Overview
Heartburn is a common digestive issue that causes patients to experience a burning pain in the chest and back of their throat. It is a common symptom of acid reflux, in which the contents of the stomach travel back up the esophagus. Because the stomach contains large quantities of acid, this reflux burns the esophagus, leading to pain.
Anatomy
Heartburn is the result of a weakened or malfunctioning lower esophageal sphincter. This band of muscle fits around the junction of the esophagus and the stomach. Normally, according to the American Gastroenterological Association, this sphincter relaxes to let food pass from the esophagus to the stomach and then tightens up to prevent the contents of the stomach from traveling up the esophagus.
Hiatal Hernia
Heartburn results when the lower esophageal sphincter is weak or if it relaxes at inappropriate times. Sometimes a condition known as a hiatal hernia can contribute to heartburn, the National Institute of Diabetes and Digestive and Kidney (NIDDK) explains. A hiatal hernia is caused by the upper portion of the stomach (and the lower esophageal sphincter) moving above the diaphragm, which is a muscular wall in the abdomen. Because the diaphragm normally helps keep the lower esophageal sphincter closed, hiatal hernias can predispose a patient to developing heartburn. Hiatal hernias can occur at any age and the NIDDK notes that they are commonly found in people older than age 50.
Risk Factors
Although what exactly causes heartburn is not completely understood, the Mayo Clinic notes that there are a number of things which can worsen heartburn. Smoking, caffeine and alcohol can all trigger heartburn. Acidic and spicy foods can also cause indigestion, which can trigger heartburn. Fatty foods, foods with chocolate and peppermint and tomato-based foods can also trigger heartburn. Many patients experience heartburn when they lie down shortly after eating.
Complications
Chronic heartburn can lead to a condition known as Barrett’s esophagus. Barrett’s esophagus describes a changing in the types of cells that line the esophagus. The cells in the esophageal lining transform in response to chronic acid burns. Patients with Barrett’s esophagus have a greater risk of developing esophageal cancer. Chronic heartburn can also cause scar tissue to build up and cause esophageal strictures, which narrow the esophagus.
Treatment
There are a number of lifestyle changes, according to the Mayo Clinic, that can be used to prevent heartburn. Patients can limit their heartburn by losing weight, avoiding tight-fitting clothing, and avoiding substances that trigger their heartburn. Antacids can also be used to neutralize stomach acid. Other medications, including proton pump inhibitors and H2 receptor blockers reduce the stomach’s production of acid and can also be used to relieve heartburn. These medications are available by prescription and over the counter.
About this Author
Adam Cloe is an MD/PhD student at the University of Chicago. He has a Bachelor of Arts in biochemistry from Boston University, where he won an award for excellence in undergraduate science writing. He has been published in various scientific journals.
