heartburn

Heartburn

Definition

The burning sensation inside the chest which can affect to the neck, throat, and face is called heart burn. It is worsen by bending or lying down. It is the primary symptom of gastro esophageal reflux, which is the movement of stomach acid into the esophagus. On rare incident, it is due to gastritis.

Description

More than one-third of the population is affected by heartburn, with about one-tenth affected daily. Irregular heartburn is generally without serious consequences, but chronic or frequent heartburn can have severe consequences. Accordingly, early management is important.

The stomach has a thick mucous coating that protects it from the strong acid it secretes into its interior when food is present, but the much thinner esophageal coating doesn't provide protection against acid. Thus, if the LES opens inappropriately or fails to close completely, and stomach contents leak into the esophagus, the esophagus can be burned by acid. The resulting burning sensation is called heartburn.

First you have to know the structure and action of the esophagus, if you want to know about the heartburn. The esophagus is a tube connecting the throat to the stomach. It is about 10 inches long in adults, lined with squalors epithelial cells, coated with mucus, and surrounded by muscles that push food to the stomach by sequential waves of contraction. The lower esophageal sphincter (LES) is a thick band of muscles that encircles the esophagus just above the uppermost part of the stomach. This sphincter is usually tightly closed and normally opens only when food passes from the esophagus into the stomach. Thus, the contents of the stomach are normally kept from moving back into the esophagus.

Infrequent heartburn has no severe long-lasting effects, but repetitive episodes of gastro esophageal reflux can eventually lead to esophageal inflammation (esophagus) and other damage. If episodes occur more frequently than twice a week, and the esophagus is repetitively subjected to acid and digestive enzymes inside the stomach, ulcerations, scarring, and thickening of the esophagus walls can result. This thickening of the esophagus wall causes a narrowing of the interior of the esophagus. Such narrowing affects swallowing and peristaltic movements. Repeated irritation can also result in changes in the types of cells that line the esophagus. The condition associated with these changes is termed Barrett's syndrome and can lead to esophageal cancer.

There are so many different factors may contribute to LES malfunction with its consequent gastro esophageal acid reflux:

1. The eating of large meals that distend the stomach can cause the LES to open inappropriately.
2. Lying down within two to three hours of eating can cause the LES to open.
3. Obesity, pregnancy, and tight clothing can impair the ability of the LES to stay closed by putting pressure on the abdomen.
4. Certain drugs, notably nicotine, alcohol, diazepam (Valium), hesperidins (Demerol),morphine, prostaglandins, calcium channel blockers, nitrate heart medications, ant cholinergic and adrenergic drugs (drugs that limit nerve reactions), including dopamine, can relax the LES.
5. Progesterone is thought to relax the LES.
6. Greasy foods and some other foods such as chocolate, coffee, and peppermint can relax the LES.
7. Paralysis and scleroderma can cause the LES to malfunction.
8. Hiatus hernia may also cause heartburn according to some gastroenterologists. (Hiatus hernia is a protrusion of part of the stomach through the diaphragm to a position next to the esophagus.)

Symptoms

There are so many people who has affected in heartburn but many people have different acid reflux-related heartburn triggers. Generally most people have similar heartburn symptoms.

1. A burning feeling in the chest just behind the breastbone that occurs after eating and lasts a few minutes to several hours.
2. Chest pain, especially after bending over, lying down or eating.
3. Burning in the throat or hot, sour, acidic or salty-tasting fluid at the back of the throat.
4. Difficulty in swallowing.
5. Feeling of food "sticking" in the middle of the chest or throat.
6. Heartburn may cause chronic cough, sore throat, or chronic hoarseness.

Treatment of Heartburn

Over-the-counter (OTC) drugs that neutralize stomach acid are, for most people, the first line of defense against heartburn. Antacids come in tablet, liquid, or foam, and in regular and extra-strength formulations.

The active agents in antacid compounds usually consist of one or more of the following ingredients: magnesium, aluminum hydroxide, sodium bicarbonate, or the centuries-old standby, calcium carbonate.

Antacids should bring relief almost instantaneously from heart burn. These active compounds buffer the accumulated acid in the stomach. This helps reduce or eliminate the burn that is felt in the esophagus. Antacids do not reduce any further acid buildup or eradicate feelings of fullness in the stomach.

A recommended dose one to three hours after eating should provide varying degrees of relief. If a single dose does not work, the problem may be more severe, and consulting a doctor should be considered.

In addition, those who have high blood pressure or who are on a sodium-restricted diet should not take antacids containing sodium bicarbonate because of its high sodium content. Also, those bothered by kidney stones should not take calcium carbonate antacids because the calcium can accelerate the problem. Calcium carbonate antacids will initially quell acid buildup, but because they contain calcium, this antacid will soon cause an increase in stomach acid.

Contrary to popular belief, milk is not a recommended antidote to heartburn. A glass of milk does provide immediate relief as it goes down, but milk contains calcium and protein, and these eventually stimulate even more acid production in the stomach. This can cause a more severe heartburn that can return in as little as a half an hour.

Prevention of Heartburn

Some simple precautions to take in order to avoid heartburn are:

1. If certain foods or drinks regularly bring on discomfort, avoid them
2. Do not smoke; avoid caffeine and alcohol
3. Cut back or eliminate chocolate and chocolate-based desserts
4. Try to lose weight
5. Eat slowly; avoid foods or drinks that are excessively hot or cold
6. Do not eat a major meal less than four hours before bedtime
7. Find ways to reduce stress
8. Sufferers of night-time heartburn can sometimes be helped by placing 6-inch blocks under the head of the bed. This often helps better than trying to use extra pillows which can shift during the night.