Heartburn
Despite its name, heartburn has nothing to do with your heart itself. Heartburn is pain or a burning sensation around your heart, that is related to your digestive system and a condition called reflux. These symptoms usually appear after eating and get worse when bending over or lying down. It’s estimated that around 20% of the population experience regular heartburn or reflux.
What causes heartburn?
The tube that connects your mouth to your stomach is called the oesophagus. Around the lower part of this tube is a band of muscle called the oesophageal sphincter. Normally when you swallow, the oesophageal sphincter relaxes to let food and liquid in and then closes again. If the oesophageal sphincter is weak, or relaxes abnormally, stomach acid can flow back up into your oesophagus – sometimes referred to as reflux or gastro-oesophageal reflux disease (GERD). This acid is what causes the burning sensation of heartburn.
Heartburn can also be a symptom of a hiatal hernia, a condition where part of the stomach pushes through the diaphragm (the thin muscle that sits at the bottom of the chest that separates the chest from the abdomen.
Pregnancy is another factor that can contribute to heartburn, as increased levels of the hormone progesterone may cause the oesophageal sphincter to relax, leading to stomach contents being released back into the oesophagus.
Heartburn Symptoms
The tube that connects your mouth to your stomach is called the oesophagus. Around the lower part of this tube is a band of muscle called the oesophageal sphincter. Normally when you swallow, the oesophageal sphincter relaxes to let food and liquid in and then closes again. If the oesophageal sphincter is weak, or relaxes abnormally, stomach acid can flow back up into your oesophagus – sometimes referred to as reflux or gastro-oesophageal reflux disease (GERD). This acid is what causes the burning sensation of heartburn.
Heartburn can also be a symptom of a hiatal hernia, a condition where part of the stomach pushes through the diaphragm (the thin muscle that sits at the bottom of the chest that separates the chest from the abdomen).
Pregnancy is another factor that can contribute to heartburn, as increased levels of the hormone progesterone may cause the oesophageal sphincter to relax, leading to stomach contents being released back into the oesophagus.
Heartburn risk factors
The risk of experiencing heartburn is increased if you:
are older – studies show that 25% of people over 75 years of age take medication for heartburn
smoke
are overweight
are pregnant
have a family history of acid reflux or GERD
exercise too soon after eating
eat a large meal
take medications and dietary supplements that irritate the lining of your oesophagus or increase acid reflux. These may include antibiotics, iron supplements, painkillers, narcotic, antidepressants and sedatives.
There are also some foods9known to trigger heartburn, including:
spicy foods
fatty or fried foods
onions
citrus
tomatoes or tomato-based products
peppermint
chocolate
alcohol
caffeine
carbonated drinks
Can you prevent heartburn?
For many people heartburn can be relieved or even cured by making some lifestyle changes. These include:
quitting smoking
achieving and maintaining a healthy weight
avoiding lying down after meals
eating smaller sized meals, and
avoiding foods that may trigger heartburn.
In some cases, prescription medication or surgery may be necessary to cure heartburn.
Treatment for heartburn
You may also wish to use over-the-counter (OTC) medications to relieve your heartburn symptoms. These include:
Antacids/alignates
Antacids provide quick relief by neutralising stomach acid. Alignates react with the acid in the stomach to produce a protective barrier to prevent stomach contents from going back up into the oesophagus. However, they can interfere with the absorption of other medications, so check with your doctor or pharmacist before taking them.
H2-antagonists/H2 blockers
These medications work by reducing the amount of acid produced by the stomach. While they don’t work as quickly as antacids, they do provide longer-lasting relief.
Proton pump inhibitors (PPIs)
This group of medications suppress acid production in the stomach.
When using OTC medications for heartburn, it’s wise to speak to your pharmacist about the most suitable option or combination of medications for your condition, and how frequently you should use them.
Prescription medications may be required if OTC medications don’t provide relief from your heartburn symptoms.
Occasionally surgery may be required to ‘tighten’ the oesophageal sphincter to prevent heartburn. However, this option is usually reserved for people who don’t respond to medication.
When to visit your doctor
If you experience heartburn twice or more per week, if your symptoms are severe, or symptoms aren’t relieved with OTC treatment, you should visit your doctor.
Heartburn may also occur in conjunction with other medical conditions such as ulcers or gastro-oesophageal reflux disease (GERD). If you experience heartburn with any of the following symptoms, you should see your doctor immediately:
difficulty or pain when swallowing
dark or bloody stools
While heartburn isn’t associated with heart attack, some symptoms can be similar. If you experience any of the following symptoms, call 000 as it may be a medical emergency:
pressure, tightness, pain or a squeezing sensation in your chest
pain that spreads to the shoulder, neck or arms
irregular heart beat
sweaty or clammy skin
suddenly feeling lightheaded, dizzy or weak
nausea, indigestion, vomiting or abdominal pain
shortness of breath
There are numerous factors that can contribute to your heartburn, including medication. At MediADVICE, we can help you manage your health with a Medication Review, where one of our pharmacists will review your medication and discuss which ones may be contributing to your heartburn and how we can best help you manage it. We can also provide advice as to which OTC medications and pharmacy products may be appropriate to help relieve symptoms.
Book a Medication Review at your nearest MediADVICE today.
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Sources
1NPS Medicinewise, Managing reflux and hearburn,https://www.nps.org.au/consumers/managing-reflux-and-heartburn
2Mayo Clinic, Heartburn or heart attack: When to worry,https://www.mayoclinic.org/diseases-conditions/heartburn/in-depth/heartburn-gerd/art-20046483
3Mayo Clinic, Heartburn,https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223
4Healthline, What You Need to Know About Heartburn,https://www.healthline.com/health/heartburn
5Cleveland Clinic, Heartburn During Pregnancy,https://my.clevelandclinic.org/health/diseases/12011-heartburn-during-pregnancy
6Cleveland Clinic, Why Does Heartburn Get Worse as You Age? https://health.clevelandclinic.org/why-does-heartburn-get-worse-as-you-age/
7Healthline, Is Acid Reflux Genetic,https://www.healthline.com/health/gerd/genetics
8Mayo Clinic, GERD: Can certain medications make it worse?,https://www.mayoclinic.org/diseases-conditions/gerd/expert-answers/heartburn-gerd/faq-20058535
9Mayo Clinic, Heartburn,https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223
10MedicineNet, How to Get Rid of Heartburn,https://www.medicinenet.com/heartburn_reflux/article.htm
11Mayo Clinic, Heartburn or heart attack: When to worry,https://www.mayoclinic.org/diseases-conditions/heartburn/in-depth/heartburn-gerd/art-20046483
Disclaimer
General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.