What Causes Heartburns
Heartburn is a burning discomfort that is felt at the back of the the chest, and it may move up and down the chest like a wave. It can be accompanied by the feeling of a warm fluid climbing the throat. Additional sites where it can be felt include: sides of the chest, neck and angles of the jaw. It is usually associated with regurgitation due to irritation of the oesophagus by reflux of acid from the stomach. Heartburn is also known as pyrosis or acid regurgitation. It is a common occurrence which may even be as a result of an underlying disease.
How does it Occur?
There is a muscular valve that serves as a junction between the oesophagus and the stomach; this valve is known as the lower oesophageal sphincter. The lower oesophageal sphincter functions as a barrier that prevents leakage of acid and contents of the stomach into the oesophagus. This sphincter is normally closed except when swallowing or belching. However, if the integrity of lower oesophageal sphincter is compromised by opening often or not closing tight enough, there is a backflow of acid into the oesophagus that is responsible for the burning sensation felt during heartburn. Heartburn becomes a problem when it occurs frequently. And, it may be a symptom of an underlying disease.
What Causes Heartburn?
The causes of heartburn differs amongst individuals. Common causes are:
· Too much food: This increases the content of the stomach and open the lower oesophageal sphincter.
· Pressure on the stomach (pregnancy, constipation, obesity).
· Some diets are also implicated in relaxing the lower oesophageal sphincter e.g. fatty meals, citric fruits, coffee, garlic, raw onion, tomatoes, chocolate, peppermint, caffeinated products, and alcohol.
· Smoking: This relaxes the lower oesophageal sphincter and causes increased acid secretion.
· Exercise after meal: This is because food is still in the process of digestion and there is increase in the production of acid which may leak into the oesophagus during bending when exercising.
· Sleeping after meals: Lying down to sleep after meals will cause stomach acid to seep into the oesophagus.
· Drugs like non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen;, steroids like prednisone; and antibiotics also cause heartburn.
· Stress and lack of food increase acid production and can therefore also cause heartburn.
Which Factors Aggravate and Relief Heartburn?
Aggravating factors: Bending forward, straining and lying down.
Relieving factors: Upright position, swallowing of saliva and water.
Which Diseases are Associated with Heartburn?
Gastrosophageal reflux disease, dyspepsia, peptic ulcer disease, Barrett’s oesophagus, indigestion, ischemic heart disease (rare).
What is the Treatment for Heartburn?
All the causes of heartburn can trigger its occurrence, so the best treatment is to avoid the aforementioned triggers that are peculiar to individual. Occasionally, antacids, histamine 2 antagonist and proton pump inhibitors are prescribed. Surgery is required in rare cases. The underlying disease should be treated in the case of heartburn presenting as a symptom.
College of Health Sciences
University of Ilorin