Heartburn

Heartburn is indigestion felt as a burning sensation due to acid coming up to the upper parts of the esophagus. The pain is more when one bends or lays down. A lot of the times its quite uncomfortable.

Here we will cover why how and when heartburn occurs and how to prevent and manage heartburn keeping in mind that heartburn is just a one of the symptoms of a more serious problem that require medical attention.

How heartburn occurs.

heartburn occurs due to weakening of the lower esophageal sphincter, a circular muscle that prevents gastric contents from going up from the stomach. The stomach contents are acidic due to presence of gastric  and hydrochloric acid. the stomach has a protective lining that prevents it from injury by the acid. Look at below diagram to see how heartburn occurs.

how heartburn occurs

Causes of heartburn

The main cause of heartburn is Gastroesophangeal Reflux Disease(GERD/GORD).

In GERD, stomach contents flows back to the esophagus. Because th stomach contents are acidic and the esophagus does not have the protective mucus lining, there is direct irritation of the esophagus. This causes the burning pain felt in the chest.

signs and symptoms of gastroesophageal reflux,

  • Hoarseness or sore throat
  • feeling of a lump in the throat.
  • regurgitation of food into the mouth.
  • Chest pain.

If the following occurs see a doctor immediately,

  • shortness of breath,
  • chest pain that radiates to the shoulders
  • Pain in the jaw...
  • these may be signs of heart attack.

other causes of heartburn.

Pregnacy causes heartburn by putting pressure on the  lower esophangeal sphincter and reflux occurs.

Overeating especially fatty foods. Full stomach puts a lot of pressure on the  lower esophangeal sphincter and reflux occurs.

spiced foods. These have a direct irritation on the gut wall and triggers the vomiting reflex. This leads to moving of stomach contents into the esophagus.

Black pepper, alcohol especially red wine, raw onions, tomatoes.

Tea and coffee cause heartburn probably by stimulating release of gastric and hydrochloric acid.

Obese people have a risk of having a heartburn because of the pressure impacted by fat on the gastric contents.

It should be noted that heartburn is caused by multiple factors.

foods that cause heartburn

foods that cause heartburn

management and treatment of heartburn.

The best treatment for heartburn is by avoiding the causative agent. other non-pharmacological methods are as follows;

Milk treats heartburn by neutralizing gastric acid using the calcium ions present in milk.

medicines used in heartburn.

calcium carbonate tablets act by neutralizing acid in the stomach. they are chewable tablets.

Magnesium trisilicate plus aluminium hydroxide. Magnesium causes diarrhea  while aluminum hydroxide cases constipation. when mixed the cancel out the effects. Because heartburn is accompanied by bloating,   most antacids also contain simethicone which relieves the bloating .

Alginic acid/alginate is very effective in preventing gastric reflux. Alginate floats on the gastric contents and blocks refluxing through the lower esophageal sphincter.

Below are some brands of medicines that contain alginate and therefore very good for gastric reflux.

medicine that reduce acid production are also used . examples are;

cimetidine and ranitidine may be used but not recommended  because they cause low libido, enlarging of breasts in males and other unwanted effects

Treating Heartburn by prevention

Foods to avoid to prevent heartburn

 

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Dr Mathu

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