Introduction
Heartburn (also called known as acid reflux) is a digestive disorder that produces a painful, burning or warm sensation behind your breastbone. Most people will experience it at various times in their lives. Adults get it more than children and pregnant women, in particular, can get heartburn regularly as the growing uterus presses on the stomach.
Two related illnesses are dyspepsia and gastroesophagal reflux disease. Commonly called gas, dyspepsia involves a feeling of fullness and a gnawing or burning sensation in the chest or upper abdomen, particularly after meals. Repeated exposure to gastric acid will eventually damage the esophagus. The resulting condition, known as gastroesophagal reflux disease, can lead to ulcers and, in rare cases, cancer.
Symptoms
Symptoms of heartburn can include chest and abdominal pain, stomach acid rising to the throat, gas, burping, bloating and, sometimes, trouble swallowing, nausea or blood in the vomit. Other potential symptoms are belching, liquid abdominal noises, increased gas, poor appetite, and changes in bowel habits. For some, it can result in sleep problems, chronic coughing, asthma, wheezing or choking.
The symptoms of heartburn and a heart attack may feel similar. Sometimes, people with heart disease ignore serious symptoms, dismissing them as simply heartburn or acid indigestion. If you have past problems with your heart or the risk factors associated with heart attacks, check with your doctor. If your chest pain is severe and feels like a crushing or squeezing sensation, call 911 and seek medical attention immediately.
Causes/Risk Factors
Heartburn is a digestive disorder associated with high stomach acidity and a disturbed acid-alkali balance. It occurs when stomach acid splashes up into the esophagus, the tube that carries food from your mouth to your stomach. Often, this is due to an overstimulation of the stomach glands, which produce hydrochloric acid, as a result of poor eating habits and the consumption of acid-producing foods. The pain often migrates upward to the throat, causing a sour taste in the mouth. The pain is often worse after meals and can be exacerbated by lying down or bending over.
Overfilling the stomach, especially with rich, fried foods high in fat content, can cause heartburn. Swallowing air while eating too quickly is another common factor. Stress and eating under stress can also contribute to stomach acidity. All these habits cause the stomach to expand upwards, carrying stomach acid which then irritates the esophagus. Heartburn can also be caused by reflux esophagitis, which occurs if the sphincter muscle, responsible for closing the stomach from the esophagus, is relaxed. Fats, alcohol, chocolate and coffee can relax the sphincter muscle, resulting in acid reflux.
Heartburn is a very common problem during pregnancy, probably due to hormonal changes combined with the pressure that the growing baby exerts on the stomach.
Another cause of heartburn is indigestion that stems from lack of bile or insufficient pancreatic enzymes, or as a result of allergies to certain foods. Even too little stomach acid will hinder digestion and cause fullness and burning.
The possibility of a hiatal hernia should be investigated if the problem is worse when bending over or lying down. Heartburn can also be a precursor to an ulcer.
Other factors associated with heartburn include obesity, tight clothes, straining with bowel movements and vigorous exercise. Smoking can also produce excessive stomach acid, as can medications like ASA, ibuprofen, prednisone, iron, potassium, antihistamines, or sleeping pills.
What You Can Do
To prevent heartburn, enjoy your food, eating slowly to avoid swallowing air.
Avoid or consume in moderation foods known to produce heartburn: chocolate, peppermint, fried foods, fatty foods, sugars, coffee, carbonated drinks, and alcohol. When you do get heartburn, the acid can make the esophagus sensitive to other foods, such as citrus fruits, tomatoes, spicy foods, garlic and onions. These foods can then exacerbate your symptoms.
Sugar and honey can trigger heartburn for some people. If this is your case, avoid these foods.
Reduce your weight through physical activity and a better diet, consisting of smaller meals with more protein and less fat. Follow the recommendations of Canada's Food Guide.
Don't lie down within two hours of eating.
Don't wear tight clothing around your stomach. Loosen belts and other tight clothing.
Raise the end of your bed where you lay your head 15-20 centimetres to prevent stomach acid from rising in your stomach. Avoid lying on your right side.
When you swallow pills, ensure you are standing or sitting up, and drink a full glass of water with the medication.
Let your doctor know if you experience any difficulty swallowing, bleeding or black stools, or weight loss. Your doctor may have to investigate further by looking into your stomach with a flexible light known as an endoscope. This is a simple procedure involving minimal discomfort.
What You Can Take
Over-the-counter antacids can help to neutralize stomach acids. Your doctor may also prescribe acid-reducing medications such as H2 blockers or proton pump inhibitors.
The old remedy of taking a teaspoon of baking soda is harmful because it builds gases and increases the acidity of the stomach. A very effective natural remedy is to drink freshly made cabbage or potato juice (do not store), which dilutes stomach acid and flushes it through the duodenum.
Do not drink dairy milk. Although milk neutralizes stomach acid, the calcium and protein in milk stimulates the production of more acid. Almond milk, raw goat's milk, rice milk or soy milk are good substitutes, provided you are not allergic to any of these foods.
Further Resources
Visit the College of Family Physicians of Canada's Web page on heartburn at www.cfpc.ca/English/cfpc/programs/patient%20education/heartburn/default.asp?s=1.
