The Lowdown on Heartburn

What is heartburn?normal LES
Heartburn is an uncomfortable, burning sensation occurring behind the breastbone and up into the neck area, occuring most often after meals.  There may be a feeling of food or acid coming back into the mouth or a bitter, acid taste in the mouth.  Heartburn occurs when food and stomach acid backs up (refluxes) into the esophagus.  Chronic heartburn is the most common symptom of  gastroesophageal reflux disease (GERD).  Sometimes the pain caused heartburn or GERD may be similar to angina or a heart attack.  If your physician says your chest pain is not caused by a heart condition, it may be caused by GERD.  You should never assume that you have heartburn or GERD until you have been evaluated for possible heart problems by a physician.

What causes heartburn and GERD?relaxed LES leading
                        to heartburn
Heartburn and GERD can be caused by a variety of causes.  The most common cause is relaxation of the muscular valve at the lower end of the esophagus, called the Lower Esophageal Sphincter (LES).  A hiatal hernia  (a weakness of the diaphragm, allowing part of the stomach to protrude up into the chest cavity) can increase LES relaxation and impair esophageal emptying, resulting in GERD.  Obesity, alcohol, smoking, certain foods, pregnancy, some medications, delayed emptying of the stomach and diet can all cause an increased risk for heartburn and GERD.

Can GERD cause any other symptoms?
Absolutely.  GERD can cause other seemingly unrelated problems.  Some manifestations of chronic GERD include:

  • Hoarseness, sore throat, laryngitis or a "full feeling" in the throat
  • Asthma, wheezing and/or a chronic cough
  • Difficulty in swallowing or a feeling of food "getting stuck" in the throat
  • Tooth decay and/or gingivitis
Doesn't everybody have heartburn?  It's not serious, is it?
While everyone experiences heartburn once in a while, chronic heartburn should not be taken lightly.  GERD can result in inflammation of the esophagus (esophagitis), ulcers in the esophagus, scarring or narrowing of the esophagus, and bleeding of the esophagus.  Some patients with GERD develop a condition called Barrett's Esophagus, which occurs when the normal lining (epithelium) of the esophagus is replaced with abnormal (Barrett's) epithelium.  Patients who have this condition are at a higher risk for cancer of the esophagus and must be carefully monitored on a regular basis.

I have a lot of these symptoms, so how can I tell if I have GERD?
Only a physician can determine if you have GERD or if your symptoms are caused by some other problem.  Gastroenterologists specialize in the diagnosis and treatment of GERD and may order specialized tests in order to diagnosis it.  Tests that may be ordered to diagnosis GERD are x-rays, EGD (upper endoscopy) and esophageal manometry studies.  You may want to refer to our heartburn quiz to help you determine if you may have GERD.  If you think you may have GERD, please make an appointment to be evaluated by a doctor promptly. 

What is the treatment for GERD?
Treatments for GERD are lifestyle changes and prescription medications.


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