Heartburn, also known as pyrosis, cardialgia, or acid indigestion, is a painful condition involving the upper digestive system, not the heart itself. Because the pain often radiates from the central chest region, some sufferers confuse the symptoms of heartburn with a heart attack. Heartburn is actually the result of stomach acids reacting strongly to certain foods during digestion. A small amount of stomach acid is forced up the unprotected esophagus and the resultant chemical burn causes moderate to severe pain. Lifestyle changes and medication are the main treatments for this condition.
Heartburn is one of the most common health conditions that people experience in today's society. It is thought that about 1 in 10 people suffer from daily heartburn and about 1 in 3 people suffer from heartburn at least once a month. The condition occurs when the acidic contents of the stomach go back up, or reflux, into the esophagus. The most common heartburn symptom is pain or discomfort that starts in the middle of the chest and can move up the throat. At other times, acid reflux can cause the burning, pressure, or pain in the chest or throat that most people call heartburn or acid indigestion. Lifestyle changes and medication are the main treatments for this condition.
Heartburn occurs when stomach acid backs up into your esophagus.
Normally when you swallow, your lower esophageal sphincter — a circular band of muscle around the bottom part of your esophagus — relaxes to allow food and liquid to flow down into your stomach. Then it closes again.
However, if the lower esophageal sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing heartburn. The acid backup may be worse when you're bent over or lying down.
The lower esophageal sphincter may not close completely allowing stomach acid into the esophagus for these reasons:
Certain foods and drinks the lower esophageal sphincter. These include chocolate, peppermint, caffeinated beverages (such as coffee, tea, and soft drinks), fatty foods, and alcohol.
Anxiety and stress can worsen heartburn symptoms. Some complementary and alternative treatments may help you cope with anxiety and stress.
Heartburn often depends on the body's position. It is easier for stomach acid to flow back into the esophagus if a person is lying on the back, on the right side, or bending over.
Anything that increases the pressure in the abdomen, forcing stomach acid backward into the esophagus, can cause heartburn. Lifting, straining, coughing, tight clothing, obesity, and pregnancy can worsen heartburn.
People with certain medical conditions have an increased risk of heartburn. These conditions include: hiatal hernia, diabetes, gastroparesis, and many autoimmune diseases (CREST syndrome, Raynaud's phenomenon, and scleroderma).
Many prescription medications can loosen the lower esophageal sphincter, including blood pressure and heart medications, and the asthma drug theophylline.
Many substances directly irritate the lining of the esophagus and contribute to heartburn. These include spicy foods, citrus fruits and juices, tomatoes and tomato sauces, cigarette smoke, aspirin, ibuprofen (Motrin, Advil etc.), and medicine prescribed to treat osteoporosis.
Heartburn is a burning feeling in the chest. The sensation may spread up into the throat, jaw, arms, or back. That's why heartburn is often mistaken for chest pain due to a heart attack. However, if a person is having chest pain for any reason, seek medical attention immediately.
Heartburn (often called acid indigestion) typically occurs 30-60 minutes after meals. The pain is worse when lying down, bending forward, and straining to pass stools. The pain is relieved by standing upright, swallowing saliva or water, or by taking antacids.
If small amounts of stomach acid or food travel beyond the esophagus and up into the mouth, the person may experience bitter a or sour taste (regurgitation). Regurgitation is common after meals, especially if the person is lying down, bending over, or straining.
Stomach acid can also affect the respiratory tract, causing asthma, hoarseness, chronic cough, sore throat, or tooth damage (acid eats the enamel on teeth). The person may feel as if he or she has a lump in the throat.
If the acid reflux continues for long periods of time, the esophagus becomes damaged. The person may have difficulty swallowing. In more serious cases, weight loss and dehydration occur. Very rarely, the esophagus may bleed or tear completely because it is so damaged. In severe cases, the person may vomit blood or have small amounts of blood in bowel movements.
Many over-the-counter medications are available to relieve the pain of heartburn. Options include:
Antacids that neutralize stomach acid. Antacids, such as Maalox, Mylanta, Gelusil, Rolaids and Tums, may provide quick relief. But antacids alone won't heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects such as diarrhea or constipation.
