Overview of Heartburn
Stomach acid is secreted from the cells in the stomach lining to aid in digestion. The extremely acidic pH of the digestive juices also helps protect the stomach from infection by microorganisms that we naturally consume in our food. The esophagus, which connects the mouth to the stomach, is protected from stomach acid by rings of muscles called the lower esophageal sphincter. Should stomach acid escape the stomach and pass through these valves and up into the esophagus, it can cause the intense, painful burning sensations associated with heartburn. While our stomach lining is designed to deal with the extreme acidity of gastric juices, our esophageal lining is very sensitive to it.
Symptoms of Heartburn
Heartburn is characterized by an uncomfortable burning sensation below the breast bone, which can extend upward into the neck, throat, and jaw. Because it is essentially caused by regurgitation of stomach acid, this burning may be accompanied by an acidic or bitter taste in the mouth. Depending on how much acid splashed into the esophagus, the burning can continue for several hours, becoming more intense as a person lies down or bends over.
Some of the minor symptoms of heartburn and acid reflux include a persistent dry cough, sore throat, and difficulty swallowing. Some also experience excessive burping, salivation, and regurgitation.
Risk Factors of Heartburn
If one occasionally has heartburn due to indigestion, it is generally nothing to worry about. The pain will subside and the esophagus will heal.
Chronic heartburn, or Gastroesophageal reflux disease (GERD), can potentially cause permanent damage to the esophagus. The pain associated with heartburn is due to the inflammation and irritation of the esophageal lining by the stomach acid. Repeated exposure to digestive juices can cause permanent damage to your esophagus, causing structural damage and scarring. If scar tissue builds up in the esophagus, it will narrow and become less flexible, causing difficulties with swallowing food. GERD can also put a patient at risk for esophageal cancers, which tend to be very aggressive and have a poor prognosis.
Causes of Heartburn
Many cases of heartburn are tied closely to the diet. Eating very spicy or fatty foods can trigger heartburn. Eating very large meals, particularly before lying down, may also put you at risk for acid reflux. If drinks are gulped or meals are eaten too quickly, the gulping of air may also induce heartburn. Consumption of alcohol and cigarette smoking may also aggravate heartburn.
Any physical pressure on the stomach can also potentially cause heartburn. Obesity, for example, may put pressure on the stomach, increasing the likelihood of developing heartburn. Many pregnant women also develop heartburn as their baby grows and crowds their stomach. Wearing tight clothes or even just bending over can also potentially squeeze the stomach, allowing some digestive juices to seep into the esophagus.
Heartburn is also a side effect of many medications, including bronchodilators prescribed for asthma, calcium channel blockers given for high blood pressure, and nitrates given for angina. Some of these medications inadvertently cause the lower esophageal sphincter to relax and allow stomach acid into the esophagus.
Conventional Treatment of Heartburn
Because the majority of heartburn sufferers can identify the foods that give them acid reflux, restricting the diet to avoid those foods is always recommended. Individuals may be particularly sensitive to specific foods and drinks, though spicy and fatty foods are very common triggers of heartburn. Changing eating habits to avoid very large meals (particularly before bedtime) is also advised.
The treatment of heartburn depends on the frequency and severity of the symptoms. For occasional heartburn related to indigestion, antacids or sodium bicarbonate are recommended to neutralize the acid and relieve the symptoms. Antacids can be bought at the grocery store in chewable tablet form and provide relief for up to an hour. Sodium bicarbonate (aka baking soda, which you may have in your kitchen cabinet) can be dissolved in water and sipped.
For chronic heartburn sufferers, more advanced medications may be advised. H2-receptor agonists, such as Zantac, lower acid production in the stomach to help prevent heartburn. Proton pump inhibitors, such as Prilosec and Prevacid, are even more potent inhibitors of stomach acid production and although they are only recommended for short term use, they are quite popular due to their efficacy. If you are diagnosed with GERD, regular endoscopy is advised to monitor the lining of the esophagus for cancerous transformations.
Patients Medical's Treatment of Heartburn
While the proton pump inhibitors and other popular medicines can offer quick relief, they are interfering with the natural process of stomach acid production which is crucial for good digestion. While they offer relief in the short term, this makes them dangerous for long term prevention of heartburn. We instead recommend a complete nutritional approach to treating and then preventing the symptoms of heartburn.
During your first consultation, our physicians can help assess the patterns of your heartburn symptoms to devise a diet plan. Identifying and eliminating foods that trigger acid reflux is just the first step. We also educate our patients about foods that can soothe and prevent heartburn. Drinking raw vegetable juices that are alkaline, such as potato, celery, and cabbage juice, can help reduce acidity in the stomach, for example. Peppermint, caraway, and fennel may also help calm the stomach and improve digestion.
Begin Your Journey to Wellness with Patients Medical
Our job at Patients Medical is to listen, to connect the dots between a patient's medical history, symptoms, and their underlying causes. Patients Medical is a superb place for women and men to secure integrative and holistic health care from providers who give personalized care, partner with the patient to focus on the root cause of their illness, support their recovery, and help them maintain good health.
To make an appointment with one of our physicians, please call us at 1-212-794-8800. We look forward to hearing from you.
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