Heartburn

We commonly hear people complaining, “Huh! I have burning sensation in the heart”. What exactly does the heartburn mean? Yes! We often hear people reporting heartburn, heartburn is a burning sensation in your chest, and it is commonly a symptom of acid reflux or gastroesophageal reflux disease.

Many people usually ignore heartburn, or just take few OTC pills and stay calm. But this does not always work. When heartburn is not properly treated, it can cause erosions or ulcers in the esophageal lining. It affects your daily routine due to severe discomfort. So, early diagnosis and appropriate treatment are extremely recommended.

Symptoms

You may have symptoms such as-

  • Frequent coughing
  • Hoarseness in voice
  • Difficulty in swallowing
  • A persistent sore throat
  • Pain in the upper abdomen
  • Inflammation in the larynx (voice box)

Surgical intervention for heartburn

You may rarely require surgery if the symptoms are too severe, or if you developed any complication such as Barrett’s esophagus, severe pneumonia, or discomfort. There are different surgical approaches to esophageal reflux such as Fundoliposuction, laparoscopic anti-reflux surgery, etc. you doctor would recommend the best type of surgery based on your condition.

Lifestyle modifications

There are several ways that help reduce your symptoms of heartburn.

  • Keep track of your weight, because excess weight can increase pressure on the LES and may aggravate the symptoms of heartburn.
  • Quit smoking and alcohol, because smoking and alcohol consumption would interfere with the normal functioning of LES.
  • Avoid foods that trigger the acids in your body, you must also never over eat.
  • Elevate the head of the bed while resting, this helps reduce the acid refluxes at nights while you are sleeping.

Some medications reduce your symptoms of heartburn, which includes:

Antacids:These medications assist in binding the excess acid and give protection to the esophagus by forming a coat. Antacids such as H2 antagonists are widely used, which helps decrease the acid production and alleviates the symptoms. Some of these medications include, (Cimetidine, ranitidine, famotidine) you can take this after meals or at bedtime. Proton pump inhibitors (PPIs):These are the medications that help in blocking the production of acid by your stomach. Some of the examples of PPIs are (Omeprazole, rabeprazole, pantoprazole, lansoprazole, etc.)

To make a preliminary diagnosis, your doctor would take your medical history and performs a thorough physical examination. If your doctor suspects any abnormality, he/she may order for further tests to evaluate the extent of damage caused.

The diagnostic tests would include:

Endoscopy :to examine your esophagus and stomach, a flexible tube is passed down the esophagus. This helps your doctor understand the extent of damage and helps in ruling out the other possible reasons for the symptoms. If indicated, biopsies may also be ordered. Upper GI series :to view the outline of your digestive system. You will be asked to drink a liquid that coats the inner side of the digestive tract and then the X-rays are taken. Ambulatory pH testing :This test helps your doctor in measuring the acidity in your esophagus. This is performed by inserting a small tube via nose to the stomach.

Based on the diagnostic results, your doctor would choose an appropriate treatment option for you. Yes! Heartburn can be managed by lifestyle modifications and medications. In rare situations, you may need a surgical intervention to help you relieve from chronic heartburn or GERD.

Heartburn is the most common symptom that occurs due to the acid reflux back into the esophagus. There are many factors that trigger the acid reflux into your esophagus, and you may develop heartburn even due to the structural problems that allow acid to reflux back into the esophagus.

Some of the triggers that may cause heartburn:

  • Alcohol consumption
  • Overeating of chocolates
  • Administration of aspirin, naproxen, buprofen
  • Consuming acid foods in diet (tomatoes, oranges, etc.)
  • Taking certain juices made of grape, orange, pineapple

Smoking- Habit of smoking can affect the function of your lower esophageal sphincter (LES), leading to the relaxation of sphincter, that lets the acid reflux into the esophagus from the stomach.

A hiatal hernia- This condition makes your LES function ineffectively leading to the acid refluxes and finally the heartburn.

Pregnancy- Pregnancy creates pressure in the abdominal cavity affecting the LES and thus causes acid refluxes.

Obesity- Obesity predisposes acid reflux due to the increased pressure near the abdomen.