The burning sensation of heartburn is felt when stomach acid backs up into the esophagus, the tube that connects the back of the throat with the stomach. A band of muscle around the bottom of the esophagus relaxes when you swallow to enable food and liquid to flow into the stomach, before this band of muscle – called the lower esophageal sphincter (LES) – tightens up again. If the LES does not function properly, through weakening or relaxing abnormally, stomach acid can flow back up into the esophagus.
Heartburn that occurs occasionally is usually a symptom of indigestion, but heartburn that occurs frequently (more than twice a week) could be a symptom of gastroesophageal reflux disease (GERD).
Symptoms:
Heartburn could be, but is not always a symptom of indigestion, as the typical symptoms of indigestion are discomfort and pain in the upper abdomen, feeling full and bloated, as well as belching and nausea.
Heartburn is typified with a burning pain that usually starts in the chest, just behind the breastbone, and may not always start just after you have eaten. The symptoms could last from a few minutes to hours.
Other symptoms include chest pain when you bend over, or lie down, or exercise on a full stomach; a burning sensation at the back of the throat; fluid at the back of the throat that tastes sour or acidic; or even a long term cough, accompanied by a sore throat.
Heartburn usually starts after meals and particularly after food or drinks that are known triggers (such as some fast foods!).
Managing heartburn:
- Keeping a heartburn diary would help to identify which foods and drinks trigger your symptoms.
- By understanding and identifying the specific causes of your heartburn, you can make changes to your lifestyle and diet.
- As the LES is controlled by various nerves and hormones, it is affected by food or drink intake, and even emotions such as anger or anxiety.
- Some foods and drinks can directly irritate the lining of the esophagus
- Avoid well known heartburn triggers such as spicy food, fatty, greasy or fried foods, large meals, citrus fruits or juices, tomatoes and tomato-based products, onions, peppermint, chocolate and beverages with caffeine.
- Eat meals at least three hours before going to bed.
- Eat smaller portions of food more regularly to avoid an overly full stomach.
- Being overweight or pregnant can increase the risk of heartburn – shed some kilograms and centimeters when you are overweight as excess pounds put pressure on your abdomen, but when pregnant you may be in for the duration!
- Eat slowly and chew properly.
- Stop smoking, as nicotine can weaken the LES.
- Significant consumption of alcohol has the same effect on the LES.
- If heartburn starts or gets worse when going to bed, raise the head of the bed by about 120mm so your head and chest are higher than your feet. Just raising your head with pillows won’t help.
- Wait two hours after a meal before you exercise.
- Drink ample amounts of water.
- Occasional heartburn is fairly common and no cause for concern – certain fast foods eaten rapidly can be a trigger!
- Avoid your heartburn triggers!
- Certain medications can cause heartburn. Once again, a heartburn diary can be very useful in this regard.
- Seek medical assistance if these remedies do not help to reduce chronic heartburn.
Sources:
Cooling heartburn. Harvard Medical School Guide, current edition. Harvard Medical School. (www.health.harvard.edu)
Heartburn. Published online 17 May 2018. Mayo Clinic. (www.mayoclinic.org)
Indigestion and heartburn differences. Published online and updated 2 November 2018. Verywell Health. (www.verywellhealth.com)
Causes and risk factors of heartburn. Published online and updated 31 October 2018. Verywell Health. (www.verywellhealth.com)
What are the symptoms of heartburn? Published online 22 October 2017. WebMd. (www.webmd.com)
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