

External Links

• Mayo Clinic - Heartburn
• National Institute of Diabetes and Digestive and Kidney Diseases - Acid Reflux (GER & GERD) in Adults

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