Everyone loves to eat, I believe. But in some cases, the enjoyment of eating can be ruined by an uncomfortable burning pain in your chest, just behind your breast bone. If this is you, then you are having a heartburn. Heartburn happens when the acid produced through digestion refluxes back to your esophagus. Most common heartburn causes are food, some meds, pregnancy, and obesity (Read more about Heartburn During Pregnancy).
The food we eat travels from the mouth to the stomach through a tube called the esophagus. Once the food reaches the stomach, it is prevented from refluxing (going back into the throat or esophagus) by the lower esophageal sphincter (LES). Lower esophageal sphincter (LES) is a special circular muscle located in between the esophagus and stomach. When the lower esophageal sphincter relaxes, nothing prevents the acids produced by digestion from going back or up to your throat. This is called acid reflux. Acid reflux is mainly what causes heartburn. There are some cases though where acid reflux may not cause heartburn. But definitely, heartburn will not take place without having acid reflux.
What Heartburn Causes?
Heartburn is basically one of the symptoms of gastroesophageal reflux disease (GERD). Heartburn can be experienced by anyone. Thus, it is only important that everyone should be aware of what causes heartburn or its triggers in order to avoid it. Here are the most common heartburn causes that you might encounter.
- The food you eat. One of the most common heartburn causes is basically the food that we consume. Some of these foods or drinks that we consume everyday may trigger or encourage increased acid secretion which primarily sets up heartburn. Here are some foods and drinks that may trigger or cause heartburn.
- Carbonated drinks such as soda
- Caffeinated drinks such as coffee, hot chocolate, etc.
- Alcohol drinks such as wine and beer
- Acidic juices such as pineapple, grapefruit, and orange juice
- Acidic foods like oranges, tomatoes, and grapes
In addition, high consumption of fatty foods is also one of the many heartburn causes. Consuming food with high-fat content affects the way your lower esophageal sphincter functions. This type of food can make your lower esophageal sphincter relax and cause acid reflux and then heartburn.
- The meds you take. You might not notice it, but the medicines you are taking might probably be the reason why you are experiencing heartburn. Some of these meds can stimulate more acid production in the stomach. Examples of these meds are:
- Ibuprofen such as Advil, Motrin, Nuprin, etc.
- Naproxen such as Aleve and Naprosyn
- Smoking. Another one of the many common heartburn causes is smoking. Smoking, just like consuming fatty foods, tends to affect the functions of your lower esophageal sphincter. Smoking causes your lower esophageal sphincter to relax, making acid reflux from the stomach to your esophagus.
- Pregnancy. What causes heartburn in women in some cases is pregnancy. That isbecause pregnancy can add pressure in the abdominal cavity which eventually affects the functions of your lower esophageal sphincter (LES). As a result, your LES cannot properly prevent acid from going back to your esophagus.
- Hiatal hernia. If a person has hiatal hernia, a segment of his or her stomach sits within the chest, not in the abdomen. This condition affects the right way the lower esophageal sphincter functions, resulting to acid reflux.
- Obesity. Obesity is one of the most common heartburn causes. This could increase or add pressure to the abdomen, affecting how the lower esophageal sphincter works. This again results to acid reflux and heartburn.
- Other esophagus diseases. Other esophagus disease or condition such as scleroderma and sarcoidosis can also cause heartburn as a symptom.
What are the symptoms of Heartburn?
Heartburn could be experienced by anyone, healthy or not. Heartburn causes an uncomfortable burning sensation in the chest. This is the most common symptom of heartburn. And this is normally accompanied by:
- A feeling of food stuck in the throat
- Water brash, sour taste at the back end of the throat
- Hoarseness or coughing episodes
However, in cases when these heartburn symptoms are accompanied by shortness of breath, cold sweat, dizziness, and/or radiation to the neck or arms, the person should immediately be evaluated by a healthcare professional as it may lead to a more serious health condition.
It is important to seek professional help from your doctor when reoccurring heartburn is experienced. Persistent heartburn can lead to a more serious issues such as the following:
- Inflammation of the esophagus that can result to ulcer which can cause serious bleeding
- Other significant GERD complications such as scarring and stricture
- Barrette’s esophagus, a condition associated with high risk of esophageal cancer
How is Heartburn Diagnosed?
Heartburn is something common to everyone. Though sometimes, the chest pain that heartburn brings may be confused with other chest-related diseases such as chest wall pain, pneumonia, heart attack, and pulmonary embolus. Thus, it is important to seek a doctor’s help to properly diagnose the issue and pinpoint what causes heartburn in you specially if it is persistent. Here are some tests used to diagnose heartburn.
- X-ray. In this test, the patient will be asked to swallow gastrografin or barium. While the barium or gastrografin travels from the esophagus to the stomach, a radiologist observes it using an x-ray or fluoroscopy machine. This way, they will know if there is any irregularity or inflammation in the esophageal wall or within the esophagus. This process can also test if the muscles in the esophagus are working well and can properly execute its rhythmic motion.
- Endoscopy. In this procedure, using a flexible scope with a fiber optic camera, a gastroenterologist takes a look at the lining of your esophagus and stomach. Through the image provided by the fiber optic camera, they will be able to see if there is an inflammation or ulcers within your esophagus and stomach. They can also take bits of small tissues for biopsy to test the presence of cancer or pre-cancerous cells.
