Heartburn is a condition characterized by burning sensation that is felt behind the sternum (breastbone). Approximately one in ten adults will have it in any given week, but most adults will experience it at least once in their life. While unpleasant, occasional heartburn is normal and should be no cause for concern. If the condition is chronic, happening several times a week or persisting for days at a time, it should be discussed with a physician as it may be an indicator of a more serious condition known as Gastroesophageal reflux disease (GERD) or acid reflux disease.
The cause of heartburn is stomach acid that gets into the esophagus. In normal circumstance, when a person swallows solid food or liquid, the esophagus contracts and moves the food down toward the stomach. At the bottom of the esophagus there is opening that separates the stomach from the esophagus. This opening is called the lower esophageal sphincter. Most of the time the lower esophageal sphincter is closed, but it does open to allow food. Sometimes this sphincter will remain open for too long or open at inappropriate time, which allows stomach acid to splash up into the esophagus. This irritates the lining of the esophagus and it is felt as a burning sensation.
The lower esophageal sphincter may remain open for too long or at inappropriate times for a number of reasons. Some acidic foods, such as citrus or tomatoes, and caffeinated drinks can cause it to relax. High fat diets have also been implicated as contributing to heartburn. Other factors, such as overeating and obesity may put pressure on the lower esophageal sphincter that weakens it. Overproduction of stomach acid from stress or smoking may also result in stomach acid getting into the esophagus.
While a burning sensation is the most common symptom of the condition, there are several others that may occur. It may manifest as chest pain, though chest pains without a clear cause should always be checked by physician. There may also be coughing, trouble with swallowing, or a sour taste in the back of the throat.
For occasional bouts of heartburn, the most common course of treatment is an over the counter antacid, such as Tums or Rolaids. If the condition is persistent a longer acting type of medication called an H-2-receptor blocker can be used. Over the counter medications of this type include Zantac 75, Pepcid AC, and Tagamet HB. A final type of medication that may be used to control the condition are proton pump inhibitors (PPI). These medications suppress stomach acid production for periods ranging between 24 to 72 hours. A common example of a PPI is Prilosec OTC. In extreme cases, a laparoscopic surgery may be used to repair a damaged lower esophageal sphincter. Lifestyle changes such as stress reduction and limiting foods that cause heartburn may also be helpful in addressing the condition.