Heartburn

Heartburn

What is heartburn?
Heartburn is a burning discomfort that is generally felt in the chest just behind the breastbone. The burning sensation results when harsh stomach juices come in contact with and irritate the delicate lining of the esophagus, the tube-like structure that connects the mouth to the stomach.

What causes heartburn?
Heartburn is caused when acidic stomach juices reflux—or flow backward—into the esophagus. This generally occurs when the lower esophageal sphincter (LES)—the natural valve that keeps stomach acid in the stomach and out of the esophagus—relaxes or is not functioning properly.

When functioning normally, the LES opens like a door that allows food into the stomach but not out the same way. However, at times the LES relaxes and allows stomach juices to flow upward into the esophagus. This relaxation exposes the esophagus to the harsh acid from the stomach. Physicians refer to this as gastroesophageal reflux.

What does heartburn feel like?
People with heartburn generally describe one or more of the following symptoms:

  • a burning chest pain that begins at the breastbone and moves up toward the throat
  • a feeling that food or liquid is coming back into the mouth or throat
  • an acid or bitter taste at the back of the throat
  • an increase in severity of pain behind the breastbone when lying down or bending over

When should I consult a health care professional?
Most types of heartburn are treatable. However, persistent and severe heartburn can signal other more serious conditions that may eventually lead to complications. With this in mind, be sure to consult a health care professional if you experience these symptoms which may signal GERD:

  • Suffer from heartburn symptoms even after taking the full course of prescription or OTC medications
  • Have taken OTC medication for heartburn for a longer period than recommended on the label without consulting a doctor
  • Experience severe hoarseness or wheezing
  • Experience swallowing that is painful or difficult, especially with solid foods or pills
  • Experience vomiting or drastic weight loss
  • Find that your discomfort interferes with your lifestyle or daily activities
  • Symptoms become more severe over time

Consult your doctor immediately if you experience any of the following alarm symptoms:
Chest pain accompanied by pain in the neck, jaw, arms or legs, shortness of breath, weakness, irregular pulse or sweating

  • Continuous nausea, vomiting or diarrhea
  • Extreme discomfort in stomach
  • Vomiting of blood or black material
  • Black or bloody bowel movements
  • Difficulty or pain with swallowing

What Is GERD?
Note: Chest pain may also be caused by heart problems. Be sure to have all chest pain evaluated by a doctor.
After you eat, food travels from your mouth down the esophagus to your stomach. Along the way, food passes through a one-way valve called the lower esophagealsphincter (LES), the opening to your stomach. Normally the LES opens when you swallow. It allows food to enter the stomach, then closes quickly. With GERD, the LES doesn’t work normally. It allows food and stomach acid to travel back (reflux) into the esophagus.

Self-help for heartburn sufferers:

  • Limit foods and beverages that fan the flames.
    Avoid foods and beverages that trigger symptoms and may irritate lining of the esophagus or affect the LES which controls the flow of acid from the stomach into the esophagus. These items include chocolate, peppermint, fatty foods, alcoholic beverages, citrus fruits and juices, garlic and raw onion, tomato sauce, vinegar, caffeinated and carbonated beverages.
  • Eat smaller dinners... and eat earlier.
    Decrease the size of portions at mealtimes and eat meals at least 2-3 hours before lying down to lessen the likelihood of reflux.
  • Monitor your meds.
    Check with your health care professional to see if one of the medications you are taking might be triggering your heartburn. Aspirin and other pain medications (other than acetaminophen), some antibiotics and iron tablets are a few of the common culprits. Never stop taking any prescribed medication without consulting your health care professional.
  • Feel the burn without the burn.
    Certain types of exercise that increase abdominal pressure can aggravate heartburn symptoms, but don't give up this healthy habit. Talk to your trainer or fitness expert at the local gym about exercise substitutes and try not to eat just before, during or just after exercise.
  • Shed some pounds.
    Extra pounds can increase heartburn incidence. Some heartburn sufferers find their symptoms improve by losing weight through a healthy weight-loss plan.
  • Stop or decrease smoking.
    Cigarette smoking inhibits saliva, one of the body's natural protective barriers against damage to the esophagus. Smoking also may stimulate acid production and weaken the important valve that prevents stomach acid from entering the esophagus.
  • Fight acid creep while you sleep.
    Elevate the head of your bed four to six inches using blocks to prevent acid from creeping up the esophagus. Also, try sleeping on your left side, which may decrease reflux symptoms.
  • Loosen up.
    Reduce abdominal pressure by not wearing tight belts or binding clothing.
  • Find the pharmacy.
    Try an over-the-counter medication and take as directed for heartburn. Ask your pharmacist to recommend a medication appropriate for your type of heartburn.
  • Relax.
    Stress is not proven to cause acid reflux but it can make you more aware of your heartburn symptoms. Also, because of stress, one may engage in behaviors that trigger heartburn—eating high-fat foods, smoking, drinking caffeinated beverages.
  • Linger over lunch.
    Slow down and eat less. Gulping down food in a hurry can result in eating more before you feel satisfied. Over-filling the stomach can result in reflux and heartburn.
  • Keep a reflux record.
    Try to keep a diary noting when heartburn hits and the specific activities that seem to trigger the incidents. The diary can help you identify what you should avoid and may be a helpful tool for your health care professional to evaluate your condition and treatment needs.
  • Ask your doctor.
    If you are consistently taking medicine for heartburn or if you still have symptoms after taking medication, you should see a health care professional. You might have gastroesophageal reflux disease, or GERD, which, if left untreated, may be potentially serious. If you have alarm symptoms consult your doctor immediately.

Heartburn or Heart Attack?
Here are some possible differences between the two ailments. Note: If you have any chest pain that lasts for more than a few minutes—or any warning signs of a heart attack do not try to decide for yourself—seek immediate medical attention.

Possible signs of angina or heart attack:

  • A feeling of fullness, tightness or dull crushing pressure or pain generally in the center of the chest
  • Often occurs with activity or exertion
  • Pain may spread to the shoulders, neck, arms or jaw
  • Often responds quickly to nitroglycerin (unresponsiveness to nitroglycerin in the presence of angina or heart attack should be treated as a medical emergency)
  • May be associated with an irregular pulse
  • Often accompanied by a cold sweat and shortness of breath
  • Nausea and possible vomiting
  • Might experience lightheadedness, weakness or dizziness

Possible signs of heartburn:

  • A sharp, burning sensation just below the breastbone or ribs
  • Pain generally does not radiate to the shoulders, neck, or arms, but it can
  • Pain usually comes after meals
  • Symptoms usually respond quickly to antacids
  • Rarely accompanied by a cold sweat, shortness of breath, lightheadedness or dizziness
Fremont Area Medical Center
450 East 23rd Street
Fremont, NE 68025
(402) 721-1610

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