From a tiny twinge to a blowtorch--like sensation behind the breastbone, heartburn is all its intensities affects about 20 percent of the population everyday. Nearly complete relief is possible with a combination of lifestyle changes and the right medications.
The lower oesophageal sphincter at the top of the stomach is normally closed, opening only to permit food to enter. Heartburn or GORD occurs when the sphincter spontaneously relaxes, allowing digestive acids, food and liquids to flow backwards (reflux) into the sensitive oesophageal tissues.
Treatment Options
What is happening
Despite its name, heartburn has nothing to do with your heart: It's the result of a mechanical problem in your digestive tract called gastro-oesophageal reflux, which occurs when stomach acid splashes back and upwards into your oesophagus, the tube connecting the back of your throat to your stomach. Heartburn happens because a valve between your oesophagus and stomach--the lower oesophageal sphincter---normally clamped tight during digestion, has weakened (see below). When simple heartburn is a frequent event, and acid damages the lining of the oesphagus, the condition is called gastro-oesphageal reflux disease, or GORD.
While your stomach is built to handle powerful digestive juices, your oesophagus is not. Hence, the burning sensation in the centre of your chest during heartburn is truly just that--an acid burn. You might also experience episodes of a hot acidy taste, feel a lump in your throat or even have an asthma-like chronic cough, which can occur when acid splashes down your breathing tube. Over time, stomach acid can even wear down your tooth enamel. And the constant erosion of the internal lining of your oesophagus can lead to a more serious disorder called Barrett's oesophagus (see on shortly) .
LIKELY FIRST STEPSWhile your stomach is built to handle powerful digestive juices, your oesophagus is not. Hence, the burning sensation in the centre of your chest during heartburn is truly just that--an acid burn. You might also experience episodes of a hot acidy taste, feel a lump in your throat or even have an asthma-like chronic cough, which can occur when acid splashes down your breathing tube. Over time, stomach acid can even wear down your tooth enamel. And the constant erosion of the internal lining of your oesophagus can lead to a more serious disorder called Barrett's oesophagus (see on shortly) .
- Medications to soothe the pain and discomfort of heartburn.
- Lifestyle changes to address the root of the problem.
- If all else fails, surgery and other procedures problems that lead to heartburn.
QUESTIONS TO ASK
- Does chronic heartburn increase my risk for cancer?
- Is it possible that my heart-burn is caused by H. plyori, the type of bacteria that can cause ulcers?
- Could my asthma be related to my heartburn?
- Might any of the medications or nutritional supplements I'm taking be causing my heartburn symptoms?
- Should I have an endoscopy?
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| THE MECHANICS OF HEARTBURN AND GORD |
The lower oesophageal sphincter at the top of the stomach is normally closed, opening only to permit food to enter. Heartburn or GORD occurs when the sphincter spontaneously relaxes, allowing digestive acids, food and liquids to flow backwards (reflux) into the sensitive oesophageal tissues.
Treatment Options
MEDICATIONS
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Antacide For occasional heartburn relief.
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H2 blockers Reduce stomach acid production
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Proton pump inhibitors Improve GORD symptoms in 80% of sufferers
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Prokinetic agents Special food through the stomach.
LIFESTYLE CHANGES
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Diet Eat small meals; avoid heartburn triggers.
NATURAL METHODS
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Deglycyrrhisinated liquorice Reduces stomach acid.
PROCEDURES
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Endoscopic procedures Stretch oesophagus and/or tighten lower oesophageal sphincter.
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Fundoplication Surgery to strengthen faulty lower oesophageal sphincter valve.
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Antacide For occasional heartburn relief.
------------------------------------------------------------------------------------------------------------------------------------------
H2 blockers Reduce stomach acid production
-------------------------------------------------------------------------------------------------------------------------------------------
Proton pump inhibitors Improve GORD symptoms in 80% of sufferers
-------------------------------------------------------------------------------------------------------------------------------------------
Prokinetic agents Special food through the stomach.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Diet Eat small meals; avoid heartburn triggers.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Deglycyrrhisinated liquorice Reduces stomach acid.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Endoscopic procedures Stretch oesophagus and/or tighten lower oesophageal sphincter.
---------------------------------------------------------------------------------------------------------------------------------------------
Fundoplication Surgery to strengthen faulty lower oesophageal sphincter valve.
TAKING CONTROL
Drink a large glass of warm water. This will wash the misplaced acid back down and ease your pain. If water isn't handy, chew a stick or two of gum to produce more saliva.
Get rid of the extra pillows. While it's good to have your whole upper body raised when lying down, elevating just your head leads to worse heartburn symptoms.
Avoid stooping or bending. This bumps up the pressure in your gut, making heart-burn worse. Crouch if you need to pick up something.
Keep a heartburn diary. Record the time of each episode and what seemed to contribute to it. This will make it easier to determine which lifestyle changes and treatments will work for you.
You're more likely to have chronic heartburn if you're very over-weight. If you smoke, if you take medications that make your lower oesophageal sphincter relax or if you have certain medical conditons (see Hiatus hernia, on shortly). At least 25 percent of pregnant women experience heartburn because increased hormone levels affect the lower oesophageal sphincter, causing it to stretch open more than usual.
Drink a large glass of warm water. This will wash the misplaced acid back down and ease your pain. If water isn't handy, chew a stick or two of gum to produce more saliva.
Get rid of the extra pillows. While it's good to have your whole upper body raised when lying down, elevating just your head leads to worse heartburn symptoms.
Avoid stooping or bending. This bumps up the pressure in your gut, making heart-burn worse. Crouch if you need to pick up something.
Keep a heartburn diary. Record the time of each episode and what seemed to contribute to it. This will make it easier to determine which lifestyle changes and treatments will work for you.
You're more likely to have chronic heartburn if you're very over-weight. If you smoke, if you take medications that make your lower oesophageal sphincter relax or if you have certain medical conditons (see Hiatus hernia, on shortly). At least 25 percent of pregnant women experience heartburn because increased hormone levels affect the lower oesophageal sphincter, causing it to stretch open more than usual.
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