Heart burn is a burning pain in your chest which is caused by the traveling up of stomach acid (acid reflux) towards the throat.

The pain often starts from the upper abdomen just beneath the lower breastbone (sternum) and spread toward the throat.

When this heart burn occurs frequently it could be a gastro-esophageal reflux disease (GERD).

It often gets worse after eating, lying down or bending over. It gets better when you stand up or sit.

Adult people experience heart burn more than children. 

Many pregnant women experiences heart burn almost every day because growing fetus puts pressure on the stomach causing the outflow of stomach acid toward the esophagus

Symptoms of Heart Burn

Symptoms of heart burn include:

• Burning pain in the chest which usually begins when a person has eaten or bends down.
• A bitter or acidic taste in the mouth
• Burning pain at the back of the throat
• Cough or sore throat which  can be stay for long
• Difficulty in swallowing

Causes of Heart Burn

Heart burn usually occurs when contents from the stomach flows into the esophagus. The esophagus is what connects the mouth to the stomach. When you eat food goes to the stomach through the esophagus

The connection of the esophagus to the stomach happens at a juncture called the lower esophageal sphincter. In normal condition when food has left the esophagus into the stomach the lower esophageal sphincter (LES) should close so as not to allow food from the stomach to enter the esophagus. But in a situation where the LES is not functioning properly and does not close the esophagus as food leaves it, contents from the stomach can find its way back into the esophagus.

The cause of the malfunctioning of LES is unknown but some factors may contribute to the condition. These factors include:

• Smoking
• Being overweight
• Pregnancy
• Taking alcohol
• Taking caffeine
• Eating foods such as garlic fried foods, and spicy foods.
• Stress and anxiety
• When there is an increase in some types of hormones such as progesterone and oestrogen in women.
• A hiatus hernia. This is a condition which occurs when part of your stomach moves up into the chest. This will weaken the LES so that acid from the stomach can easily flow into the esophagus
• Medicines like pain killers, anti- depressants, beta-blocker used for treating high blood pressure, Theophylline for treating asthmatic condition.

Mild, moderate and severe Heart Burn

Heart burn may be severe, mild or moderate. It is severe if it occurs every day and can cause problems such bleeding, difficulty swallowing and in some cases weight loss. It is mild if it occurs once a month and moderate if it occurs once a week.

When the heart burn symptoms are persistent it could be a sign of stomach or esophagus cancer. It can also be a sign of severe inflammation of the esophagus. If the heart burn has symptoms like tightness in your throat, wheezing, asthma, dental problems, hoarseness of voice the person may be suffering from gastroesophageal reflux disease (GERD).

Diagnosis of Heart Burn

If your doctor is suspecting that your symptoms is a sign of gastroesophageal reflux disease (GERD) he may recommend:

• Endoscopy: This is an instrument that can be used to view the esophagus and the stomach. It has a tiny camera that when inserted into the esophagus or the stomach can help the doctor see any irregularities in them.
• X-ray: X.ray can be used to see the condition of the esophagus and the stomach to detect any abnormality.
• Ambulatory acids probe tests: These are tests that can used to know how long low stomach acid stays in the esophagus.  An acid monitor can be inserted into the esophagus and then connected to a small computer that can be worn around the waist or shoulder.

Treatment of Heart Burn

Medications that can be used to treat heart burn include:

• Proton pump inhibitors (PPIs): These are drugs that can reduce the production of stomach acid by the glands in the lining of the stomach. This will prevent these stomach acids from backing up into the oesophagus. Examples of PPIs include lasoprazole (Prevacid), omeprazole (Prilosec), esomeprazole (Nexium, pantoprazole (Protonix), rabeprazole (AcidHex).
• Antacids: Antacids are drugs which can be used to neutralize stomach acids. Common types of antacids include aluminum hydroxide, magnesium carbonate, magnesium hydroxide, calcium carbonate, sodium bicarbonate. Gaviscon (alginic acid) and Pepto- bismol (bismuth subsalicylate) are some brands names of antacids.
• H2 blockers: These drugs perform similar function like the PPIs. They work by reducing the amount of stomach acids produced by glands in the stomach linings. Examples of H2 blockers include cimetidine (Tagamet), nizatidine (Axid), fomatidine (Pepsid), and ranitidine (Zantac).

How to prevent a Heart Burn

There are lifestyle changes which can help to prevent a heart burn. These lifestyle changes include:

• Stop smoking and taking alcohol
• Do not lie down  immediately after taking a meal
• Identify the foods that trigger the heart burn and avoid them.
• Avoid eating meals late
• Do not wear tight fitting clothes which can put pressure on your abdomen and the LES.
• If the heart burn usually comes in the night or whenever you want to sleep elevate the head of your bed or put something under the mattress to elevate your body from the waist up.