Heartburn

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Heartburn refers to irritation of the oesophagus from the acid in the stomach. Though it is called heartburn, this condition does not have anything to do with heart. 

How does heartburn occur?

Heartburn results from the stomach acid moving backwards into the oesophagus, leading to burning of the lining of the oesophagus and therefore causing burning sensation at the upper central part of the abdomen. This acid burns the lining of the oesophagus because it lacks the protective layer against the acid which is present in the stomach.

Normally, the stomach is demarcated from the oesophagus by lower oesophageal sphincter, which is a smooth muscle ring between the stomach and the oesophagus. It opens to allow food enter the stomach and closes thereafter, preventing the content of the stomach from entering the oesophagus. 

What are the risk factors for heartburn? 

There are two mechanisms for heartburn to occur: malfunctioning of the lower oesophageal sphincter and excessive production of stomach acid (gastric acid).

1. Factors that affect the functions of lower oesophageal sphincter: 

  1. Overeating
  2. Pregnancy
  3. Obesity
  4. Constipation

These factors put pressure on the lower oesophageal sphincter and prevents it from closing properly, thus allowing gastric acid to flow back into the oesophagus and cause the symptoms of heartburn.  

2. Factors that increase acid production in the stomach 

Certain food items have been associated with increased gastric acid production. These include:

  1. Chocolate
  2. Tomatoes
  3. Oranges
  4. Onions
  5. Alcohol
  6. Coffee
  7. Tobacco

What are the symptoms of heartburn?

The following are what you will likely feel when you have heartburn 

  1.  Burning sensation at the upper portion of the abdomen behind the sternum (the bone at the centre portion of the chest)  or in the middle of the chest
  2. Burning sensation in the throat
  3. Bitter or salty taste at the back of the throat
  4. Difficulty in swallowing
  5. Chest pain while lying flat or bending over

What is the treatment for heartburn?

The treatment for heartburn is aimed at either neutralising the already produced acid or reducing the production of gastric acid. Both may be necessary. 

  1. Neutralising the stomach acid can be achieved by antacids. This helps to reduce the pain inflicted by the effect of the acid on the lower portion of the oesophagus. In addition, antacids help with indigestion or gas in the intestine, causing bloating.
  2. Reduction of acid production is achieved by certain drugs such as proton pump inhibitors and others. By reducing acid production, they reduce the tendency for acid to move into the oesophagus to cause heartburn.  

What are the complications of heartburn?

  1. Ulcer in the oesophagus from the wound created by the acid
  2. Difficulty in swallowing due to pain from the wound
  3. Cancer of the oesophagus may ensue if the condition persists unchecked  

How can heartburn be prevented?

  1. Eat moderately; avoid overeating
  2. Avoid lying down immediately after eating. Allow two to three hours after eating before sleeping 
  3. Elevate the head of bed when lying down or sleeping 
  4. Reduce weight if you are overweight or obese
  5. Avoid smoking and alcohol
  6. Avoid foods associated with increased symptoms of heartburn
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