Heartburn Tips

Heartburn or pyrosis is a painful burning sensation inthe esophagus, just

belowthe breastbone. The pain often rises in the chest and may radiate tothe neck or throat. Heartburn is also identified as one of the causesof asthma and chronic cough.

Heartburn occurs when there is an abnormal backflow of stomach acidinto the tube (esophagus) that leads from the mouth to the stomach.The acid backflow (reflux) causes a feeling of burning, warmth or heatbeneath the breastbone

Last Updated - 25th November 2005

Pathophysiology

The sensation of heartburn is caused by exposure of the lower esophagusto the acidic contents of the stomach. Normally, the lower esophagealsphincter (LES) separating the stomach from the esophagus is supposedto contract to prevent this situation. If the sphincter relaxes forany reason (as normally occurs during swallowing), stomach contents,mixed with gastric acid, can return into the esophagus. This returnis also known as reflux, and may progress to gastroesophageal refluxdisease (GERD) if it occurs frequently. Peristalsis, the rhythmic waveof muscular contraction in the esophagus, normally moves food down andpast the LES and is responsible for ultimately clearing refluxed stomachcontents. In addition, gastric acid can be neutralized by buffers presentin saliva.

Causes

Foods that may cause Heartburn:

Alcohol

Coffee, tea, cola, and other caffeinated and carbonated beverages

Chocolate

Citrus fruits and juices

Tomatoes and tomato sauces (such as pizza and pasta sauce)

Spicy foods and fatty foods (including full-fat dairy products)

Peppermint and spearmint

Treatment

If heartburn occurs when lying down, raising the head with pillowsor sitting up frequently provides relief – although care must betaken to avoid placing continuous strain on the neck. Avoidance of certainfoods shortly before bedtime is frequently advised to avoid future attacks.

Prevention

Eat smaller meals

Avoid late-night snacks

Don't lie down for 2 to 3 hours after eating

Avoid foods that bring on heartburn. These include chocolate, fattyfoods, fried foods, peppermint, spearmint, coffee, alcohol and carbonateddrinks.

Limit acidic foods that can irritate your esophagus. These includecitrus fruits and juices such as orange juice and tomato juice.

Limit spicy foods.

Avoid clothing with tight belts or waistbands.

Stop smoking.

Lose weight if you are overweight.

Raise the head of your bed 6 to 8 inches.

Use actaminophen instead of aspirin, ibuprofen, naproxen sodiumand other anti-inflammatory drugs.

Take a non-prescription product for heartburn

When To Call A Physician

If symptoms are not relieved by home treatment or if symptoms lastlonger than 2 weeks. Call sooner if symptoms are severe or are notrelieved at all by antacids or acid blockers.

Pain in the upper abdomen with chest pain that is crushing or squeezing(call 911)

If there is blood in your vomit or stools.

If you suspect that a medication is causing heartburn.

If you are routinely having pain or difficulty when swallowing solidfoods.

If you are losing weight and you don't know why.

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