This article is about the medical condition. For the film see Heartburn (film) .
or '''pyrosis''' is a painful or burning sensation in the and may radiate to the
Neck ,
Throat , or angle of the jaw. Heartburn is also identified as one of the causes of
Asthma and chronic
Cough .
The sensation of heartburn is caused by exposure of the lower esophagus to the
Acidic contents of the
Stomach . Normally, the lower esophageal
Sphincter (LES) separating the stomach from the esophagus is supposed to contract to prevent this situation. If the sphincter relaxes for any reason (as normally occurs during swallowing), stomach contents, mixed with
Gastric Acid , can return into the esophagus. This return is also known as ''reflux'', and may progress to
Gastroesophageal Reflux Disease (GERD) if it occurs frequently.
Peristalsis , the rhythmic wave of muscular contraction in the esophagus, normally moves food down and past the LES and is responsible for ultimately clearing refluxed stomach contents. In addition, gastric acid can be neutralized by
Buffer s present in
Saliva .
Foods that may cause Heartburn:
Physicians typically diagnose
Gastroesophageal Reflux Disease (GERD) based on symptoms alone. When the clinical presentation is unclear, other tests can be performed to confirm the diagnosis or exclude other disorders. Confirmatory tests include:
A probe can be placed via the nose into the esophagus to record the level of
Acidity in the lower esophagus. Because some degree of variation in acidity is normal, and small reflux events are relatively common, such monitors must be left in place for at least a 24-hour period to confirm the diagnosis of GERD. The test is particularly useful when the patient's symptoms can be correlated to episodes of increased esophageal acidity.
A series of x-rays of the upper digestive system are taken after drinking a barium solution. These can demonstrate reflux of barium into the esophagus, which suggests the possibility of gastroesophageal reflux disease. More accurately,
Fluoroscopy can be used to document reflux in real-time.
In this test, a pressure sensor (manometer) is passed through the mouth into the esophagus and measures the pressure of the lower esophageal sphincter directly.
The esophageal mucosa can be visualized directly by passing a thin, lighted tube with a tiny camera attached (an endoscope) through the mouth to examine the esophagus and stomach. In this way, evidence of esophageal inflammation can be detected, and biopsies taken if necessary.
A small sample of tissue from the esophagus is removed. It is then studied to check for inflammation, cancer, or other problems.
If heartburn occurs when lying down, raising the head with pillows or sitting up frequently provides relief – although care must be taken to avoid placing continuous strain on the neck. Avoidance of certain foods shortly before bedtime is frequently advised to avoid future attacks.
Antacid s,
H2-receptor Antagonist s and
Proton Pump Inhibitor s are used (in that order) to treat heartburn.
Daily treatment with
Antacid s is effective for 25-30% of people with GERD. Acid-blocking medications are the most effective for mild forms of the condition.
With the advent of proton-pump inhibitors,
H2-receptor Antagonist s are not widely used.
Proton Pump Inhibitor s are a class of medications which can be effective for people who do not respond to antacid or acid blockers. Proton-pump inhibitors directly block acid production in the stomach cells and provide more effective relief than less powerful medications. In order to prevent heartburn the medication disfigures and disables the proteins (proton pumps) that control the pH of the stomach, allowing the body to digest them.
Restricting diet is very important, since 90-95% of sufferers of heartburn or esophageal disorder can link their symptoms to specific foods. Therefore, it is important that heartburn sufferers manage their diets as a way to treat their heartburn. Sufferers should choose the kinds of foods and drinks which have little risk of causing acid reflux, while some kinds of foods or drinks should be avoided as they are major heartburn triggers.
