There are several factors that influence the occurrence and severity of gastroesophageal reflux and heartburn:
People experience gastroesophageal reflux and heartburn in a variety of ways. Heartburn usually begins as a burning pain that starts behind the breastbone and radiates upward to the neck. Often there is a sensation of food coming back into the mouth, accompanied by an acid or bitter taste. Heartburn is sometimes called acid indigestion and usually occurs after meals.
What are the Symptoms of Heartburn?
What if Symptoms Persist?
People with severe esophageal reflux or with heartburn symptoms unresponsive to the measures described above may need more complete diagnostic evaluation. A variety of tests and procedures are currently used to further evaluate the patient with heartburn:
How Common is Heartburn?
Although heartburn is common in our society, it is rarely life-threatening. However, heartburn can severely limit daily activities and productivity. With proper understanding of the causes of heartburn and a consistent approach to a treatment program, most people will find relief.
Is Heartburn Caused by Hiatal Hernia?
Heartburn is not caused by hiatal hernia, which is the pushing up of the stomach into the chest cavity through a hole in the diaphragm.
However, hiatal hernias do predispose individuals to heartburn. The majority of people over 60 years of age have hiatal hernias and most do not have any symptoms related to the condition.
Can Heartburn Require Surgery?
A small number of people with heartburn may need surgery because of severe reflux disease and poor response to medical treatment plans. Fundoplication is a surgical procedure that reduces reflux. Patients not wanting to take medication to control their symptoms are also candidates for surgery.
What are the Complications of Long-Term Reflux and Heartburn?
The reflux that causes heartburn can result in serious complications. Esophagitis, an irritation of inflammation of the esophagus, can occur as a result of the constant presence of stomach acid in the esophagus. Esophagitis may result in esophageal bleeding or ulcers. In addition, a narrowing or closure (stricture) of the esophagus may occur.
Some people develop a condition known as Barrett’s esophagus, a change in the cells lining the esophagus that predisposes the esophagus to the development of cancer. Individuals with Barrett’s esophagus should be monitored with periodic surveillance endoscopies and biopsies.
Tips to Control Heartburn
Avoid food, beverages, and medicines that affect the lower esophageal sphincter muscle action or irritate the lining of the esophagus such as:
Any chest pain requires prompt medical evaluation. Other causes, such as heart disease, must be considered.
For occasional heartburn, over-the-counter medicines taken as directed can be helpful in reducing symptoms. If prolonged or frequent use of nonprescription medicines (more than directed on the product) becomes necessary, or if they do not completely control symptoms, a physician should be consulted.