How to Treat Heartburn?

Introduction:

Usually, at night, an individual may feel a sour liquid in their throat coming from beneath or a burning sensation in their upper tummy. The pain goes up through our chest to the throat. Sometimes, people fear it as a heart attack. In medical terms, this is called heartburn or gastroesophageal reflux disease (GERD).

How Does Heart Burn Occur?

The food people eat starts getting digested right from the mouth up to the large bowel. Food passes through the mouth to the throat and then the food pipe, stomach, small and large bowels, rectum, and at last excreted as feces. Every part of the digestive system plays a role in digesting food. The stomach is unique among other parts as it has acid in it. Yes, the stomach produces hydrochloric acid (HCl). This helps digestion and kills germs that may be present in unhygienic food.

Hydrochloric acid is present only in the stomach. A functional valve at the lower end of the food pipe called the lower esophageal sphincter prevents acid reflux back into the food pipe. It remains closed most of the time, opens briefly to swallow food or liquid, and then closes again. Sometimes, it opens briefly, even without food, to eliminate the air swallowed or gas produced by some chemical reactions in the stomach.

These transient openings are for very short periods. In some individuals, the openings of this valve are recurrent or have a longer duration. In that case, the acid may come back into the lower part of the food pipe and cause burning of the walls of the pipe. This causes pain or a burning sensation and it is due to acid reflux.

What Are the Causes of Heartburn?

The causes of heartburn are as follows:

• Gastroesophageal reflux disease (the muscle causing stomach separation from the esophagus).

• Consuming acidic and spicy foods.

• Eating large meals.

• Stress.

• Lack of sleep.

• Hormonal changes during pregnancy cause heartburn.

What Are the Symptoms of Heartburn?

The symptoms of heartburn are as follows:

• Burning sensation in the chest.

• Acidic taste in the mouth.

• Chest pain and discomfort.

• Difficulty swallowing.

• Involuntary return of stomach contents.

• Chronic cough.

• Sore throat.

• Worsening symptoms after eating.

• Disrupting sleep.

• Difficulty breathing.

How Long Does Heartburn Last?

The duration of heartburn is based on the severity of the symptoms and appropriate measures to alleviate discomfort. Generally, mild heartburn may last for a shorter duration and can be managed with lifestyle modifications. The episodes may occur frequently and last longer if heartburn is due to gastroesophageal reflux disease. Chronic heartburn requires medical attention and appropriate treatment. People experiencing symptoms like difficulty swallowing and breathing may consult a healthcare provider for personalized management.

What Are the Risk Factors of Heartburn?

Some common risk factors for acid reflux are as follows:

• Obesity.

• Binge eating.

• Lying down just after eating.

• Taking a lot of coffee, tea, and citrus juices.

• Take some medicines containing acid, such as Aspirin, and medicines that loosen this valve, for example, nitrates.

• Tight-fitting clothes.

• With some medical conditions, such as hernia, in which a part of our stomach is pulled upwards into the chest.

Heartburn is very common. Most people experience it three to four times per month. Unless an individual does not have dangerous symptoms, this condition is of no concern. Danger symptoms or red flags are weight loss, persistent vomiting, blood vomiting, black-colored feces, and difficulty swallowing. If an individual experiences these dangerous symptoms, go straight to the doctor immediately.

What Are the Investigations of Heart Burn?

Usually, no investigations are required, but sometimes, when the diagnosis cannot be made, a few investigations are done to check acid reflux.

1. Esophageal Manometry: A probe is inserted into the food pipe’s lower end, which measures its pressure. If it is decreased, then it causes acid to reflux back.

2. Monitoring pH: In this, a pH probe is inserted into the food pipe through the mouth to continuously measure the food pipe's pH for 24 to 48 hours. If it is under four, it gives a clue to acid reflux. Normal pH is around six. This test is also called the Bravo test.

3. Endoscopy: In this test, a flexible probe is passed through the mouth to the stomach, with a camera to view inside the food pipe and stomach. It also removes a small piece of tissue from there to test, known as a biopsy.

4. Acid Suppressing Medicines: Sometimes, a medicine that suppresses acid production is given and if there is symptomatic improvement, the treatment will be continued.

What Are the Treatments for Heart Burn?

The treatment strategies are described below:

• Antacids: The acid is neutralized by alkali, and an alkaline medicine is given. Usually, Sodium bicarbonate (baking soda) and Magnesium bicarbonate are used to neutralize the acidic environment. It gives relief in a very short time.

• Acid Suppressants: These medicines suppress acid production, and thus decrease burning pain caused by acid. Examples include Omeprazole, Pantoprazole, and Ranitidine.

• Surgery: Rarely, surgery is needed, especially for a hernia.

What Are the Complications of Heartburn?

• Usually, there are no complications of acid reflux, but rarely arise. There may be stricture formation in which the lower end of the food pipe is narrowed or blocked, thus causing pain and difficulty following swallowing, especially solid foods.

• If acid reflux remains for a long time, there may be some changes at the microscopic level in our food pipe that are sometimes precancerous and later may lead to cancer. Do not worry, as the chance of it is very low.

• An ulcer may develop in the food pipe due to longstanding damage from acid.

• Sometimes, the acid, along with liquid we had drunk a short time ago, refluxes up to the throat and mouth. It may cause tooth enamel decay, and if this sour fluid goes into the windpipe (trachea), especially if reflux occurs during sleep, it can cause pneumonia, which is inflammation of the lungs.

How Heart Burn Can Be Prevented?

If an individual suffers from recurrent heartburn, the following steps may be taken to decrease or prevent further episodes.

• Do not eat on a full stomach. Avoid fatty foods, excessive coffee, tea, or other caffeinated beverages.

• Stop smoking and drinking. Do not wear tight clothes.

• Don't go to sleep just after having a meal. Go to bed about two hours after a meal. Keep the head end of your bed about six to eight inches above the foot end so that acid may gravitate down.

• Do not eat acidic foods such as lemons, oranges, and tomatoes. Avoid acidic medicines such as Aspirin or medicines that cause more reflux, such as nitrates, with your doctor's advice.

• Do not take stress as it causes more acid production and acidity.

Conclusion:

Understanding the causes, treatment, and prevention of heartburn is crucial for maintaining optimal digestive health. Heartburn, often triggered by lifestyle factors like diet, stress, and obesity, can be effectively managed through a combination of dietary adjustments, medication, and lifestyle changes. Incorporating a balanced diet, practicing portion control, and avoiding trigger foods can significantly reduce the frequency and intensity of heartburn episodes.