Causes Of Heartburn And Acid Reflux
Lots of people get heartburn from time to time. There’s often no obvious reason why.
Sometimes it’s caused or made worse by:
- certain food and drink such as coffee, tomatoes, alcohol, chocolate and fatty or spicy foods
- being overweight
- some medicines, such as anti-inflammatory painkillers
- a hiatus hernia when part of your stomach moves up into your chest
What Can I Do To Prevent Indigestion
There are many things you can do to try to prevent indigestion.
Making changes in your diet and eating habits can help. These include:
- Eating several small, low-fat meals each day instead of 3 large meals
- Eating slowly and giving yourself enough time for meals
- Limiting spicy, fatty, greasy, or high-fiber foods
- Chewing your food well
- Limiting or not having any coffee, soda, or alcohol
Avoid medicines that hurt your stomach. These include aspirin and over-the-counter pain and fever medicines . If you do take them, do so after you eat.
Other lifestyle changes that may keep indigestion from happening include:
- Quitting smoking
- Finding ways to lower your emotional and physical stress, such as meditation or yoga
- Exercising before a meal or waiting at least 1 hour after eating
How Is Heartburn Diagnosed
Often all that a health-care professional requires is a thorough history and physical to make the preliminary diagnosis of heartburn. To evaluate if there is any damage and how severe your heartburn is, the doctor my suggest some of the following tests:
- Endoscopy: A flexible scope is passed down the esophagus to examine the esophagus as well as the stomach. Biopsies can be taken if indicated. This lets the doctor see if there is any obvious damage, and also eliminate other reasons for the patient’s symptoms .
- Upper GI series : After drinking a liquid that coats the inside of the digestive tract, X-rays are taken. These X-rays will show the outline of the digestive system.
- Ambulatory pH testing: This test measures the acidity in the esophagus via a small tube that goes through the nose into the stomach.
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What Are The Signs & Symptoms Of Gerd
Often, people who have GERD notice that they regularly have the pain of heartburn in the chest or stomach. This can last up to a couple of hours. Many notice their heartburn is worse after eating.
Regurgitation when food and liquid containing stomach acid comes back up into the throat or mouth is also a sign of GERD. But, like heartburn, occasional regurgitation is common for everyone.
Other symptoms of GERD include:
- a sore, raw throat or hoarse voice
- a frequent sour taste of acid, especially when lying down
- a feeling of burping acid into the mouth
- trouble swallowing
- bad breath
How Do Acid Blockers Work To Treat Heartburn
Products like Pepcid AC® are called histamine H2 blockers, or acid blockers. Acid blockers reduce the production of stomach acid. They relieve heartburn, acid indigestion and sour stomach. Always follow the directions on the packaging or talk to your healthcare provider about how to take this medication. Acid blockers you can buy without a prescription include:
- Pepcid AC®.
- Tagamet HB®.
Take your acid blocker medicine regularly for as long as directed by your healthcare provider, even if you do not have any pain or if your symptoms get better.
Stronger acid blockers are prescription medications. These can be used to block stomach acid, treat stomach and duodenal ulcers, erosive esophagitis, and GERD. They work by reducing the production of stomach acid. Your healthcare provider will give you a specific prescription for this type of acid blocker.
The United States Food and Drug Administration recently reported elevated levels of a possible carcinogen, NDMA, in the drugs ranitidine and nizatidine . You should speak to your healthcare provider if you are taking one these medications.
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Health Conditions That Can Cause Heartburn
When the valve that separates the stomach from the esophagusthe lower esophageal sphincter, or LESisnt closed tightly, it can lead to heartburn. “The LES has to relax to allow the meal to go down,” says Kenneth R. DeVault, MD, professor of gastroenterology and chair of the department of medicine at the Mayo Clinic, in Jacksonville, Fla. “But when those relaxations become too many or occur at the wrong time, that allows acid to reflux.”These 5 conditions can affect the LES, boosting your heartburn risk.
Tips To Keep Heartburn On The Backburner
To prevent occasional bouts of heartburn, try taking the following five steps:
1. Avoid eating within three hours of the time you go to bed.
2. Take any acid suppressant medication, such as a proton pump inhibitor, first thing in the morning. “Because of the way proton pump inhibitor-type medications activate, it’s not helpful to take these medications at night on an empty stomach,” says Brown.
3. Sleep on a slight incline, with your head elevated, and/or sleep on your left side. If you have chronic heartburn, falling asleep in the wrong position enables acid to sneak into the esophagus. Keeping your head raised slightly keeps that from happening. Studies have also found that while sleeping on the right side actually aggravates heartburn, flipping over to your left side is likely to calm it, although the reason why is unknown.
4. Avoid foods that may cause acid reflux, such as peppermint, coffee and chocolate. “Interestingly, spicy foods haven’t been shown to cause heartburn,” says Brown. “And there’s some evidence that spicy foods may actually protect the body from ulcers.”
5. If you smoke or use other tobacco products, quit. Not only does smoking relax the lower esophageal sphincter, allowing stomach acid to move up into the esophagus where it doesn’t belong, but it also can slow the production of saliva, which protects against acid in the esophagus.
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Are There Any Tests For Heartburn
If it is obvious from the symptoms that a person has heartburn, no tests or exams may be necessary. Advice in regard to lifestyle modifications, diet, or medications may begin immediately.
If your health care professional is not sure about the diagnosis, or if he or she is concerned about damage done by chronic heartburn, tests may be ordered. This is true especially if the patient has already been prescribed medications that are not relieving the heartburn.
There is no simple blood test for heartburn. The tests used to diagnose heartburn include the following:
Severity Of Constant Heartburn
As per research, Individuals who endure frequent episodes of acid heartburn are 78% more prone to get throat cancer. Specialists, who published their discoveries in the journal Cancer Epidemiology, Biomarkers and Prevention, have revealed that using stomach antacids has defensive results. People who have experienced the ill effects of indigestion yet take acid neutralizers have a 41% chances to bring down the danger of throat cancer than those who dont take the medicines.
Hence, people who have constantly suffered heartburn ought to counsel a doctor to discover what might be causing it.
|Written, Edited or Reviewed By:Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc.This article does not provide medical advice. See disclaimerLast Modified On: April 4, 2018|
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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.
When Heartburn Becomes Acid Reflux
There is a fairly simple way to know if heartburn is caused by gastroesophageal acid reflux disease, commonly known as acid reflux. As Andrew Gawron, MD, a gastroenterologist with University of Utah Health puts it, The definition of gastroesophageal acid reflux disease is when reflux of stomach contents into the esophagus cause troublesome symptoms or complications that impact the quality of life.
In other words, if heartburn is frequent enough that it causes problems that make your quality of life diminished, you may have acid reflux disease. This might mean that youre unable to sleep at night because of pain, or you might go so far as to find that acid is eating away at the lining of the throat or esophagus. In some cases, GERD can also predispose someone to a pre-cancerous condition in the esophagus called Barretts esophagus.
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What Exactly Is Heartburn Anyway
Heartburnor gastroesophageal reflux or acid refluxis a painful burning feeling in your chest or your throat, according to the US National Library of Medicine .
Basically, heartburn happens when your esophagus relaxes too much and stomach acid comes back up into your esophagus, according to the National Institute of Diabetes and Digestive and Kidney Diseases . It can be managed by making changes to your diet, like cutting back on coffee and alcohol, or through medications.
Having heartburn every once in a while, like after a spicy meal or taking a nap too soon after eating, is normal but if it occurs more than twice a week for more than a few weeks, its time to see a doctorin that case, you could have gastroesophageal reflux disease , a chronic, sometimes damaging form of heartburn.
But GERD isnt the only issue that is related to heartburn. Many other conditionssome even life-threateningcan mimic the feeling of heartburn. Here, nine other conditions that heartburn could be masquerading asand when to see your doctor about it.
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How Gastroenterologists Help With Gerd
The key to treating your GERD: a board-certified gastroenterologist
If you are suffering from chronic acid reflux, a specialist can help. GERD is a potentially serious condition, and it will not go away on its own. Untreated GERD can lead to inflammation of the esophagus and cause complications like ulcers, strictures and increased risk of Barretts esophagus, which is a precursor to esophageal cancer.
A gastroenterologist is a physician with specialized training in managing diseases of the gastrointestinal tract . Our gastroenterologists are fellowship-trained and qualified to diagnose GERD and help develop a meet your treatment plan.
To prepare for your appointment, see the topicMaking the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
Remember to take your heartburn symptom record to your doctor visit. Be sure to note any lifestyle changes you have made or nonprescription medicines you use.
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Things To Stop Doing If You Have Gerd
When you suffer from chronic heartburn that can be associated with gastroesophageal reflux disease , this condition can affect your entire life. It may be necessary to stop eating some of your favorite foods. The heartburn may interfere with your sleep. It may even interfere with your availability to work well.
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Symptoms Can Last Up To Several Hours After Onset
Heartburn involves a burning, painful sensation behind your breastbone in the center of your chest.
This pain often gets worse after you eat, in the evening, when you bend over, or when you lie down.
Episodes of heartburn can last between a few minutes and several hours.
In addition to burning sensations in your chest, heartburn may also involve:
- A burning sensation in your throat
- Fluid in your throat that tastes bitter, sour, or salty
- Difficulty swallowing
- A sense that food is stuck in your chest or lower throat
Heartburn often begins after youve eaten a large meal, but it can also be triggered by certain foods even if you dont eat very much.
How Long Does Heartburn Last
Heartburn can affect people differently. In general, heartburn symptoms begin shortly after eating and can last anywhere from a few minutes to a couple of hours, or even longer.
How long you experience symptoms depends on the underlying cause. It also depends on what you do at the first sign of symptoms. For example, sometimes heartburn symptoms last until your body digests the triggering food. Other times, it goes away if you stand up instead of lying down after eating.
If you take OTC antacids or prescription medications as part of a treatment plan, you may experience a shorter duration or fewer heartburn symptoms.
Your esophagus connects to your stomach at a juncture known as the lower esophageal sphincter. If the lower esophageal sphincter is functioning properly, it closes when food leaves the esophagus and enters the stomach.
In some people, the lower esophageal sphincter doesnt function properly or it becomes weakened. This leads to contents from the stomach leaking back into the esophagus. Stomach acids can irritate the esophagus and cause symptoms of heartburn. This condition is known as reflux.
Certain conditions and other factors may make it more likely for you to experience heartburn. Risk factors include:
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Control Your Acid Reflux
If you have frequent acid reflux, that means you have acid reflux disease . The vast majority of patients with acid reflux disease respond well to daily acid suppressing medications, such as proton pump inhibitors.
It’s important to note, however, that while these medications effectively manage symptoms, they are not a cure. The heartburn pain will go away, but the backsplash of damaging fluid still occurs.
That’s because proton pump inhibitors can’t fix the underlying mechanical problem the dysfunction of the valve between the esophagus and stomach. Long-term use of proton pump inhibitors can also cause significant side effects, and you must consider the lifetime cost of taking these medications.
For these reasons, surgery may be necessary to correct the valve mechanism, with the goal of eliminating the need for reflux medication. Advances in technology have improved doctors ability to tailor procedures to each individual patient, with greatly improved outcomes.
These techniques are performed through small or even no incisions, and serve to restore the valve mechanism between the esophagus and stomach to prevent acid reflux, explains Justin Karush, DO, a thoracic surgeon at Rush. Common procedures for GERD include laparoscopic Nissen fundoplication, transoral incisionless fundoplication and magnetic sphincter augmentation .
What Does Heartburn Feel Like
Heartburn feels like an uncomfortable or burning pain in the middle of your chest. You may also experience:
- a burning sensation in your throat
- pressure or pain behind your breastbone
- difficulty swallowing
- worsening pain after lying down or bending over
- an acidic, sour, or bitter taste in your mouth
- coughing or hoarseness
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Why Do I Get Heartburn When I Havent Eaten
If you visit a doctor to talk about your heartburn, one of the first things they will ask is your diet.
As most people know and what we constantly mention, heartburn is often caused by what you eat and what you drink, so your doctor wants to be sure you are eating a diet that wont provoke any additional symptoms before moving into treatment options.
If youre getting heartburn without eating anything, here are some of the reasons:
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Check If You Have Acid Reflux
The main symptoms of acid reflux are:
- heartburn a burning sensation in the middle of your chest
- an unpleasant sour taste in your mouth, caused by stomach acid
You may also have:
- a cough or hiccups that keep coming back
- a hoarse voice
Your symptoms will probably be worse after eating, when lying down and when bending over.
What Are My Options If These Treatments Don’t Work
If a person continues to have heartburn, a health care professional may recommend adding a drug such as metoclopramide . This drug empties food and acid quickly from the stomach so less can back up into the esophagus. Reglan also helps tighten the lower esophageal sphincter.
If a person still have symptoms, a health care professional will then recommend one of the drugs called proton pump inhibitors. Examples of these drugs are omeprazole , lansoprazole , esomeprazole , rabeprazole , and pantoprazole . These tablets prevent the stomach from secreting acid. They are very effective and are typically taken only once a day. These drugs usually are prescribed if other drugs have not helped. They may have to be used indefinitely.
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