Heartburn and Acid Reflux

Heartburn and acid reflux are common digestive disorders that affect millions of people worldwide. They occur when stomach acid flows back up into the esophagus, causing discomfort, pain, and other symptoms.

What is Heartburn?

Heartburn, also known as pyrosis, is a burning sensation in the chest and throat that occurs when stomach acid flows back up into the esophagus. It is usually felt behind the breastbone and can radiate to the arms, neck, and jaw.

What is Acid Reflux?

Acid reflux, also known as gastroesophageal reflux disease (GERD), is a condition in which stomach acid flows back up into the esophagus, causing inflammation and damage to the lining of the esophagus. It can cause symptoms such as heartburn, regurgitation, difficulty swallowing, and chest pain.

Causes of Heartburn and Acid Reflux

• Weakening of the lower esophageal sphincter (LES), which allows stomach acid to flow back up into the esophagus
• Hiatal hernia, a condition in which part of the stomach protrudes through an opening in the diaphragm
• Obesity, which can put pressure on the stomach and cause stomach acid to flow back up into the esophagus
• Pregnancy, which can cause the stomach to be pushed upwards and put pressure on the LES
• Certain foods and drinks, such as citrus fruits, tomatoes, chocolate, spicy foods, and caffeine, which can trigger heartburn and acid reflux
• Smoking, which can weaken the LES and reduce saliva production, making it harder for the esophagus to clear stomach acid

Symptoms of Heartburn and Acid Reflux

• Heartburn, a burning sensation in the chest and throat
• Regurgitation, a feeling of food or liquid coming back up into the mouth
• Dysphagia, difficulty swallowing
• Chest pain, which can be severe and may be mistaken for a heart attack
• Bloating and discomfort in the upper abdomen
• Nausea and vomiting

Diagnosis of Heartburn and Acid Reflux

Diagnosis is typically made based on symptoms and medical history. Tests that may be used to diagnose heartburn and acid reflux include:

• Upper endoscopy, a procedure in which a flexible tube with a camera is inserted through the mouth and into the esophagus
• Ambulatory acid probe tests, which measure the amount of acid in the esophagus over a 24-hour period
• Esophageal manometry, a test that measures the muscle contractions of the esophagus
• Barium swallow, an X-ray test that uses barium to visualize the esophagus and stomach

Treatment of Heartburn and Acid Reflux

Treatment typically involves lifestyle changes and medications. Lifestyle changes include:

• Avoiding trigger foods and drinks
• Eating smaller, more frequent meals
• Avoiding lying down after eating
• Raising the head of the bed by 6-8 inches
• Quitting smoking
• Losing weight if overweight or obese

Medications that may be used to treat heartburn and acid reflux include:

• Antacids, which neutralize stomach acid
• H2 blockers, which reduce the production of stomach acid
• Proton pump inhibitors (PPIs), which block the production of stomach acid

Complications of Heartburn and Acid Reflux

If left untreated, heartburn and acid reflux can lead to complications such as:

• Esophagitis, inflammation of the esophagus
• Stricture, narrowing of the esophagus due to scarring
• Barrett's esophagus, a precancerous condition in which the lining of the esophagus changes
• Esophageal cancer, a type of cancer that affects the esophagus