What is Heart Burn?

Heart burn is a discomfort or pain caused by the stomach contents traveling up from the stomach up into the gullet (lower part of your esophagus). The gullet is not made to withstand acid and is irritated and inflamed when acid from the stomach travels up into it.

Sometimes the pain caused by heart burn can also be felt in the mid-line of the back.

Heartburn has nothing to do with the heart. Heart burn is a digestive problem. Heart burn is usually related to meals and posture and can often be relieved by remedies for indigestion. Most people suffer from heart burn at one time or another during their lifetime.
If you have heartburn, you might have a bitter taste in your mouth from stomach acid.

Heart burn is also called reflux oesophagitis.

What are the Symptoms of Heart Burn?

The main symptoms are: burning sensation in the center of the chest and belching.

What Causes Heart Burn?

Heart burn is caused by a faulty muscle in the stomach. There is a "flap" at the top of the stomach that stops food from traveling back up into the esophagus. Sometimes the flap doesn't work properly and stomach acid escapes from the stomach. When the acid escapes, heartburn occurs.

Factors that contribute to Heart burn: pregnancy, smoking, eating large meals, being overweight, and wearing tight clothing around the waist.

How do you get Heartburn?

Normally, a ‘valve’ at the lower end of the swallowing pipe (the lower oesophageal sphincter) opens when you swallow and closes when food has passed. In some people, this does not work properly and does not close off when it should, usually after a meal.

• Heartburn can be infrequent or can occur regularly in patients with conditions such as acid reflux disease.
  
  
• In patients with acid reflux disease, heartburn usually gets worse after they eat, or when they lie down or bend over.

How serious is Heartburn?

Heartburn symptoms produce a lot of discomfort and can affect feelings of well-being when they appear regularly. Heartburn may signal other problems such as oesophagitis (inflammation of the oesophagus) or GERD, which can be more serious. Patients may then require stronger medicines to control symptoms if heartburn persists, so it is important to seek a doctor’s advice.

How long does Heartburn last?

The symptoms of heartburn can be frequent and may last several weeks, months or longer if left untreated. Because they may appear now and again they may be experienced for a long time before a decision is taken to seek medical advice. They can also re-occur after treatment

What increases the risk of heartburn?

There is often no known reason for increases in heartburn. But occasionally one of the factors below may contribute.

Hiatus hernia

This is the name for the condition where the upper part of the stomach has passed up through the hole in the diaphragm.

This means the muscle fibres of the sphincter can't press on the lower part of the food pipe. As a result, the lower part of the gullet is normally open, when it should be closed.

Obesity

In people who are overweight the fat in their abdominal cavity exerts more pressure on the stomach. This causes high pressure inside the stomach, and the contents of the stomach may then be pushed up into the food pipe. Weight loss will reduce the chance of stomach acid reflux.

Pregnancy

The enlarged uterus (womb) presses on the stomach. This causes the same kind of high pressure inside the stomach as in people who are overweight.

The change that pregnancy brings to the balance of the hormones also leads to a general relaxation of the gullet sphincter.

Large meal portions

The risk of stomach acid reflux increases with more food in the stomach. The risk will be greater after large (and especially fatty) meals, where the food is in the stomach for a long time before it passes on to the intestines. If you avoid eating more than is necessary, the risk of stomach acid reflux is reduced.

Lying down

If you lie down, the chance of stomach acid reflux increases due to gravity. You can avoid this to some extent by raising the head-end of your bed

Is Heart Burn Caused by Hiatal Hernia?

Hiatal hernia is a very common condition. It occurs when the stomach partially sits in the chest cavity through a weakness in the diaphragm. Sometimes, a persistent hiatal hernia can cause heartburn. However, many people who experience heartburn do not have a hiatal hernia. Also, many people with a hiatal hernia do not experience heartburn. Your doctor can determine if heartburn is caused by a hiatal hernia.

Heart Burn Statistics

In the United States, about 50% of the population has heart burn at least once a month. About 7% of the population has heart burn daily.

How is Heartburn treated?

Medications commonly used in the treatment of heartburn include:

• Acid suppressants, such as histamine H2-antagonists (blockers). Histamine is a chemical released in the body under many different conditions. In the stomach it can release more acid, so blocking histamine’s action reduces acid production.
  
  
• Proton-pump inhibitors also work on the cells in the stomach wall, which make acid, to reduce the amount of acid produced and released into the stomach chamber.
  
  
• Other medicines (called pro-kinetic agents) increase the movement of the stomach. They work by increasing the pressure of the lower oesophageal sphincter (the point where the oesophagus joins the stomach) and promote emptying of the stomach.
  
  
• Antacids are medicines that are commonly used to treat acid-related symptoms, like heartburn or indigestion, and work by neutralising acid in the stomach. However, they are not usually recommended to treat the frequent heartburn suffered by people with GERD.<br>
  
  

Complications of Heart Burn

If heart burn is not controlled, it can cause serious complications. Some common complications of heart burn are:

• Esophagitis
  
  
• Esophageal bleeding
  
  
• Esophageal ulcer
  
  
• Barrett's esophagus
  
  
• Strictures
  
  
• Increased risk of esophageal cancer