health

Heartburn: Is it a Sign of Concern?

Dr.Poonam Sharma

February 23, 2022

Heartburn is a condition that most of you may experience. It is a primary symptom of acid reflux, where some of the food returns from your abdomen to the food pipe. In that case, you feel a burning sensation in the heart. The primary causes of heartburn are unhealthy eating and lifestyle habits. These habits include overeating or eating just before bedtime etc. Your lifestyle has a significant role in triggering heartburn. Habits like stress, obesity, smoking, excess consumption of alcohol etc., can be the primary reasons for heartburn. In addition, some foods also trigger heartburn. These foods include high-fat foods, citrus fruits, alcohol, carbonated drinks etc.

What is Heartburn?

Heartburn is an uncomfortable burning sensation in your chest. It can move upwards to your neck and throat. You get it either after overeating a huge meal or lying down after your meal. It lasts from seconds to several hours. The sensation worsens when you go to bed immediately after eating. In addition, your lifestyle habits can also play a part in why you might experience heartburn. These everyday factors often contribute to medical conditions that cause heartburn, GERD or hiatal hernia. 

Symptoms

Heartburn is like a burning pain in the centre of your chest after eating. You can experience it behind your breastbone. It intensifies as you change your position or lie down. The pain lasts for seconds to hours. You will even find difficulty in swallowing.

How and When Does Heartburn Occur?

Heartburn occurs when acidic contents from your food back up into the food tube or oesophagus that carries food from your mouth to your abdomen. There is a ring-like structure at the meeting point of the food pipe and stomach. It is termed the oesophageal valve or sphincter.  Similarly, there is another ring, where it joins the throat. The valves close on swallowing. They ensure that food doesn’t return upwards. 

During the process of swallowing, the esophageal muscles relax. It allows the food to move down to your stomach. Then muscle contracts. It is the usual process. However, some foods relax that lower valve or sphincter. These foods include alcohol, fatty and deep-fried, spicy food etc. If the oesophageal valve weakens or abnormally relaxes, it causes acid reflux. As a result, the food contents return to the food pipe, leading to heartburn.  

Heartburn: Causes

Multiple reasons can cause acid reflux and heartburn. For example, underlying medical conditions, medication etc., cause heartburn. However, unhealthy dietary and lifestyle habits also trigger these issues and cause frequent heartburn. The primary causes include:

  • Overeating 
  • Lying down immediately after eating
  • Obesity or overweight
  • Smoking
  • Stress and anxiety 
  • Caffeine, carbonated drinks, alcohol, citrus fruits, and fatty or spicy foods

Heartburn: Risk Factors

Some people have a weak esophageal valve genetically, which cannot regulate the normal food pressure. As a result, it leads to acid reflux and causes heartburn. Moreover, various risk factors may increase the chances of heartburn. They are:

1. Alcohol

Alcohol weakens the esophageal valve and facilitates the reflux of food contents into the food pipe. It may also enhance the secretion of stomach acid. That makes the oesophagus all the more sensitive to acid and initiates heartburn.

2. Smoking 

The nicotine and chemicals in cigarette smoke impact the oesophageal valve. It also limits the secretion of saliva, a primary defence for the oesophagus. However, in smokers, the bicarbonate content can be less. Bicarbonates are the acid neutralising content in saliva. Moreover, smoking stimulates the secretion of stomach acid.

It also promotes the flow of bile salts to your stomach, further altering the stomach acid to worsen the impact. Nonetheless, smokers can have slow digestion and take time.

3. Foods and Drinks

Foods that trigger heartburn vary for everyone. However, certain foods are most likely to trigger heartburn.

Caffeinated Drinks: 

Caffeine relaxes the oesophagal valve and causes the food particles to reflux into the oesophagus. In addition, caffeinated drinks enhance acid secretion to trigger heartburn. 

Chocolate:

Research has agreed to the fact that chocolate can cause heartburn. Chocolate contains theobromine, a compound that relaxes the oesophagal valve muscle. As a result, it allows the food content to squirt up into the food pipe.

Fried Fatty and Oily Foods:

These foods tend to delay digestion due to the excess fat content. Thus, the stomach has to retain food for longer. It results in pressure buildup in the stomach. As a result, it weakens the oesophagal valve to reflux food.

Some foods stimulate stomach acid production and secretion. These foods include tomatoes, black pepper, spicy foods. In addition, citrus fruits like lemon and oranges also trigger acid secretion in the stomach. So be mindful of the quantity of these foods.

4. Eating Habits

Your dietary habits also initiate heartburn episodes. That is because a full stomach always exerts pressure on the lower oesophageal valve. As a result, it increases the risk of food particles reflux to the food pipe.

Going to bed immediately with a full stomach can also be harmful.  Your food contents press hard against the food pipe valve. It further worsens the chances for food to reflux. Therefore, eating two hours before bedtime is ideal.

5. Excess Body Weight

Being overweight or obese exerts pressure on your abdomen. It pushes the food upwards to reflux into the oesophagus. Thus, it initiates heartburn. So, it is always beneficial to maintain the ideal body weight. 

Tight clothes and belts may also cause pressure in your stomach. Some of you will find specific postures or workouts that trigger heartburn. It can be high-impact workouts like jumping, crunches etc. They exert pressure on your abdomen and trigger heartburn.

6. Medications

Several drugs may cause heartburn. However, some of them induce heartburn. There are multiple ways due to which medicines cause heartburn. For example, it can be due to a combination of drugs or the interaction of drugs with food. If you experience heartburn signs when on medication, you can inform your doctor and get a substitute for your medications. It eases your heartburn symptoms.

7. Health Concerns

Some unhealthy habits lead to medical conditions that manifest as heartburn. The most common health concern can be Gastroesophageal reflux disease (GERD). It is a collective term for disorders caused by acid reflux. Additionally, you will experience heartburn due to indigestion, pregnancy, and few medications. These medications are anti-inflammatory drugs, aspirin, antibiotics etc. It can also be a symptom of various health disorders.

8. Heartburn in Pregnancy

Heartburn can be frequent in pregnancy. It is due to hormonal imbalances, which affect the muscle that holds food in your tummy and cause the food contents to move up to the food pipe. They also slow down digestion to increase the risk of heartburn.

Nausea during pregnancy may trigger heartburn in expecting mothers. In addition, it reduces the pressure in the lower part of your food pipe or oesophagus. As a result, it facilitates the acidic food content to pass from the stomach to the food pipe. 

The expansion of the uterus also exerts pressure on your abdomen. It forces the acidic contents upwards to your food pipe. 

Some medications like nonsteroidal anti-inflammatory drugs and antibiotics also lead to heartburn. In addition, they damage the abdominal lining and result in irritability, pain, and reflux.

Natural Remedies to Relieve Heartburn Symptoms

You can avoid acid reflux or heartburn using simple tricks at home. Try out these simple ways to ease your symptoms:

Eat a Ripe Banana

Bananas are high in potassium content, which makes them alkaline. As a result, it neutralises the stomach acid. It limits the impact on your oesophagus and helps offset acid reflux. However, unripe bananas are less alkaline and high in starch. Thus, they trigger acid reflux. Melons, cauliflower, fennel are a few other alkaline foods.

Avoid Late Meals or Snacking 

Going to bed immediately after a meal is harmful. It triggers acid reflux to cause heartburn. Instead, ensure to eat three hours before your bedtime. It facilitates plenty of time for digestion. You should eat at least two hours before bed and exercise.

Chew Sugar-free Gum

Chewing gum increases the secretion of saliva. Saliva can help to swallow. It, in turn, helps keep acid levels low. Thus it neutralises the acid that pumps back to your oesophagus. As a result, it helps prevent heartburn. 

Avoid Acidic Foods

Some foods and drinks precipitate acid reflux and heartburn. However, it varies from person to person. Therefore, you should identify the particular foods to avoid them.

Adjust Your Sleep Position

Raise your upper body higher than your feet while at sleep. It helps prevent acid reflux and heartburn. You can adjust your bed position accordingly. For example, you can do it by elevating bedposts with woodblocks. However, avoid piling pillows because they can be harmful and even worsen your symptoms. Moreover, sleeping on your left side aid digestion and help control stomach acid reflux.

How Serious is Your Heartburn?

Occasional heartburn is common. You can treat it at home with over-the-counter drugs like antacid syrup. In addition, altering your dietary habits and lifestyle will help. However, antacids cause adverse effects like constipation or diarrhoea. Therefore, you should always take them after consulting with your doctor. It helps rule out further complications.

You need to consult your doctor if you have intense heartburn symptoms. These symptoms can signify some health disorders like esophagitis, Barrett’s syndrome etc. Therefore, you should immediately see a doctor if you experience severe heartburn. The persistent symptoms that need medical help are:

  • Persistent heartburn that does not lower down with antacids. 
  • Difficulty in swallowing 
  • Frequency of heartburn 
  • Heartburn with vomiting
  • Disruption in your routine activities
  • Difficulty breathing

Diagnosis of Heartburn

The heartburn diagnosis is based on multiple factors. The primary areas to consider are your symptoms, physical examination and medical history. In addition, heartburn can be a sign of an underlying disorder. To rule it out, you need to undergo specific investigations. For example:

  • Ambulatory acid (pH) Test: The doctor passes a tube into your oesophagus via the nose. The tube has a sensor at the tip. It helps detect the level of acid in your oesophagus. 
  • Endoscopy: In this procedure, a small tube fitted with a mini camera is passed down to your stomach via the mouth. It helps rule out any ulcer of the food pipe or stomach.
  • Oesophageal pH Monitor: It places a capsule along the lining of the food pipe and helps to measure acid levels.
  • Radiographs: It uses X-ray imaging to view your food pipe and stomach to rule out any abnormalities
  • Oesophageal Manometry involves passing a tube to your oesophagus via the nose. It helps observe any abnormality in contractions of food pipe during swallowing.

Treatments for Heartburn

Based on your diagnosis, your doctor will proceed with the treatment options. They will prescribe medications based on the severity of symptoms. The medicines include various classes. Some of them are:

1. Antacids

Antacids help provide immediate relief in heartburn symptoms. They help neutralise and reduce the acid in the stomach. As a result, antacids effectively cure indigestion and other associated abdominal pains.

2. Histamine-2 (H2) Blockers

H2 blockers limit the acid secretion by the stomach. 

3. Proton Pump Inhibitors (PPIs)

They reduce the acid quantity in your stomach and heal injured oesophagal tissues. 

4. Complications of Heartburn 

Frequent or prolonged heartburn is not safe and can be a symptom of some diseases. Untreated heartburn worsens the disorder. In addition, it results in certain complications, which include:

5. Oesophagitis

It is the inflammation of the food pipe or oesophagus. Repeated acid influx results in this disorder. The symptoms include heartburn and sore throat.

6. Esophageal Ulcers

Untreated oesophagitis results in esophageal ulcers. It also leads to esophageal perforation, a disorder where a hole develops in the esophageal lining. In addition, it harms the food pipe. Symptoms can be heartburn, indigestion, nausea etc.

7. Aspiration Pneumonia

Stomach acid may rise to your throat or mouth, and you may inhale it into your lungs. It results in aspiration pneumonia. It can be fatal if untreated.

8. Barrett’s Oesophagus

Frequent acid reflux injures the oesophagus lining. It can result from stomach acid and transform the lining cells into cancerous cells. If untreated, it may lead to cancer of the food pipe.

Heartburn: Prevention

Now that you learnt the complications of heartburn. It is essential to prevent it. So, let us find simple ways to protect ourselves from the extreme symptoms of heartburn. You can easily control and manage heartburn. All it requires is patience and lifestyle modifications. It includes changes in your diet and habits. 

1. Avoid Overeating

Overeating increases abdominal pressure. Excess food in your stomach exerts more pressure on the oesophageal valve. As a result, the valve may relax to allow stomach acid to move to the oesophagus and enhance acid reflux, leading to heartburn. Additionally, eating quickly will also stimulate heartburn. So, take time to chew and eat food.

2. Reduce Your Meal Portion

Eat small portions of meals. Large meals stimulate the synthesis of higher levels of acid. Eating small meals is a tried-and-tested remedy to prevent heartburn. 

3. Avoid Foods That Trigger Heartburn

Some foods trigger heartburn. These foods include onions, citrus fruits, fatty food etc. However, it differs from person to person. These foods might irritate your stomach and relax the lower valve in the oesophagus. In addition, caffeine, alcohol, and carbonated drinks will likely impact the lower esophageal valve.

4. Finish Your Meals at least 3 Hours Before Bedtime

Finish your meals at least three to four hours before you sleep. It gives your body time to digest the food. As a result, it limits the risk of heartburn overnight.

5. Maintaining a Healthy Weight

Optimum body weight helps relieve heartburn. In comparison, excess body weight leads to developing abdominal flaps. It exerts pressure on the abdomen and forces the food to move upward to the food pipe.

6. Quit Smoking

Nicotine in tobacco distends or weaken the lower oesophagal sphincter. It triggers food to move upwards and cause acid reflux. Smoking reduces the secretion of saliva. It affects the valve that prevents acid reflux to the oesophagus. Thus, it makes heartburn likely. Cessation of smoking prevents and limits acid reflux.

7. Physical Activity 

Exercise helps digestion and prevent acid reflux. However, excess weight will exert pressure on your stomach and precipitate acid reflux and heartburn. A well-balanced nutritious diet with regular workouts maintains a healthy body. As a result, it prevents heartburn.

8. Posture

An upright posture helps limit stress on your abdomen and oesophagus. Thus, it prevents acid reflux.

9. Wearing Comfortable Clothes: 

Tight clothes are similar to being overweight. It will exert equal pressure on your abdomen and lead to heartburn.

The Conclusion

Heartburn is a burning sensation in your chest. It may be likely behind your breastbone. You may also feel a sour taste in your throat or mouth. Heartburn occurs when stomach acid or food content returns into the oesophagus. Heartburn symptoms are felt after eating and worsen after lying down.

Usually, the symptoms are mild to cure at home. However, if heartburn is frequent and impairs your routine, you need to be cautious. It may cause associated symptoms. For example, you will find it difficult to swallow, breathe, have chest pain etc. It can be a sign of some underlying disorders. You need to seek immediate medical help.

About the Author

I, Dr. Poonam have 3+ years of experience in the field of Medicine. Currently serving as a Resident Physician at HealthifyMe, I have worked with premier hospitals such as Manipal Hospital, Bangalore as a Resident in Plastic and Reconstructive surgery and Rajiv Gandhi Government Hospital, Chennai as a Medical Officer. I aspire to put my knowledge in medicine to use in providing healthcare and fitness services to people and help enhance my abilities in meeting the ever-growing healthcare needs.


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