Heartburn

Article written by
Dr Jaya Ghosh Chatterjee
DNB (General Medicine),
DNB (Gastroenterology),
Consultant Gastroenterologist & Hepatologist

Heartburn is a burning sensation in your chest that often occurs with a bitter taste in your throat or mouth. The symptoms of heartburn may get worse after you eat a large meal, spicy/fatty meal or when you’re lying down immediately after meal. In general, you can successfully treat the symptoms of heartburn at home. However, if frequent heartburn happens, or if there is difficulty in swallowing, respiratory symptoms & also in case of elderly or anemic patients, with or without weight loss they should consult a physician or gastroenterologist.

What Causes Heartburn?

Heartburn typically occurs when contents from the stomach back up into the esophagus. The esophagus is a tube that carries food and fluids from the mouth into the stomach. Your esophagus connects to your stomach at a junction known as lower esophageal sphincter which is considered a functional sphincter like zone. If the LES (lower esophageal sphincter) is functioning properly, it remains closed most of the time & relaxes following meal to help food to enter the stomach.

In some people, the LES doesn’t function properly or it becomes weak. This leads to contents from the stomach regurgitate back into the esophagus even when in empty stomach. Stomach acids can irritate the esophagus and cause symptoms of heartburn. This condition is known as gastro esophageal reflux disease (GERD).

Heartburn can also be the result of a hiatal hernia. This happens when part of the stomach pushes through the diaphragmatic hiatus of esophagus and into the chest.

Heartburn is also a common condition during pregnancy. When a woman is pregnant, the progesterone hormone can cause the lower esophageal sphincter to relax. This allows stomach contents to travel into the esophagus, causing irritation.

Other health conditions or lifestyle choices can worsen your heartburn, including:

• smoking
• being overweight or obese
• consuming caffeine, chocolate, or alcohol
• eating spicy foods
• lying down immediately after eating
• taking certain medications, such as aspirin or ibuprofen

When to See Your Doctor

 Many people occasionally experience heartburn. However, you should contact your doctor if you experience heartburn frequently; persisting for more than 6 months or associated with alarming manifestation. The symptoms are given below:

• difficulty swallowing
• pain with swallowing
• dark, tarry, or bloody stools, anemia, weight loss, elderly patient, with family history of GI cancer
• shortness of breath

Heartburn isn’t associated with a heart attack. However, many people that have heartburn believe they’re having a heart attack because the symptoms can be very similar. So if in doubt consult physician (look for jaw pain, pain radiation to left arm, crushing chest pain, etc)

What Are the Treatment Options for Heartburn?

If you experience occasional heartburn, there are several home remedies and lifestyle changes that can help alleviate your symptoms.

Lifestyle changes, such as maintaining a healthy weight, can help reduce your symptoms. You should avoid:

• lying down after meals
• using tobacco products
• consuming chocolate
• consuming alcohol
• consuming caffeinated drinks

Certain foods can increase the likelihood of experiencing heartburn. These include:

• carbonated drinks, alcohol, chocolates
• citrus fruits
• tomatoes
• peppermint
• fried foods, pickles

As an initial home remedy you may take antacid / H2 blocker or a PPI if no known contraindication is there.