An in depth guide for anyone who asks: What is heartburn?

For millions of people all over the world, meal time can come with a touch of trepidation. The reason being the horrible burning pain that can also cause nausea, and enough discomfort to seek medical attention. What is this horrific experience? It is an aptly named condition called heartburn, and it can feel exactly like your chest is burning inside. Despite it being a rather unpleasant condition to deal with, many people never seek medical treatment from a doctor for it. The most common solutions involve changing a diet, or simply trying different over-the-counter remedies for it. However, it is important to understand that frequent episodes of bad heartburn can be a sign of something more severe than a temporary nuisance.

A bit on the science behind what is heartburn. 

Even though it can feel like your chest, in particular your heart region, is on fire and hurting, heartburn pain is actually originating from the esophagus. More specifically, it is the result of stomach acid rising up from the stomach and irritating the lining of the esophagus. Normally food and liquids travel down the esophagus and into the stomach, through the LES (lower esophageal sphincter). This ring of muscle tissue normally keeps the stomach acid where it belongs. At times, if the muscles do not close tightly enough, or when they open too often, acid will escape from the stomach and cause harm to soft tissues in the esophagus, which are not made to withstand the stronger digestive enzymes. A good example to think of is if you’ve ever eaten something too quickly and got a bit of painful nausea.

Some people may ask, “Why do I have heartburn when I’ve eaten normally?”

There are actually a number of reasons why people develop heartburn. Poor eating habits, which include eating food too quickly, or eating rich, spicy, or fatty foods can also contribute to developing heartburn. Caffeine, garlic, tomatoes, citrus, onions, peppers, and even chocolate are common food triggers for heartburn. This is due to the relaxing effect these and other foods can have on the LES. Other contributing factors for heartburn include excessive or persistent pressure being applied to the stomach. Binding garments such as girdles, obesity, and pregnancy are all conditions or devices that can contribute to developing heartburn. At times, there can be a serious underlying medical condition called GERD, which stands for GastroEsophageal Reflux Disease. It is a condition that is characterized by frequent and sometimes, severe heartburn, which can also lead to other conditions such as esophageal ulcers if left untreated. At times, those who suffer with GERD may not even have the typical triggers or conditions that other people, who have regular occasional bouts of heartburn.

It is important to discuss frequent or persistent heartburn with your doctor.

Heartburn can often be a term that is interchanged with others, such as indigestion and acid reflux. Whatever you refer to it as, if it is occurring frequently, or is unresponsive to over the counter treatments, medical advice should be sought. It is a very common problem and, while some people have reservations when it comes to discussing such things with their doctor, it is a very natural condition to discuss. Doctors are highly trained individuals, and have likely been asked, “What is heartburn, should I be concerned?” thousands of times over the course of their career. The truth is, any concern is a valid one that deserves being addressed. With the potential seriousness of an underlying condition, stubborn heartburn should be discussed with your doctor. The stomach is specially designed with a thick mucous lining to protect the tissues from the harsh stomach acid used to break down food. It is the only place in the body that acid belongs. When it gets into the throat, the nasty burning pain, which can even feel like a heart attack at times when it is really severe, can also cause severe damage. When there is another cause behind the frequent and severe acid reflux (the act of the acid coming into the esophagus), it is important to address it and treat it as thoroughly as possible.

The treatments will vary depending on the reasons for heartburn.

For some patients, such as those who get some relief from over-the-counter medications, the answer can be simply taking prescription level doses. Ranitidine (Zantac) is a very common medication that can be used to keep heartburn under control and is available in an over-the-counter and prescription strength dosage. Famotidine (Pepcid) and Cimetidine (tagamet) are the three most common heartburn treatments that are available in over-the-counter and prescription strength forms. They are all intended to help combat and neutralize the acid that is causing the heartburn. When taken as prescribed, they can treat acid reflux in patients of all ages, from infant to elderly. When there is an over production of acid in the stomach to begin with, which can also be the cause behind frequent heartburn, stronger medications that actually inhibit the amount of acid production can be used. Esomeprazole (Nexium) and Omeprazole (Prevacid) are two medications used that can reduce the amount of stomach acid, and again are available in over-the-counter and prescription strength doses. When none of these, or some of the other prescription do not work, it may take more in depth testing to get to the bottom of the problem.

Less common problems that contribute to frequent heartburn.

At times, the problem is beyond just having too much acid, or having other issues that are contributing to heartburn. There is a bacteria that has gotten a good bit of press in the last decade or so: H. Pylori. The symptoms of a H. Pylori infection can include indigestion or heartburn like symptoms that many people mistake for just being a mild to moderate case of heartburn. The fact that an antacid can soothe the milder symptoms is partially why many people are not treated until the symptoms get more severe, or not until they develop an ulcer. It is one of the reasons why doctors tend to not ignore and encourage patients to discuss any sort of indigestion or heartburn problems they may be having. The earlier H. Pylori is caught and treated, the better the outcome and more reduced the risks for complications are. Ulcers and in rare cases, cancer can both be the end result of an H. Pylori infection.

In other cases, heartburn is not as much a result of excessive acid, but an injured or deformed LES. A simple operation, performed with a laparoscope and not an open incision, can be done to correct the defect. It is not usually a long hospital stay for patients and the recovery period is fairly short. Though, in addition to the operation, a modified diet is prescribed, along with complimentary medications to ensure the LES heals as quickly and completely as possible. Diagnosing a serious problem with the LES can take specialized imaging test to watch the LES in motion, or through a scope. When heartburn does not respond well to multiple treatments over a long period of time, doctors will often consider investigating the LES itself once other conditions such as H. Pylori are ruled out.

Can heartburn be treated naturally?

Occasional and less severe cases of heartburn can possibly be treated by paying closer attention to what is eaten, or with more natural remedies. Simple treatments include chewing sugarless gum for half an hour after eating a meal can help prevent heartburn for some people. It works by using saliva to help flush any acid that might creep up into the esophagus back down into the stomach and through the rest of the digestive tract. Aloe Vera juice is another remedy that people can try to help calm the irritation and inflammation caused by the acid refluxing into the esophagus. Other natural remedies include having snacks to help reduce the acid naturally, such as apples and bananas, which can be eaten as needed or daily as a form of natural prevention. A teaspoon of quality yellow mustard is also a natural antacid treatment that can be a pleasing alternative for those who don’t like to take a lot of manufactured medications. Though, the only problem with natural remedies is that they are not able to handle more serious cases of heartburn.

Knowledge is power when it comes to understanding what is heartburn.

Even mild heartburn, when it happens more than just occasionally, should be enough discomfort to prompt a visit to the doctor. Acid damage in the esophagus can lead to a host of much more unpleasant problems, which also require more costly treatments. The widespread problem of heartburn has made it a very commonplace condition, that doctors are accustomed to treating, and one they have gotten very skilled at treating. In almost every instance, pain is your body’s way of saying something is wrong. So why should the pain of heartburn not be taken as serious as any other pain?

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