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Heartburn

Heartburn is a pain caused by stomach acids backing up into the esophagus. The esophagus is the tube that connects the mouth to the stomach. Heartburn is very common. About one-third of adults report occasional heartburn symptoms and 10 percent report daily symptoms. It is common during pregnancy.

Occasional attacks pose little threat, although the pain can be intense and alarming. Heartburn sends some people to the emergency room thinking they are having a heart attack. Heartburn has nothing to do with the heart.

Symptoms of heartburn include:

• a burning sensation below or behind the breastbone

• belching

• sour or bitter fluid (stomach contents) may be spit up into or tasted in the mouth

• coughing or loss of voice may occur or

• pain is relieved by using antacids

A weakness in the valve between the esophagus and the stomach causes a reflux, or backing up, of strong stomach acids. This most often occurs 30 to 60 minutes after a meal or when the person lies down. Frequent reflux may damage the lining of the esophagus. Reflux during sleep may stay in the esophagus longer, leading to more damage. Most people with heartburn have mild conditions with minimal damage to the esophagus.

Prevention and treatment of heartburn starts with lifestyle changes. Foods to avoid include fatty foods, coffee, alcohol, tomato products, citrus juices, colas, and chocolate. Avoid aspirin. Eat small, frequent meals, and quit smoking. If overweight, many patients note relief after losing weight. Avoid lying down or bending over within 3 hours of a meal. Elevating the head of the bed helps prevent nighttime reflux.

Antacids should be taken when symptoms occur. Common products include Maalox, Mylanta, and Gaviscon. Gaviscon appears to work best because it floats at the top of the stomach contents. Ulcer medications, such as Tagamet, are now available over-the-counter. Most people respond well to lifestyle changes, antacids and ulcer medications. Cases that do not respond may need antibiotic therapy or rarely surgery.

Seek emergency care if heartburn symptoms happen along with shortness of breath, excessive sweating, weakness or chest, arm, or back pain.

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