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What’s Actually Happening When You Have Heartburn?

What's Actually Happening When You Have Heartburn?

Heartburn is a burning feeling in the chest that can last for a few minutes or several hours. It sometimes travels up into the neck and throat and can cause an acidic or sour taste. Heartburn itself is a symptom of acid reflux. It often worsens after eating or upon lying down after a meal.

Symptoms of acid reflux include:

  • A burning feeling in the throat
  • A hot or bitter taste in the back of the throat
  • Pain behind the breastbone
  • Chest pain when bending over
  • Difficulty swallowing

What Causes Heartburn?

Swallowed food travels through a long tube, called the esophagus, which connects the mouth and stomach. The esophagus and stomach are connected by the lower esophageal sphincter (LES). The LES opens to let food pass into the stomach, then closes to keep contents inside. The stomach produces an acidic mixture that helps to digest food. The stomach is lined and designed to handle highly acidic contents but the esophagus is not.

Sometimes, the esophageal sphincter doesn’t close properly due to weakness or relaxation. When this happens, the acidic mixture from the stomach goes back into the esophagus. That’s called acid reflux and it is often accompanied by the burning sensation known as heartburn.

There are several conditions that can cause acid reflux and heartburn, including:

  • Gastroesophageal reflux disease (GERD)
  • Hiatal hernia: when the stomach bulges up into the chest through an opening in the diaphragm
  • Pregnancy
  • Medications such as non-steroidal anti-inflammatory drugs (NSAIDs)
  • Being overweight

Certain foods can trigger heartburn symptoms for some people, including:

  • Tomatoes or tomato-based products
  • Citrus fruits or juices
  • High-fat foods
  • Spicy foods
  • Onions
  • Caffeinated beverages
  • Carbonated beverages
  • Alcohol

Lifestyle factors can trigger symptoms for some people, including:

  • Smoking
  • Having high-stress levels
  • Eating large meals
  • Eating too close to bedtime
  • Wearing tight clothes or belts

Can Heartburn Be Prevented?

This can often be prevented or managed with diet and lifestyle changes. Cutting back on portion size and eating at least three to four hours before lying down can help reduce the chance of symptoms.

Other ways to manage or reduce symptoms are:

  • Eating slowly
  • Eating four or five small meals instead of three larger ones
  • Not lying down or going to bed with a full stomach
  • Wearing loose-fitting clothes
  • Becoming aware of and avoiding foods that trigger symptoms
  • Maintaining a healthy weight
  • Not smoking
  • Raising the head of the bed to sleep
  • Waiting at least two hours after eating to exercise or engage in strenuous activity

When Is It Time To Call the Doctor?

Although occasional heartburn is common, frequent occurrences may lead to more serious health problems.

Chronic heartburn has been linked to conditions such as:

  • Inflammation and narrowing of the esophagus
  • Chronic cough
  • Respiratory problems
  • GERD
  • Barrett’s esophagus, which is a precursor to esophageal cancer

It is important to contact the doctor if:

  • Heartburn occurs more than twice weekly
  • Over-the-counter medications don’t help
  • Wheezing or hoarseness occurs
  • It becomes difficult to swallow
  • Unexpected weight loss occurs
  • It becomes difficult to participate in daily activities
  • Heartburn does not go away

If you’re experiencing chronic heartburn, testing to help identify the cause of symptoms is important. Typically, an upper endoscopy (EGD) is done to evaluate the esophagus and stomach. This can help get an accurate diagnosis and better treatment.

Don’t continue living with uncomfortable heartburn – schedule an appointment today!

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