We’ve all heard something similar to, “My chest is on Fire!”

Though really, this could mean a ton of different things. Heartburn is one of the options and it can literally feel like your chest is on fire. Of course, other options may be heart attack, angina, muscle pains, anxiety and much more.

Today I am going to look at Heartburn

Heartburn is also known as acid indigestion, acid reflux, and much more.

The pain arises in the chest, but can also occur in the stomach, throat and back.

It occurs when acid from the stomach becomes to much of a problem. This could happen in the stomach itself or when acid is regurgitated into the esophagus.

This condition is often seen during pregnancy.

GERD

This is another name for acid reflux.  This is when the cells of the esophagus are damaged because of the acid.  Often an area on the lower end of the esophagus holds the stomach opening closed until food comes into play.

If this area is damaged or impaired, the acid can become a problem.

Functional Heartburn

This occurs when the heartburn occurs without a known cause.   It can be from other medical disorders like irritable bowel syndrome, gastrointestinal disorders, as well as other causes.

Cardiac

Sometimes, heartburn can follow angina or a heart attack.  Ischemic heart disease may also precede heartburn.

In these cases, treatment of the underlying condition is vitally important.

Symptoms

1.)     Feeling of acid in throat, chest, or stomach
2.)     Regurgitation of food.
3.)     Difficulty sleeping
4.)     Symptoms worsen after spicy foods
5.)     Symptoms worsen after acidic foods
6.)     Symptoms worsen after other foods
7.)     Symptoms worsen after eating
8.)     Symptoms worsen when laying down
9.)     Nausea
10.)     Diarrhea
11.)    Chest pain  (In some cases – traditional heart burn is not felt. Instead, a chest discomfort or pain is seen.)
12.)    Chronic cough
13.)    Breathing difficulties
14.)    Change in voice
15.)    Need to clear throat
16.)    Burping or gas
17.)    Others

Diagnosis

Since the cause and symptoms are so overwhelming, symptoms are often treated with Tums, Pepto, or over the counter medications before an actual diagnosis can be seen.

Diagnosis is primarily done by signs and symptoms.  Pregnancy is another place where symptoms can be seen.

A normal X-ray is usually unhelpful.

Another specific X-ray can be done called an Upper GI series. It will find ulcers in some cases. A fasting is done.  A drink is given that will help enhance the X-ray.  Can also be called a barium swallow.

Endoscopy

This is another diagnostic approach.  It is done with a camera that enters the mouth and continues into the stomach. It can evaluate tissue, damage, ulcers, and much more. Biopsies can be taken to examine tissue, ulcers, or blockage.

The endoscopy is a scope that is highly used for chronic heartburn.

In some cases hiatal hernia can be seen.  In these cases, an out pocketing of the stomach results in a larger chance for heartburn.

Ulcers are often seen through endoscopy

pH monitoring –

A probe is placed through the nose that can record the acidity of the esophagus.  The stomach has a specific acid level.   When the acidity ph changes – a larger amount of heartburn can be seen.

Prevention

1.)     Lose weight
2.)     Sleep on left side of body
3.)     Sleep with upper body raised
4.)     Avoid spicy foods
5.)     Avoid acid foods
6.)     Exercise
7.)     Eat smaller meals

Treatment

Often treatment consists of starting with over-the-counter medications including TUMs or Antacids.  Fiber tabs may be beneficial in some cases

If symptoms don’t improve, prescription medications to treat acid production can be given. In some cases, these medications are becoming over-the-counter.  But continued heartburn should be discussed with a medical provider.

Surgery – when the cause is a hiatal hernia, which can increase the acid in the esophagus, surgery is a great choice. Not something that everyone with a hiatial hernia needs, but it should be considered.