Heartburn is common after a heavy or a spicy meal. But if heartburn occurs regularly, is it something to worry about? Let us find out.

Table Of Contents

What is Heartburn?

Heartburn is a burning feeling in the lower chest, behind the breastbone, which can rise towards the throat. The burning pain usually occurs in waves. It is usually caused by stomach acid that moves up through a valve and irritates the unprotected oesophagus.

The following are other symptoms of heartburn:

  • Burning sensation in the middle of the chest
  • A burning feeling in the throat
  • Unpleasant sour or salty taste in the mouth due to stomach acid
  • Bad breath
  • Bloating and feeling sick
  • Difficulty swallowing
  • Recurrent cough or hiccups
  • Hoarse voice

Heartburn can happen after meals, when lying down, bending over, or during the night. It can last for a few minutes, a few hours or more. Some individuals cannot sleep due to heartburn, as lying down increases the pain.

Pregnant women have regular episodes of heartburn as their body undergoes several hormonal and physical changes.

Occasional heartburn can often be managed by certain lifestyle changes and over-the-counter medicines. However, frequent episodes of heartburn may interfere with your daily routine and may become a cause for concern; it may indicate a serious medical condition that needs medical care.

What Causes Heartburn?

Understanding how the oesophagus and stomach work, can give you a clear idea of how heartburn occurs.

When you eat food, it passes from the mouth to a narrow tube called oesophagus. At the bottom of this tube is a band of muscle (valve or sphincter) that opens and allows the food to pass through it and enter the stomach. Following this, it closes to prevent the backflow of the stomach contents. In the stomach, a strong acidic mixture is present which helps digest the food.

Due to some reason, if the sphincter does not close properly, the acidic mixture from the stomach may enter the oesophagus, this is known as acid reflux. This results in the burning sensation in the chest.

The lining of the stomach is designed to bear the acidic environment; however, the oesophagus is not built to hold the acidic mixture, which results in damage to the oesophagus wall.

Few medical conditions may cause reflux and heartburn, such as:

Heartburn can also occur due to some lifestyle and eating habits, such as large portion of meals, certain fried and spicy foods that you eat, eating closer to the bedtime

Regular Heartburns – Should I Worry?

Frequent episodes of heartburn can indicate a serious medical condition.

When acid reflux and heartburn occur frequently, the lining of the oesophagus may get damaged. It can lead to inflammation and narrowing of the oesophagus and conditions like Gastroesophageal Reflux Disease, Barrett’s Esophagus and rarely oesophageal cancer. Therefore, it is important to visit a doctor and get diagnosed properly.

If you have the following, immediately contact your doctor:

  • Heartburn that does not go away
  • Heartburn symptoms have worsened or occur frequently
  • Difficulty in swallowing
  • You have lost significant amount of body weight suddenly
  • Over-the-counter antacids did not relieve heartburn, despite taking them for more than two weeks
  • Prescribed medications failed to reduce heartburn
  • Serious hoarseness or wheezing
  • Heartburn interferes with your daily activities

About GERD

Heartburn is a common symptom of GERD due to the acid reflux, which irritates the lining of the oesophagus. GERD is defined as mild acid reflux that occurs at least twice a week or moderate to severe acid reflux that occurs at least once a week. It is experienced by 1 in 10 people every day.

Along with heartburn, individuals with GERD have other symptoms, including coughing, asthma and laryngitis. However, some people do not show any symptoms.

In severe cases of GERD, the oesophageal lining begins to appear like the stomach lining. This is a pre-cancerous condition called Barrett’s Esophagus. But only few patients with GERD develop Barret’s Esophagus, and a small fraction of these patients develop esophageal cancer. According to the Society for Gastrointestinal Endoscopy, one of 200 patients with Barrett’s Esophagus develop cancer per year.

To be on the safer side, if you have heartburn and other symptoms of GERD, consult a doctor for an accurate diagnosis.

Treatment of Heartburn

Heartburn is usually treated with over-the-counter medications, such as:

  • Antacids: These medicines neutralize stomach acid and provide quick relief. But these drugs cannot heal the oesophagus lining damaged by stomach acid.
  • H-2-receptor antagonists: These drugs reduce the stomach acid. The do not provide immediate relief like antacids but may provide relief for a longer period.
  • Proton pump inhibitors: These drugs can also reduce the stomach acid.

If over-the-counter treatments do not provide any relief, or you can take them repeatedly, you must consult a doctor.

Your doctor may prescribe alternative medicines to treat heartburn or help diagnose the underlying cause. Sometimes, an endoscopy may be performed to view inside the oesophagus and understand the problem. During an endoscopy, a flexible catheter with light and camera is inserted into the digestive system.

Your surgeon will also help you identify the foods that may trigger heartburn, so that they can be avoided. The doctor would also advise on making certain lifestyle changes to manage heartburn.

If heartburn is severe and is caused by GERD, surgical interventions such as fundoplication, insertion of LINX device, or transoral incisionless fundoplication may be performed.

Reach us

If you have regular heartburn and the medications prescribed do not seem to be effective, you can email or call us.

Our specialist, Dr. Parthasarathy is one of the most renowned surgical gastroenterologists in Hyderabad, India. He has about 15 years of experience and has obtained surgical training from the premier institutes of the country and abroad.

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