Heartburn Tips

Heartburn or pyrosis is a painful burning sensation in the esophagus, just

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

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

Last Updated - 25th November 2005

Pathophysiology

The sensation of heartburn is caused by exposure of the lower esophagus to the acidic contents of the stomach. Normally, the lower esophageal sphincter (LES) separating the stomach from the esophagus is supposed to contract to prevent this situation. If the sphincter relaxes for any reason (as normally occurs during swallowing), stomach contents, mixed with gastric acid, can return into the esophagus. This return is also known as reflux, and may progress to gastroesophageal reflux disease (GERD) if it occurs frequently. Peristalsis, the rhythmic wave of muscular contraction in the esophagus, normally moves food down and past the LES and is responsible for ultimately clearing refluxed stomach contents. In addition, gastric acid can be neutralized by buffers present in 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 pillows or sitting up frequently provides relief – although care must be taken to avoid placing continuous strain on the neck. Avoidance of certain foods 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, fatty foods, fried foods, peppermint, spearmint, coffee, alcohol and carbonated drinks.

Limit acidic foods that can irritate your esophagus. These include citrus 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 sodium and 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 last longer than 2 weeks. Call sooner if symptoms are severe or are not relieved 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 solid foods.

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

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