Medications to reduce acid production. Called H-2-receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac 25, Zantac 75, Zantac 150). H-2-receptor blockers don't act as quickly as antacids, but they provide longer relief. Stronger versions of these medications are available in prescription form.
Medications that block acid production and heal the esophagus. Proton pump inhibitors block acid production and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC).
According to the Food and Drug Administration, long-term use of proton pump inhibitors, especially in people age 50 and older, has been associated with an increased risk of fractures of the hip, wrist and spine.
Read and follow the instructions on over-the-counter medications. If you find over-the-counter treatments don't work or you rely on them often, make an appointment with your doctor.
The medications that are usually prescribed for heartburn include antacids, omeprazole, famotidine (pepcid), H2-receptor antagonists, alginates, proton-pump inhibitors, etc. But over dependence on such medications may not be good for health in the long run. On the other hand, home remedies are very effective in alleviating heartburn and acid reflux in a natural way, thereby reducing the dependence on medications. The simplest of all home remedies for heartburn relief is drinking a glass of water at the onset of the initial symptoms. Water washes away acids from the esophagus to where it belongs, i.e. the stomach.
Some fruits like papaya, banana and almonds are other natural heartburn cures. Papaya contains an enzyme known as papain that aids in digestion. Fresh papaya is the best medicine for people suffering from frequent heartburn. It should be taken before meals to prevent acidity and indigestion. However, pregnant women and people with latex allergy may not be able to take papaya, and so always consult a health expert before taking it. Banana is an easily available fruit that can act like natural antacids and provide relief in heartburn. It also coats the stomach and thereby shields it from the gastric acids.
Vinegar and sodium carbonate or baking powder can be found in almost every household, but very few people are aware of the fact that they can be excellent home remedies for heartburn relief. Vinegar is actually a base that helps to neutralize the stomach acids. However, its frequent use can damage the tooth enamel and to avoid such a problem, its intake should be followed by a glass of water. On the other hand, sodium carbonate can provide quick relief, though excessive use can raise blood pressure and cause other health related problems. A solution of apple cider vinegar and water is another natural treatment for acid reflux and heartburn.
Many people with acid reflux and heartburn have benefited from aloe vera juice, and almond and licorice extract. Aloe vera juice can be effective in healing the intestinal tract, while almonds with its rich oil contents can neutralize acids. Licorice, on the other hand contains a compound, known as glycyrrhizin, which has anti-inflammatory properties and can be beneficial for both stomach and esophagus ulcers.
Though an occasional bout of heartburn is quite normal, recurrent and frequent occurrence can irritate and inflame the lining of the esophagus leading to ulcers as well as bleeding caused by their rupture. In the long run, it can bring about a change in the cells of the esophageal lining and can increase the risk of esophageal cancer. So, in addition to the home remedies for heartburn, also avoid or reduce the intake of the potential irritants like caffeine, nicotine, acidic foods, alcoholic and carbonated beverages, as well as spicy and oily foods. Also, eat several frequent meals, instead of two or three heavy meals, and avoid eating before bedtime if you are having frequent bouts of heartburn and acid reflux.
You may find heartburn relief by making small changes. Consider trying to:
Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus. If your weight is healthy, work to maintain it. If you are overweight or obese, work to slowly lose weight — no more than 1 or 2 pounds (0.5 to 1 kilogram) a week. Ask your doctor for help devising a weight-loss strategy that will work for you.
Avoid tight-fitting clothing. Clothes that fit tightly around your waist put pressure on your abdomen and the lower esophageal sphincter.
Avoid foods and drinks that trigger heartburn. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse. Avoid foods you know will trigger your heartburn.
Eat smaller meals. Avoid overeating by eating smaller meals.
Don't lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
Elevate the head of your bed. If you regularly experience heartburn at night or while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by six to nine inches. If it's not possible to elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Wedges are available at drugstores and medical supply stores. Raising your head with additional pillows is not effective.
Don't smoke. Smoking decreases the lower esophageal sphincter's ability to function properly.
Anxiety and stress can worsen heartburn symptoms. Some complementary and alternative treatments may help you cope with anxiety and stress. If your heartburn is worsened by anxiety and stress, consider trying:
Aromatherapy
Gentle exercise, such as walking or riding a bike, but avoid vigorous exercise, which can worsen heartburn
Listening to music
Massage
Relaxation techniques