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Heartburn

Heartburn is a very common condition that affects about 1 out of every 3 people at least once a month. The condition occurs when the acidic contents of the stomach go back up, or reflux, into the esophagus. The most common heartburn symptom is pain or discomfort that starts in the middle of the chest and can move up the throat. Lifestyle changes and medication are the main treatments for this condition.

 

What Is Heartburn?

Heartburn is one of the most common health conditions that people experience in today's society. It is thought that about 1 in 10 people suffer from daily heartburn and about 1 in 3 people suffer from heartburn at least once a month. Before talking about the symptoms and treatment for heartburn, it may be helpful to understand the normal digestive process and how certain conditions can impact this normal process, resulting in heartburn.
 

Normal Digestive Process

As you chew your food and swallow, food particles travel from your mouth to the esophagus. The esophagus is a muscular tube that contracts and relaxes in a wave-like motion to help move food and liquids down toward your stomach. This motion is called peristalsis.
 
Just before the esophagus gets to the stomach, it travels through your diaphragm. The diaphragm is a broad muscle that separates your stomach from your chest cavity. The opening in the diaphragm where the esophagus travels through is called the hiatus.
 
The esophagus then joins the stomach at the lower esophageal sphincter (LES). This sphincter acts as a doorway between the esophagus and the stomach. After you swallow, it opens to let food into the stomach. Then the sphincter closes to keep food and stomach juices from going back up into the esophagus. The hiatus also helps close off the entryway to the stomach.
 
Inside your stomach, strong acids and enzymes make up the stomach juices that break down your food. Your stomach has special mechanisms that help protect it from these strong juices.
 
Your esophagus, however, doesn't have these same defenses, so it's important for the LES to close off the stomach opening to keep the juices in the stomach. Sometimes, the acidic contents of the stomach do go back up, or reflux, into the esophagus. Some reflux is normal. Much of the time, this never causes any problems, because the esophagus also has some ways to protect itself. For example, the saliva in your esophagus can help neutralize stomach acid, and gravity and peristalsis help to wash the saliva and stomach juices back down into the stomach.
 
At other times, acid reflux can cause the burning, pressure, or pain in the chest or throat that most people call heartburn or acid indigestion.
 

Impact of Heartburn on the Digestive System

For people who have heartburn, the sphincter between the esophagus and the stomach either opens at the wrong time or is weak and doesn't completely close off the opening to the stomach. When this happens, stomach juices and food particles can flow back up into the esophagus more frequently than normal.
 
If stomach juices stay in the esophagus for long periods of time, or if acid reflux happens often, the natural way the esophagus protects itself from stomach juices may simply be overwhelmed. The lining of the esophagus may become irritated, and this can lead to heartburn.
 

Risk Factors

While they don't necessarily cause the condition, risk factors increase a person's chances for developing heartburn. Just because you have these risk factors does not guarantee that you will have symptoms -- it just makes it more likely. Common risk factors include:
 
  • Being overweight or obese
  • Use of tobacco products
  • Dietary factors
  • Certain medications
  • Medical conditions
  • Use of alcohol
  • Stress
  • Hiatal hernia
  • Pregnancy.
     

Symptoms

The most common symptom is pain or discomfort that starts in the middle of the chest. This sensation can move up through the throat. The pain can be frequent, constant, and/or severe.
 
Heartburn symptoms can be made worse by large meals, lying down, and bending over.
 
The pain experienced with heartburn can often be confused with the pain associated with having a heart attack. (Click Heartburn or Heart Attack? to learn the difference between the two.) Knowing the difference and taking immediate action can save lives.
 
(Click Heartburn Symptoms for more information on this topic.)
 

Treatment

Fortunately, there are several treatment options available. For people who only get occasional heartburn, over-the-counter medications often provide heartburn relief. Lifestyle changes can also be helpful in decreasing the frequency of heartburn, reducing the severity of the symptoms, and preventing the condition in the first place.
 
The treatment recommended by your healthcare provider will depend on a number of factors, including:
 
  • How often heartburn occurs
  • How severe your symptoms are
  • When your symptoms occur
  • How much your symptoms interfere with your life
  • What you have tried in the past.

 

(Click Heartburn Treatment for more information.)

 

Other Heartburn Information

You can also learn lifestyle strategies for dealing with heartburn by clicking on any of the following eMedTV articles:
 
(Click Heartburn Medicine to learn more about specific heartburn medications.)
 
Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD