Causes Of Heartburn & Acid Reflux
When food or drink is ingested, it passes from the mouth, down the oesophagus into the stomach. A muscular ring which joins the oesophagus to the stomach should ensure that this flow is one way. Acid reflux occurs when this one-way system fails and whatever happens to be in your stomach travels in the wrong direction back up into the oesophagus. The stomach makes acid, which aids digestion by breaking down food and drink. Whilst the stomach can resist acid, if it refluxes in sufficient quantities into the oesophagus it will cause pain and sometimes the lining of the oesophagus can become inflamed ie oesophagitis. If the inflammation is severe, ulcers can form.
Lifestyle Factors: There are certain factors which appear to increase the risk of heartburn and reflux. These include:
- Stooping or bending forwards
- Weight gain
Pregnancy: Many women can develop heartburn during the later stages of pregnancy as the growing baby pushes upwards on the stomach. The symptoms will often go once the baby is born but can continue afterwards.
Hiatus Hernia: A hiatus hernia is when part of the stomach slides upwards into the chest by pushing itself through a hole in the diaphragm muscle . The hernia itself rarely causes any symptoms but it does seem to make reflux more likely. Between 15%-25% of people suffer from a hiatus hernia with it being more common in the male population. For those people who have a large hiatus hernia, surgery may be required.
Causes Of Acid Reflux In Women
Here is a list of some common and not so common causes of acid reflux that women may experience. Eating or Drinking Acidic based Fruits. Smoking Milk or Milk-Based Products Fried Foods Hot or Spicy Foods Stress Pregnancy Women may experience anything from mild to major heartburn during pregnancy. It can also be different with the same mom and separate pregnancies. In other words, you may have no signs of heartburn or acid reflux with your first pregnancy but then when your second comes along, you could suffer for the full 9 months.If this is the case, youll really want to watch what you eat. A plant-based, grilled chicken type diet is best to follow. I wrote another post showing a diet plan to follow if you suffer from acid reflux. You can find it here.
What Are Prescription Medications For Heartburn
If over-the-counter antacids and acid blockers do not relieve your heartburn, your healthcare provider may give you a prescription for other medicines, such as:
- Prescription-strength acid blockers: In prescription-strength , Zantac®, Tagamet®, Pepcid® and Axid® can generally relieve heartburn and treat GERD.
- Proton pump inhibitors: These are drugs that block acid production more effectively. Proton pump inhibitors include Aciphex®, Nexium®, Prevacid®, Prilosec® and Protonix®.
There are some proton pump inhibitors that can be purchased over-the-counter. Talk to your healthcare provider about these medications and what is best for you.
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Structural Physiology And Aetiology
Heartburn, indigestion and acid reflux all commonly occur in pregnancy, usually in the latter stage, although they may also accompany first trimester nausea and vomiting. Symptoms are largely due to the effects of progesterone, which relaxes the cardiac sphincter of the stomach, causing acid reflux. It is worse in women with multiple pregnancy and when the fetal presentation is breech, due to upwards pressure on the diaphrgam. Some mothers may experience a burning sensation at varying levels in the oesophagus, which will usually correspond to tender areas on the oesophagus reflex zones of the feet, relative to the level of heartburn. Mechanical distress also occurs at the junction of the oesophagus, cardiac sphincter and stomach due to changes within the abdominal/uterine cavities, the spinal kyphosis/lordosis and the inter-relationship between the shoulder and pelvic girdles. Heartburn is also often exacerbated by the weight of the breasts, particularly if the mother wears an ill-fitting brassiere, or if her general posture is poor with an accentuated thoracic kyphosis.
Suzanne Yates BA DipHSEC MRSS APNT PGCE, in, 2010
Other Symptoms Of Gord
GORD can also cause other problems such as:
- feeling or being sick
- laryngitis which causes throat pain and hoarseness
- bad breath
- bloating and belching
Some people may also find swallowing painful. This is caused by ulcers in the oesophagus and can happen with hot or cold solids or liquids.
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How Do Doctors Treat Ger And Gerd In Children And Teens
You can help control a child or teens gastroesophageal reflux or gastroesophageal reflux disease by having him or her
- not eat or drink items that may cause GER, such as greasy or spicy foods
- not overeat
- avoid smoking and secondhand smoke
- lose weight if he or she is overweight or obese
- avoid eating 2 to 3 hours before bedtime
- take over-the-counter medicines, such as Alka-Seltzer, Maalox, or Rolaids
Upper Gastro Intestinal Endoscopy And Biopsy
In an upper GI endoscopy, a gastroenterologist, surgeon, or other trained health care professional uses an endoscope to see inside a child or teens upper GI tract. This procedure takes place at a hospital or an outpatient center.
An intravenous needle will be placed in the child or teens arm to give him or her medicines that keep him or her relaxed and comfortable during the procedure. They may be given a liquid anesthetic to gargle or spray anesthetic on the back of his or her throat. The doctor carefully feeds the endoscope down the child or teens esophagus then into the stomach and duodenum. A small camera mounted on the endoscope sends a video image to a monitor, allowing close examination of the lining of the upper GI tract. The endoscope pumps air into the child or teens stomach and duodenum, making them easier to see.
The doctor may perform a biopsy with the endoscope by taking small pieces of tissue from the lining of the child or teens esophagus, stomach, or duodenum. He or she wont feel the biopsy. A pathologist examines the tissue in a lab.
In most cases, the procedure only diagnoses GERD if the child or teen has moderate to severe symptoms.
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What Does Heartburn Feel Like
Heartburn typically feels like a burning in the center of your chest, behind your breastbone. When you have heartburn, you may also feel symptoms like:
- A burning feeling in your chest that can last anywhere from a few minutes to a couple of hours.
- Pain in your chest when you bend over or lay down.
- A burning feeling in your throat.
- A hot, sour, acidic or salty taste in the back of your throat.
- Difficulty swallowing.
What Is Gastroesophageal Reflux
Gastroesophageal reflux , also called reflux, is when food and acid from the stomach go back up into the esophagus. This causes an uncomfortable feeling in the chest, often called heartburn.
With GER, reflux happens after nearly every meal and causes noticeable discomfort. After eating, people with GER feel a burning sensation in the chest, neck, and throat.
While it’s more common in adults, kids, teens, and even babies can have gastroesophageal reflux.
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How Do Doctors Diagnose Reflux And Gerd In Children
In most cases, a doctor diagnoses reflux by reviewing your child’s symptoms and medical history. If the symptoms do not get better with lifestyle changes and anti-reflux medicines, your child may need testing to check for GERD or other problems.
Several tests can help a doctor diagnose GERD. Sometimes doctors order more than one test to get a diagnosis. Commonly-used tests include
What Can You Do About Your Heartburn
A good rule of thumb is to seek medical attention if you have more than two episodes of heartburn a week especially if you notice difficulty swallowing, weight loss or anemia, Dr. Gabbard says.
Your doctor may help you lose weight or adjust your medications.
A change in blood pressure medicine may help reduce your heartburn symptoms, for instance. Or your doctor may suggest a proton pump inhibitor such as Prilosec OTC® or Nexium® to help control your GERD.
If your heartburn is worse at night, changing your sleeping position may help. Dr. Gabbard recommends using a body pillow or sleep-positioning device that helps keep you on your left side with your head elevated.
Finally, he has a warning for men over 50 who have chronic heartburn.
If at least two of these conditions apply you are Caucasian, have abdominal obesity, are a former or current smoker you may have a higher risk for Barretts esophagus, a precancerous condition that can lead to esophageal cancer.
Even if you are feeling fine, you should see your doctor. He or she may recommend a one-time scope examination to make sure there are no signs of the condition.
There is no pill to strengthen and restore your sphincter muscle to its younger days. But you can work with your doctor to reduce that burning sensation as you age.
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Foods That May Help Relieve Heartburn
While many foods can make your heartburn worse, there are several foods that may help relieve symptoms.
Here are some foods that may help relieve heartburn:
- Ginger: This is a natural remedy for nausea and vomiting. While there is limited evidence about gingers effects on heartburn, it may help reduce reflux (
- 41 ).
Summary While many foods can make your heartburn symptoms worse, there are plenty of foods that may ease heartburn symptoms. These include ginger, bananas and melons, veggies, oatmeal, grains and potatoes.
When Should I Call My Doctor About My Heartburn
Even though heartburn is common, it can sometimes lead to more serious health problems. Severe, chronic heartburn has been linked to inflammation and narrowing of the esophagus, respiratory problems, chronic cough, GERD, and Barretts esophagus, which may lead to esophageal cancer.
You should contact your doctor if:
- Your heartburn wont go away.
- Your heartburn symptoms become more severe or frequent.
- Its hard or hurts to swallow.
- Your heartburn causes you to vomit.
- You have had substantial, unexpected weight loss.
- You take over-the-counter antacids for more than two weeks and you still have heartburn symptoms.
- You have heartburn symptoms even after taking prescription medicines.
- You have serious hoarseness or wheezing.
- Your discomfort interferes with your lifestyle or daily activities.
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How Is Gerd Diagnosed
Tell your parents and visit your doctor if you’ve had heartburn that doesn’t seem to go away or any other symptoms of GERD for a while.
The doctor will do an exam and ask about your symptoms. If the doctor suspects GERD, you might go see a pediatric gastroenterologist. This is a doctor who treats kids and teens who have problems of the gastrointestinal system.
Doctors sometimes order these tests to diagnose GERD or rule out other possible problems:
When To Go To The Doctor
Usually, indigestion only happens once in a while, like after eating certain foods that don’t agree with you. But you’ll want to see the doctor if you get indigestion even when you’re eating healthy foods, exercising, and getting enough sleep.
You may need to be examined or have stomach X-rays or other tests to make sure your indigestion is not a sign of another problem in your digestive tract. Depending on what the doctor finds, you might need to make changes in your diet or take medicine.
Be sure to tell your parent or talk to a doctor if these things happen in addition to your indigestion:
- vomiting , especially if you see blood in your vomit
- weight loss
- frequent or intense stomach pain
- black or bloody bowel movements
These can be signs of other problems, so be sure to talk to a doctor if you experience one or several of these symptoms.
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If I Have Heartburn Should I See My Health Care Professional
That depends. If a person has heartburn more than three times a week for at least two weeks, he or she should see a health care professional. On the other hand, if a person only has occasional bouts of heartburn, he or she may find that taking nonprescription antacids and making some simple changes in lifestyle can resolve the heartburn. If these measures do not help, then a visit to a health care professional is warranted.
If a person has any of these symptoms, with or without heartburn, call a doctor or go to a hospital emergency department right away:
- Throwing up blood or passing blood in bowel movements
- Severe pain, dizziness, or lightheadedness
- Difficulty swallowing
With proper understanding of the condition and treatment, relief can be attained.
When I have chest pain, how can I tell whether it is my heart or just heartburn?
Sometimes a person can’t tell the difference. Just like chest pain from the heart, heartburn sometimes spreads from the chest to the jaw, shoulders, arms, or back. If a person has chest pain for any reason, seek medical care immediately.
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What Are The Complications Associated With Heartburn
Occasional heartburn isnt typically a cause for concern. However, if you get this symptom frequently, you may have a serious health problem that requires treatment.
If you dont get treatment for serious heartburn, you can develop additional health problems, such as an inflammation of the esophagus, which is called esophagitis, or Barretts esophagus. Barretts esophagus causes changes in the lining of the esophagus that can increase your risk of esophageal cancer.
Long-term heartburn can also affect your quality of life. See your doctor to determine a course of treatment if you find it difficult to carry on your daily life or are severely limited in your activities due to heartburn.
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What Treatments Are Available For Heartburn & Acid Reflux
Most treatments revolve around lifestyle changes as your symptoms are likely to lessen if you take measures to reduce the amount of reflux that you have. For example, stopping smoking and drinking less alcohol can all make a big difference to the discomfort you experience. Some foods are more likely than others to trigger reflux symptoms so you may find it helpful to look at how you eat as well as what you eat. Avoid late night, high fat meals so you dont go to bed with a full stomach. Propping up your head when you sleep may also alleviate symptoms. Eat little but more often if necessary. Try to avoid bending forward or wearing tight clothes as this can put extra pressure on your tummy.
There are also a variety of medicines you can buy at your local pharmacy to help lessen your reflux symptoms.
Antacids: alkaline liquids or tablets that reduce the amount of stomach acid. They work immediately and last for four hours. They are best taken after meals and before going to bed.
Acid-supressing medications: capsules or tablets which reduce the amount of acid produced by the cells in your stomach.
These are split into 2 groups:
- Histamine H2-receptor antagonists . These include Ranitidine, Cimetidine, Famotidine and Nizatidine. These can be taken prior to bedtime.
- Proton pump inhibitors . These include Omeprazole, Pantoprazoleand Esomeprazole. These are best taken 30 minutes prior to breakfast or evening meal.
What Makes Your Heartburn Worsen Over Time
There are four common reasons for increased heartburn.
Your muscles weaken as you grow older. And that includes one critical to fending off heartburn the lower esophageal sphincter.
Food passes down your throat and through your esophagus to your stomach. This sphincter controls the opening between the esophagus and the stomach. It typically remains tightly closed except when you swallow food. But as you age, it can weaken and stop functioning properly.
Many older adults carry extra weight that can weaken the sphincter further. And, for reasons that arent entirely clear, the risk and severity of GERD is higher for those who are overweight, Dr. Gabbard says.
As you age, your health problems increase and so does your need for medication.
Some blood pressure and antidepressant medications can cause heartburn. Also opiates, says Dr. Gabbard. Being overweight and taking certain medications may be the major driving factors for heartburn.
With age often comes a hiatal hernia, where the upper part of the stomach pushes up into the chest cavity.
Sixty percent of people over 60 have a hiatal hernia, Dr. Gabbard says. Most are small and do not cause problems, but the larger ones put you at risk for heartburn.
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How Is Heartburn Treated
In most cases, heartburn can be treated at home with over-the-counter medications and changes to lifestyle habits that cause the feeling. Occasional heartburn is common and is typically not serious. However, if you have frequent and severe heartburn, reach out to your healthcare provider. This could be a sign of a chronic condition like GERD. GERD can lead to other serious conditions like esophagitis, Barretts esophagus and even cancer. Sometimes, your doctor may want to do an endoscopy to check for underlying medication conditions. An endoscopy is the examination of your digestive tract with a lighted flexible instrument.
Over-the-counter medications for heartburn typically include antacids and acid blockers.
Heartburn In Young Adults
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