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Many people suffer from heartburn every now and then, especially after consuming a big meal. They are thus aware of the undesirable burning sensation in their chest, behind the breastbone. This characteristic noncardiac pain, known as heartburn, is sometimes normal.
About 20% of the populace living in Western nations commonly has troubles such as heartburn or regurgitation. Although both are disagreeable, they don’t normally lead to other health troubles.
If you have very regular or harsh heartburn and frequently have acid reflux, you may suffer from what is known as gastroesophageal reflux disease (GERD). (1)
Find out more about what heartburn is, who is at risk, and how it is related to the gastric system and not your heart. Read on.
Why do you have heartburn?
The path between the food pipe and the gut is mostly sealed. It just opens when the mix of chewed food and saliva reaches it. It shuts down again when the food has passed into the stomach. This guarantees that the stomach contents don’t rush back to the food pipe.
If the stomach is lengthened a lot such as after a big meal, the sphincter, which is a muscle at the opening of the stomach, might loosen up. This causes the stomach contents to rush back up into the food pipe.
The digestive juice in the stomach contents irritates the lining of the food pipe, and this irritation of the food pipe is felt as heartburn. (1)
How is heartburn different from GERD?
Heartburn is a common feeling that many people experience when stomach acid goes back up into the tube that connects the mouth and stomach (food pipe). This causes a burning sensation in the chest area that can sometimes feel like it’s coming from the heart.
However, if heartburn occurs frequently or becomes more severe, it could be a sign of a medical condition called gastroesophageal reflux disease (GERD).
In this condition, the stomach acid is regularly flowing back into the food pipe, which can lead to inflammation and other complications. If you are experiencing frequent or severe heartburn, it’s important to talk to your doctor to determine if you have GERD. (1)
Causes and Risk Factors of Heartburn
Underlying conditions such as GERD, hiatal hernia, stomach ulcer, obesity, pregnancy, food allergies, and stomach infections can be responsible for heartburn. (2)
1. GERD
Your food pipe naturally gets narrow before it arrives at the stomach. This narrow part is commonly kept closed by the muscles in the food pipe called the sphincter and the diaphragm. But this mechanism doesn’t function adequately in people with GERD, leading to heartburn.
GERD typically manifests as heartburn, with or without the regurgitation of stomach contents into the mouth. In infants, it may present as vomiting, irritability, anorexia, and symptoms of chronic aspiration.
In cases of chronic aspiration, adults and infants may experience cough, hoarseness, or wheezing. (1)(3)
2. Hiatal hernia
Some people have hiatal hernia or hiatus hernia. This is when the diaphragm that separates the chest and abdominal cavities has a small hole from which the food pipe passes to enter the stomach.
Also, the upper portion of the stomach goes up through this hole in the diaphragm into the chest cavity, hindering the diaphragm’s ability to shut down the entrance to the stomach. (2)
3. Obesity
An increase in intra-abdominal pressure is seen in people with obesity, and this is why obesity is associated with an increased danger of acquiring GERD.
Several other risk factors include: (2)
- Age ≥ 50 years
- Low socioeconomic status
- Tobacco use
- Excessive alcohol consumption
- Connective tissue disorders
- Pregnancy
- Postprandial supination
- Spicy food diet
4. Drugs that can increase the risk of heartburn
Some classes of drugs can also cause heartburn. These include:
- Anticholinergic drugs (2)
- Benzodiazepines
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Aspirin
- Nitroglycerin
- Albuterol
- Calcium channel blockers
- Antidepressants
- Glucagon
Signs and Symptoms of Heartburn
Heartburn comes with very common signs and symptoms such as a burning pain that circulates from the upper stomach, or from the region behind the breastbone, up the throat. It is occasionally linked with problems swallowing. (2)
Other possible symptoms include:
- Burning sensation in your throat
- Bad taste in your mouth
- Stomach noises
- Feeling very full
- Nausea and vomiting
- Hoarse voice
It can also demonstrate atypical symptoms such as: (2)
- Chest pain
- Dental erosions
- Chronic cough
- Laryngitis
- Asthma
Management of Heartburn or GERD
Most people suffering from symptoms of GERD are commonly identified and overseen by primary healthcare specialists. Those with heartburn are usually directed to gastroenterologists.
The control of GERD mandates an interprofessional strategy involving your:
- Gastroenterologist
- Otolaryngologist
- Pulmonologist
- Pharmacist
Lifestyle improvements are the most important part of GERD management. Patients are usually advised:
- Weight loss
- Tobacco cessation
- Alcohol avoidance
- Not eating late meals
Complications of GERD should be identified, assessed, and dealt with on time to prevent permanent morbidity. (2)(4)
What Happens if GERD Is Left Untreated?
If left untreated, GERD can result in esophagitis, strictures, and, in rare cases, metaplasia. Investigations such as endoscopy may be necessary to diagnose and manage GERD effectively. (4)
Diagnosing GERD
GERD is typically diagnosed based on clinical symptoms and may involve endoscopy and acid testing.
Patients with typical symptoms may be given a trial of therapy, but those who do not respond or have long-standing symptoms or complications should be further evaluated.
- Endoscopy is the preferred test, as it can detect abnormalities and biopsy abnormal areas. Additionally, it is the only test that consistently identifies changes in the esophageal lining associated with Barrett’s esophagus. (5)
- Patients with normal endoscopy results but continued symptoms may undergo a 24-hour pH testing.
How Is Heartburn Different From Pain From Heart Issues?
Chest pain from heart issues often comes with these symptoms:
- Harsh chest pain, especially if it spreads out to the arm, neck, or back
- Shortness of breath
- Profusely sweating
- Vomiting
- Dark stools
- Difficulty swallowing
Risk Factors of Heartburn or GERD
The occurrence of GERD or heartburn is influenced by various factors:
- Smoking is a significant risk factor for GERD, and the risk increases with the number of cigarettes smoked per day, especially in male smokers.
- Physical activity has an ambiguous effect on the occurrence of GERD symptoms, and its influence may be related to the type, level, and duration of exercise. Moderate physical activity is protective against GERD symptoms, especially in overweight people. Lack of physical activity is a risk factor for GERD, particularly in women.
- Alcohol consumption has an inconsistent effect on GERD symptoms, but moderate to high intake of alcohol increases the risk of GERD.
- Obesity is a well-documented risk factor for GERD, and the risk increases with an increase in body mass index (BMI). (6)
When to See a Doctor
It is crucial to seek immediate medical attention for GERD if any of the following symptoms occur:
- Unintentional weight loss
- Presence of blood in stools
- Unexplained anemia
- Fever accompanied by GERD symptoms
- Abdominal mass or enlargement of organs
- Swelling (edema)
If you’re encountering heartburn continually, talk with your doctor before taking any medications. If you have serious heartburn symptoms and they persist or worsen after taking remedial steps to lessen them, consult your doctor.
In some patients, heartburn can be an indication of an underlying ailment, such as gastroesophageal reflux disease (GERD), or conceivably a side effect of medication.
Final Word
Heartburn is a burning feeling in the chest, spreading out toward the mouth, as an outcome of acid reflux into the food pipe. Nonetheless, only a tiny portion of reflux issues cause any symptoms.
Heartburn is also frequently linked with a bad taste in the back of the mouth.
GERD is a common health issue with substantial morbidity and has a negative effect on the quality of life. Early assessment of symptoms is crucial to prevent complications of GERD. Lifestyle changes are a must for heartburn treatment.
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