Heartburn

Heartburn is a common condition characterized by a burning sensation in the chest, often associated with a sour or bitter taste in the mouth. It occurs when stomach acid flows back into the esophagus, irritating its lining. Although heartburn is generally harmless, frequent occurrences may indicate gastroesophageal reflux disease (GERD), requiring medical attention.

Symptoms

Heartburn typically presents with the following symptoms:

• A burning sensation or discomfort in the chest, usually after eating or at night.
• Pain that worsens when lying down or bending over.
• A sour or bitter taste in the throat or mouth.
• Difficulty swallowing or a sensation of food being stuck in the throat.
• Chronic cough, sore throat, or hoarseness in some cases.

Causes

Heartburn is primarily caused by acid reflux, which occurs when the lower esophageal sphincter (LES) — a valve-like muscle — fails to close properly or relaxes inappropriately. This allows stomach acid to escape into the esophagus. Contributing factors include:

• Diet: Spicy, fatty, or acidic foods, chocolate, caffeine, alcohol, and carbonated beverages.
• Lifestyle: Smoking, obesity, and stress.
• Pregnancy: Hormonal changes and increased abdominal pressure can lead to reflux.
• Medical conditions: Hiatal hernia, delayed stomach emptying, or certain medications like NSAIDs, aspirin, and some blood pressure drugs.

Treatment

Treatment for heartburn focuses on symptom relief, preventing recurrence, and addressing underlying causes.

Lifestyle Modifications:

• Avoid trigger foods and eat smaller meals.
• Maintain a healthy weight.
• Avoid lying down for at least 2-3 hours after meals.
• Elevate the head of the bed to prevent nighttime reflux.
• Quit smoking and reduce alcohol consumption.

Medications:

• Antacids: Provide quick relief by neutralizing stomach acid.
• H2 blockers: Reduce acid production (e.g., ranitidine, famotidine).
• Proton pump inhibitors (PPIs): More effective for long-term management by blocking acid production (e.g., omeprazole, esomeprazole).
• Prokinetics: Enhance stomach emptying and strengthen the LES.

Surgical Interventions:

• In severe or refractory cases, procedures like fundoplication may be considered to reinforce the LES.