Feeling the Burn? Understanding Heartburn and How to Find Relief

You’re lying in bed, just about to drift off to sleep, when you feel a burning sensation in the middle of your chest that rises into your throat. You sit up, hoping the uncomfortable feeling will pass quickly. That burning feeling in the chest and throat is a classic sign of heartburn, something many people experience. Fortunately, you don’t have to take heartburn lying down. Many treatments are available to help.

Occasional heartburn — also known as acid reflux or acid indigestion — probably isn’t a cause for concern. Heartburn that occurs more than twice per week, however, may be a sign of a more serious condition called gastroesophageal reflux disease (GERD).

If you have frequent heartburn, tell your primary care physician because GERD can cause complications, including a condition that can lead to cancer of the esophagus. Early diagnosis and treatment can help you get ahead of GERD and reduce your risk of complications.

Why Heartburn Happens

At the end of your esophagus, a tube that carries food and fluids from mouth to stomach, a group of muscles helps these substances get where they’re going — and keeps stomach acid where it belongs. Known as the lower esophageal sphincter (LES), a ring of muscles that opens like a valve, allows food and fluids to enter the stomach while also preventing stomach acid from flowing into the esophagus. Sometimes, however, the LES loses some of its effectiveness.

If the LES weakens, it may not close fully. As a result, stomach acid may reach the esophagus, causing heartburn. A variety of risk factors can weaken the LES and contribute to frequent acid reflux, including:

• Certain medications, including calcium channel blockers and nonsteroidal anti-inflammatory drugs
• Excess weight
• Pregnancy
• Smoking or exposure to secondhand smoke

In addition, alcohol and some foods, including acidic and spicy foods, can trigger heartburn. In some people, a hiatal hernia — when part of the stomach bulges into the chest through a hole in the muscle separating the two — may cause heartburn.

What Heartburn Feels Like

The signs of heartburn are tough to miss but can be easy to attribute to something else. The most common symptom of heartburn is a burning feeling ranging from chest to throat, which may be a sign that stomach acid has entered the esophagus. Other symptoms can include:

• A sour taste in your mouth due to acidic contents reaching your throat or mouth
• Chest pain
• Coughing that won’t go away
• Difficulty swallowing
• Hoarseness
• Nausea

Symptoms of heartburn, such as chest pain and nausea, can also occur during a heart attack, which is a medical emergency. If you experience these symptoms and worry that they might indicate a heart attack or develop other heart attack-like symptoms, such as shortness of breath or pain in the jaw, back, or arms, call 911 right away.

Healthy Changes to Reduce Acid Reflux

If heartburn affects your quality of life, including frequently interrupting your sleep, tell your primary care provider, who can help you find a solution or, if necessary, refer you to a gastroenterologist for specialized care.

Diagnosing heartburn or GERD typically doesn’t require much testing, if any at all. Your medical provider will likely recognize acid reflux based on your symptoms. In some cases, however, your medical provider may want to use a scope to look in your esophagus for signs of GERD or test the pH level in the digestive passage to check for acid reflux.

Treating heartburn usually begins with conservative steps. Your medical provider may recommend changes you can make to your lifestyle, sleeping environment, and wardrobe to reduce the risk of heartburn, including:

• Avoid eating at least two hours before bedtime.
• Eat only until you feel full.
• Elevate your head during sleep by arranging several pillows behind your head and neck or raising the head of the bed at least 6 inches with wood blocks.
• Lose weight.
• Quit smoking.
• Wear loose-fitting clothes.

Keeping a journal of foods and drinks that trigger heartburn can help you pinpoint what to avoid. This may include high-fat or spicy foods, citrus fruits, tomatoes and tomato products, chocolate, and beverages with caffeine. On the other hand, a healthy diet that includes non-citrus fruits, vegetables, and high-protein and low-fat foods may help reduce acid reflux. Do you need help adjusting your eating habits to reduce heartburn? Medical nutrition therapy with a registered dietitian may be right for you.

Medications and More

Lifestyle changes may not be enough on their own to control heartburn. If you need some extra help, several over-the-counter and prescription medications may offer a path to tame acid reflux.

Start with medicines that don’t require a prescription. These include antacids, which can help with mild symptoms. Before you start taking antacids, however, be sure to discuss them with your medical provider, who can determine whether they’re right for you. Don’t depend on these medications as a long-term solution for acid reflux. You should only take them for a short time because extended use can cause side effects, such as constipation or diarrhea.

Antacids aren’t the only types of medications that work on heartburn. Proton pump inhibitors, which are available with or without a prescription, reduce stomach acid production and may repair damaged esophageal lining. These medicines, and another group called H2 blockers, which work similarly but may not be as effective as proton pump inhibitors, may be appropriate if you have GERD.

Like many people, you may be able to treat frequent heartburn successfully with at-home or over-the-counter treatment, but that’s not always the case. If lifestyle changes and medications don’t help, surgery may be a good option. For many people who need surgery for acid reflux, surgeons perform an operation called fundoplication. This strengthens the LES by attaching the top of the stomach to the lower esophagus.

Don’t resign yourself to living with frequent heartburn. With treatment, you can put out the fire.

Have you been experiencing frequent heartburn? Find a primary care provider at Memorial Hospital of Sweetwater County who can determine the cause and help you identify the cause and get control of symptoms.