HeartBurn: Symptom, Causes, Risks and Treatment

Heartburn, also known as acid reflux, is a common condition that affects many individuals. It occurs when the contents of the stomach, including stomach acid, come up against the flow into the oesophagus. This backward movement may cause a burning sensation in the thoracic region just behind the breastbone. Having heartburn occasionally is normal, but frequent or persistent episodes of this condition can indicate the presence of an underlying condition. In this blog, we will see the answer to a common question: "What causes heartburn every day”?

Symptoms of Heartburn

Heartburn can manifest in various ways, and recognising the signs is crucial for seeking appropriate treatment. Common symptoms are:

• Burning in the Chest or Throat Region: This is the most prominent symptom of heartburn. The burning sensation typically starts in the upper abdomen and radiates upward, sometimes reaching the throat. It generally gets worse after having food, at night or when lying down or bending over. 
• Sour or Bitter Taste: When stomach acid flows into the oesophagus, it can leave a sour or bitter taste in the mouth, followed by a burning sensation.
• Difficulty Swallowing: In some cases, heartburn can cause discomfort or pain when swallowing, making it difficult to eat food or drink liquids.
• Regurgitation: Heartburn may cause the stomach's contents to move back into the oesophagus. 
• Chest Pain: In the worst cases, heartburn can cause chest pain. It may look like a symptom of a heart attack, because the pain can extend to the arm, neck, or jaw.

Causes of Heartburn

Many reasons may contribute to heartburn. Common causes are:

• Diet: Some foods and drinks that usually cause or worsen heartburn in some people. These include spicy, fried and fatty foods, along with citrus fruits, tomatoes, coffee and alcohol. They usually relax the lower oesophageal sphincter (LES) or increase stomach acid, which can increase the chances of heartburn.
• Obesity: Excess weight, especially around the waistline, can put pressure on the stomach and cause acid reflux in some people.
• Pregnancy: Hormonal changes seen in a pregnant woman can relax the lower oesophageal sphincter (LES), allowing stomach acid to flow back into the oesophagus.
• Medications: Some medicines, such as certain pain relievers, antidepressants, and blood pressure medications, can weaken the LES or increase stomach acid production.
• Hiatal Hernia: This condition occurs when a part of the stomach protrudes through the diaphragm, allowing stomach contents to reflux more easily into the oesophagus.
• Smoking: Smoking is one of the reasons for heartburn. Nicotine from tobacco can weaken the LES and increase stomach acid production.
• Stress and Anxiety: When you take stress for a long time, it may increase your stomach acid secretion and cause heartburn.

Risk Factors

Heartburn can affect anyone, but certain things can increase your chances of getting this problem, like if you are:

• Obese or overweight
• Pregnant
• Smoking
• Consuming certain foods and beverages (e.g., spicy, fried, or fatty foods, citrus fruits, tomatoes, coffee, alcohol)
• Having a lot of stress 

How is Heartburn Diagnosed?

The diagnosis of heartburn is usually done by the symptoms that the patient reports. However, a doctor may recommend further testing to rule out other conditions or identify the underlying cause if the symptoms are severe or persistent. Diagnostic tests for heartburn may include:

• Endoscopy: In this test, a doctor may put a thin, flexible catheter to see the lining and check if there are any abnormalities or damage.
• pH Monitoring: In this test doctors use a small catheter or a wireless sensor to evaluate the acidity of the oesophagus over a 24-hour period.
• Barium Swallow: In this test, a person swallows a barium solution, which coats the oesophagus and stomach. After that the doctor uses X-ray imaging to check these organs.
• Oesophageal Manometry: This test usually checks the strength and coordination of the oesophageal muscles and the function of the LES.

Treatment for Heartburn

The treatment usually depends on its severity, frequency and the real cause behind it. Common treatment options are:

• Lifestyle Changes: Making some dietary changes, such as avoiding trigger foods, eating smaller meals, and not lying down immediately after eating. These can reduce heartburn symptoms.
• Over-the-counter Medications: Antacids can neutralise stomach acid and provide temporary relief. Histamine-2 receptor antagonists (H2 blockers) and proton pump inhibitors (PPIs) can also reduce stomach acid production.
• Prescription Medicines: In cases of severe or chronic heartburn, doctors may prescribe stronger medicines, such as prescription-strength PPIs or prokinetic agents, which help strengthen the LES and improve gastric emptying.
• Surgery: In some cases, when lifestyle changes and medications are not giving relief, doctors recommend surgery to reinforce the LES or repair a hiatal hernia.

When to See a Doctor?

While occasional heartburn is common, you can often manage it with over-the-counter medications and lifestyle changes. It's essential to seek medical attention in certain situations:

• Persistent or Severe Symptoms: If heartburn occurs frequently or is accompanied by intense pain, difficulty swallowing, or weight loss, it may be an indicative sign of a more serious ailment, such as gastroesophageal reflux disease (GERD) or oesophageal cancer.
• Symptoms Lasting More Than Two Weeks: Prolonged heartburn may indicate an underlying disease that requires medical evaluation.
• Presence of Additional Symptoms: If heartburn accompanies other symptoms, like chest pain, breathing difficulty, or jaw or arm pain, it can even be a sign of a heart attack.

Conclusion

Heartburn is a common problem, but it can be managed with healthy lifestyle changes, diet modifications, and over-the-counter medicines. Some people may need to talk to a doctor for prescription treatment or medical procedures, depending on the severity and actual cause. When you understand the symptoms, triggers, and risk factors, you can take the right steps to reduce discomfort and lower the risk of complications. However, if you get heartburn frequently, or if it is severe or if you have other symptoms (like chest pain, difficulty swallowing or unexplained weight loss) talk to a doctor. They will diagnose the exact cause and give you the right treatment.

FAQs

1. What reduces heartburn?

Several strategies can reduce heartburn symptoms, like:

• Avoid beverages and foods that can worsen heartburn, such as spicy, fried, or fatty foods, citrus fruits, tomatoes, coffee, and alcohol.
• Try to maintain a proper body weight.
• Don't lie down immediately after having food.
• Stop smoking. Nicotine can make your lower oesophageal sphincter weak and also increase the production of acid in your stomach.
• Reduce your stress and anxiety.
• Take over-the-counter antacids or medications as recommended by a doctor.

2. What can I drink if I have heartburn?

When you have heartburn, it is better not to take some beverages, like caffeinated drinks (coffee, tea, sodas), alcohol, and citrus juices (like orange, grapefruit, and lemon). It is best to keep yourself hydrated with water and some non-acidic drinks like:

• Milk or plant-based milk alternatives
• Herbal teas (e.g., chamomile, ginger, fennel)
• Low-acid fruit juices (e.g. apple, pear, papaya)

3. What food stops heartburn?

While no single food can completely stop heartburn, certain foods may help alleviate symptoms or reduce the risk of acid reflux:

• Low-fat dairy products (milk, yoghurt, cottage cheese)
• Whole grains (oats, brown rice, whole-wheat bread)
• Lean proteins (chicken, turkey, fish)
• Vegetables (leafy greens, broccoli, carrots)
• Fruits (bananas, melons, apples)
• Ginger (fresh or grated)
• Fennel seeds or fennel tea