Gastroesophageal Reflux (Heartburn)

When food is swallowed, it travels down a tube called the esophagus, and a valve at its bottom relaxes to allow the food to enter the stomach. This valve normally only allows food to move downward, but a drop in pressure in the lower esophagus or a weakening of the sphincter muscle can permit a backflow (reflux) of powerful stomach acids into the esophagus.This causes the burning sensation associated with heartburn.

Certain foods or circumstances greatly increase the risk of heartburn. Overeating, consuming alcohol, cigarette smoking, and eating fatty or spicy foods can lead to acid indigestion. Pressure on the esophageal sphincter can cause a drop in pressure in the esophagus that allows stomach acid to flow back into it.

A hiatal hernia, a disorder in which a portion of the stomach pushes up through the small opening in the diaphragm where the esophagus and stomach meet, also can allow a backflow of acids.

Simple heartburn usually can be diagnosed on the basis of the symptoms. If there is any suspicion that the pain is coming from the heart instead of the intestinal tract, an electrocardiogram should be done immediately.

Nonprescription antacids are usually sufficient to relieve an attack.

Prevention is the best approach to controlling heartburn. Eat small meals and avoid or cut back on aspirin, coffee, cigarettes, and alcohol. Wait at least two hours before lying down after eating. If heartburn occurs after going to bed, elevate the head of the bed by placing bricks under its legs.

If heartburn does occur, an antacid usually brings prompt relief. Check the ingredients to make sure the product does not contain unwanted substances, such as sodium.

If the pain is unusually severe and is accompanied by nausea or vomiting, numbness in a limb, or a cold, clammy sensation, it may be a heart attack instead of heartburn. If these symptoms occur, seek immediate emergency medical aid. A doctor also should be consulted if heartburn occurs on a regular basis.

Symptoms of Heartburn

• Burning sensation behind the breastbone
• Nausea, belching, or a bloated feeling
• A sore throat from acid reflux

Usually, heartburn is not dangerous. However, frequent heartburn over a long period of time may indicate other problems, such as a peptic ulcer. Frequent, severe heartburn can cause erosion of the esophagus, resulting in bleeding, difficulty swallowing, and other problems.