Heartburn – Symptoms, Causes, Risk Factors, Diagnosis and Treatment
Heartburn (a burning sensation in the chest) is a common problem in which you feel pain in the chest behind your breastbone. You experience this problem in the evening, after having food while lying down or bending over. If you encounter this problem occasionally then there is no cause for concern. You can manage it using over-the-counter medicines and by making lifestyle changes.
The cause for concern with heartburn is when you experience it frequently and when your activities and daily routine get disturbed. In such cases, you should seek medical help to rule out any serious health issue, which may require medical care.
How common is heartburn?
Heartburn is common after meals in many people. Some people experience it while sleeping. In some people, heartburn and its associated symptoms manifest after they eat some foods or drink some beverages. In others, the problem seems to be common and frequent. In women, heartburn is common during pregnancy.
Symptoms of Heartburn
- Chest pain
- Burning sensation in the chest after eating food
- Chest pain and burning sensation at night
- Chest pain that aggravates with bending over and lying down
- Acidic or bitter taste in the mouth
Risk factors for heartburn
The avoidable risk factors that can trigger heartburn are mostly lifestyle-related including the following food items:
- Fried and fatty foods
- Spicy foods
- Excessive use of spices in foods
- Fatty meals
- Large meals
- Citrus products
- Carbonated beverages – soft drinks
- Coffee & Tea
- caffeinated beverages
The other risk factors include pregnancy and overweight.
What causes heartburn?
The food you eat passes through a tube that connects your mouth to the stomach. At its lower end, a band of muscles is present (lower oesophagal sphincter [LES]). Once the food leaves oesophagus and enters stomach these muscles contract and close to prevent the stomach contents’ re-entering into the oesophagus. LES may relax or weaken at the wrong time causing the backflow of stomach acid into the oesophagus. This leads to heartburn.
When is heartburn a sign of any complex health issue?
When you experience heartburn and its associated symptoms regularly and more frequently, it interferes with your daily activities. In other words, it is considered as GERD (gastroesophageal reflux disease). Frequent heartburn can damage the oesophagus and may lead to Barrett’s oesophagus (abnormal changes in the oesophagus).
When to See a doctor for Heartburn
You must see a doctor immediately if you experience severe chest pain with heaviness and pressure inside your chest. In addition to chest pain, if you experience pain in your jaw, arms, neck and back with breathing difficulty, then these symptoms could be due to heart problem or heart attack.
You should make an appointment with the doctor
- If the symptoms of heartburn occur more frequently
- If you are not getting any benefit by the use of OTC medicines
- If your symptoms seem to persist in spite of taking all measures
- If you have swallowing difficulty
- If you have persistent nausea and vomiting
- If you have lost weight due to poor appetite and eating difficulty
Diagnosis of GERD if your heartburn is due to GERD
When your gastroenterologist suspects that your heartburn is due to GERD, he or she may perform a diagnostic procedure called endoscopy to check abnormalities in your oesophagus. During this procedure, a small tissue sample from the oesophagus is taken out for analysis (biopsy). Oesophageal motility testing and ambulatory acid probe tests may also be done to diagnose GERD.
Treatment for Heartburn
Many people take over-the-counter medicines including antacids and antagonists to get relief from heartburn symptoms. However, when the underlying cause is GERD, you should seek an appointment with a gastroenterologist for appropriate treatment.
When you experience heartburn frequently and the episodes of heartburn are interfering with your work and routine activities, you should consult your gastroenterologist to rule out any major health issue, which may be the cause for heartburn.
Dr. Nagarjuna Yarlagadda
MBBS, MD (General Medicine), DM (Gastroenterology – PGI)
Chief Gastroenterologist, Hepatologist & Therapeutic Endoscopist
Medical Director, Sunshine Hospitals