- Manometry and pH test. This process uses acid measurements and pressure monitors to diagnose and to know what causes heartburn in you.
What Can Treat Heartburn?
After confirming and knowing what causes heartburn in you, your doctor will prescribe things that you can do to avoid heartburn and maybe medications that can prevent it depending on your condition. Here are the most common treatments prescribed to people who are frequently experiencing heartburn:
- Change in lifestyle. As far as your lifestyle is concerned, you might be advised by your doctor to do the following:
- Avoid eating a lot in one meal; rather, eat in small portions more frequently.
- Make sure to eat at least 3 to 4 hours before bedtime.
- Avoid eating or drinking food that can encourage acid reflux such as alcohol drinks, caffeine drinks, and foods with high fat content.
- Avoid medicines that can increase acid secretion such as ibuprofen and aspirin.
- Stop smoking.
- Increase head elevation when lying down or sleeping to avoid acid from going up to your esophagus.
- Medication. Aside from the adjustments in your lifestyle, some medication may also be prescribed by your doctor to counteract acid reflux and avoid heartburn. These medications normally work by preventing or reducing acid production in the stomach. These meds are normally taken after meal, before going to sleep, or when needed. Its main purpose is to gather excess acid in the stomach and to cover esophagus from possible acid reflux.
- Antacids. For mild heartburn, antacids can provide quick relief by neutralizing stomach acids. However, antacids are not intended to heal an inflamed or damaged esophagus. Side effects of antacids if overused are constipation or diarrhea. Examples of these are Gaviscon, Gelusil, Maalox, Rolaids, and Tums.
- Histamine H2 antagonist. This type of medications work by blocking histamine’s action. Histamine is a chemical that encourages acid production within the stomach. As an outcome, production of acid decreases and acid reflux can be avoided. Examples of these are cimetidine, ranitidine, and famotidine.
- Proton pump inhibitors (PPIs). This is another type of medication that prevents stomach acid production. Examples of these are esomeprazole, lansoprazole, omeprazole, pantoprazole, and raberprazole.
- Promotility agents. This type of medication works by encouraging muscles of the gastrointestinal tract to work properly, which may help prevent acid from staying in the stomach for a long period. When the gastrointestinal tract works okay, it also strengthens the lower esophageal sphincter which results to a decreased chance of acid reflux and heartburn. One of the most common promotility agents occasionally used to treat heartburn is Reglan. Side effects of this medication are restlessness, fatigue, diarrhea, drowsiness, and some movement issues.
Though some of these medications are over-the-counter, it might have some possible counteraction with other drugs. That is why it is important to talk to your doctor before taking any of these to avoid further complications.
- Heartburn surgery. For those with severe conditions, heartburn surgery is another option. Heartburn surgery is prescribed for patients:
- Who did not get adequate relief from medical therapy
- With Barrett’s esophagus
- With severe acid reflux resulting to hoarseness, wheezing, or pneumonia
Heartburn surgery is only prescribed to patients with severe condition. The most common type of heartburn surgery is fundoplication. This surgery involves several procedures such as:
- The first step involves cutting into the abdomen. The surgeon may either make one large incision or a couple of small incisions to perform laparoscopic surgery.
- In laparoscopic fundoplication, the surgeon operates from outside the body using tools placed in the abdomen. While in open fundoplication, the surgeon directly uses his or her hands for the operation.
- The next step is completed by casing or wrapping the top part of the stomach at the lower part of the esophagus and then sewing these in place.
- Wrapping and sewing the top portion of the stomach tightens the lower part of the esophagus. This way, acid is prevented from refluxing from the stomach to the esophagus.
4 Effective Home Remedies for Heartburn
Knowing what causes heartburn is as important as knowing the remedies for it. Do you know that for mild or occasional heartburn, remedies can just be found in the four corners of your homes? Although over-the-counter (OTC) medicines are quite fast and effective, knowing some home remedies is an advantage specially when OTC meds are not available. Here are some home remedies you can do or use to treat heartburn.
- Chew a gum. Aside from the fact that it can freshen your breath, chewing a gum has other advantages specially for people experiencing frequent heartburns. In a study by the Journal of Dental Research, people with GERD experience relief from heartburn after chewing a sugar-free gum, 30 minutes after a meal. Chewing a gum stimulates and increases saliva production. When there is good saliva production, it helps dilute accumulated acids in the gut and clear out acid fast.
- Banana or apple. These fruits, banana and apple, contain natural antacids that can help block acid reflux and avoid heartburn. If you want a healthy and natural way to combat acid reflux, try eating one banana a day. You can also try eating one apple few hours before going to bed and experience the comfort it can bring to your stomach and esophagus.
- Almonds. These nuts are not just delicious and tasty. Almonds have natural properties that can neutralize the acids in your stomach. Eating a couple of almonds after every meal can reduce the chances of acid reflux and heartburn.
Baking soda. Baking soda has lots of uses at home, one of which is to relieve and prevent several heartburn causes. Because it is a base, sodium bicarbonate commonly known as baking soda can counterbalance stomach acids. Half or one teaspoon of baking soda when mixed with a glass of water can do the trick. However, baking soda should not be used as a regular remedy by people having persistent acid reflux or heartburn as it is high in salt which could cause nausea and swelling. For occasional acid reflux and heartburn, baking soda is definitely a relief provider.