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HeartburnHeartburn Overview Heartburn is an uncomfortable but common feeling of burning or warmth in the chest. Although the pain of heartburn is felt in the chest, heartburn has nothing to do with your heart. Instead, heartburn is caused by stomach acid. Continual bouts of heartburn can be a symptom of a more serious condition called gastroesophageal reflux disease or GERD. Frequent or severe heartburn may limit daily activities and lead to further complications such as ulcers in the oesophagus. With proper understanding of heartburn and treatment, relief can be obtained from this condition. About 30% of adults experience occasional heartburn, while 10% experience heartburn every day. About 25% of pregnant women have heartburn or related symptoms. Heartburn Causes The food that is swallowed travels from the mouth to the stomach through a hollow tube called the oesophagus (or food pipe). Before entering the stomach, food must pass through a tight muscle at the lower part of the oesophagus called the lower oesophageal sphincter (LES). The lower oesophageal sphincter prevents food from travelling backward into the oesophagus. Once in the stomach, stomach acid digests the food. This acid is very strong and can damage most parts of the body. Fortunately, the stomach is protected from its own acid by a special mucous layer. The oesophagus, however, does not have any such special protection. If the lower oesophageal sphincter does not close completely, the lower part of the oesophagus can be damaged by stomach acid. When this happens, heartburn may be experienced.The lower oesophageal sphincter may not close completely thus allowing stomach acid into the oesophagus for these reasons: Certain foods and drinks are known to loosen the lower oesophageal sphincter. These include chocolate, peppermint, caffeine-containing beverages (such as coffee, tea, and soft drinks), fatty foods, and alcohol.Heartburn often depends on the body's position. It is easier for stomach acid to flow back into the oesophagus if you are lying down or bending over. Anything that increases the pressure on the stomach and forces stomach acid backward into the oesophagus can also cause heartburn. This is why lifting, straining, coughing, tight clothing, obesity, and pregnancy can worsen heartburn. People who suffer from certain medical conditions may have an increased chance of heartburn. These conditions include hiatus hernia, diabetes, and many autoimmune diseases (CREST syndrome, Raynaud phenomenon, and scleroderma). Many prescription medications can loosen the lower oesophageal sphincter, including certain blood pressure and heart medications, and the asthma drug theophylline. Many substances directly irritate the lining of the oesophagus and can contribute to heartburn. These include spicy foods, citrus fruits and juices, tomatoes and tomato sauces, cigarette smoke, aspirin, ibuprofen (with brand names such as Motrin and Advil), and medicines for osteoporosis. Heartburn Symptoms The pain of heartburn is described as a burning feeling in the chest. Often, the sensation may spread up into the throat, jaw, arms, or back. That's why heartburn is often mistaken for chest pain due to a heart attack. However, do not second guess yourself. If you are having chest pain for any reason, seek medical attention immediately, if only to rule out a heart attack. Heartburn (often called acid indigestion) typically occurs 30-60 minutes after meals. The pain is worse when lying down, bending forward, and straining to pass stools. The pain is relieved by standing upright, swallowing saliva or water, or by taking antacids. If small amounts of stomach acid or food travel beyond the oesophagus and up into the mouth, you may experience bitter or sour taste. This is known as regurgitation. It is common after meals, especially if you are lying down, bending over, or straining. Stomach acid can also affect the respiratory tract, causing asthma, hoarseness, chronic cough, sore throat, or tooth damage (acid eats the enamel on teeth). You may feel as if you have a lump in your throat. If the acid exposure continues for long periods of time, the oesophagus becomes damaged. You may then have difficulty swallowing. In more serious cases, you may lose weight and become dehydrated. Very rarely, the oesophagus may bleed or tear completely because it is so damaged. In severe cases, you may vomit blood or have small amounts of blood in your bowel movements. However, all these are uncommon. When to Seek Medical Care Call your health care provider if your heartburn continues to bother you despite lifestyle modifications and use of antacids or low doses of acid blockers. Call if you have heartburn more than 3 times a week for over 2 weeks. Your provider will prescribe medications or make other recommendations to help your pain. Seek emergency medical care. Chronic heartburn can sometimes lead to serious complications that require immediate medical attention. Go to a hospital's emergency department if you have any of the following symptoms: Throwing up blood or passing blood in your stools Severe pain, dizziness, or light-headedness Difficulty swallowing Dehydration Unintentional weight loss NOTE: The pain of heartburn can often be confused with pain that is actually due to more serious heart problems, such as a heart attack. If you or a family member has a history of heart disease, you need to be particularly aware of this possibility. If your pain is accompanied by sweating, nausea, vomiting, difficulty breathing, or is worse with activity, you may need to have your heart evaluated immediately. Heartburn Treatment Antacids, acid blockers, and perhaps surgery may provide relief from heartburn and prevent it from turning into more serious disease. Self-Care at Home For mild or occasional symptoms, simple lifestyle modifications can be helpful. Avoid large meals. Avoid caffeine (coffee, teas, and some soft drinks). Avoid foods or drinks that reduce pressure on the lower oesophageal sphincter such as chocolate, peppermint, caffeine-containing beverages, and fatty or fried foods. Avoid foods that damage the oesophagus such as spicy foods, citrus fruits and juices, tomatoes and tomato sauces. After eating, beware of activities that force acid back into your oesophagus. Such activities include lifting, straining, coughing, and wearing tight clothing. Use gravity to your advantage. Avoid lying down within 3 hours of meals. If you suffer from night-time heartburn, elevate the head of your bed when sleeping. Place 6-inch blocks underneath the head of the bed, or place a wedge under the mattress. Simply using more pillows under your head will not help. In fact, it may worsen the heartburn by increasing the pressure on your stomach. Lose weight if you are overweight. Stop smoking. Limit alcohol intake. Antacids such as Maalox, Mylanta, Tums, or Rolaids can also be helpful. Antacids work by neutralizing acid. They should be taken 1 hour after meals or when heartburn symptoms occur. Low doses of drugs that block the production of stomach acid are available over-the-counter. Some examples include cimetidine (Tagamet), ranitidine (Zantac), and famotidine (Pepcid). Essential oils of Basil, Bergamot, Black Pepper, Carrot Seed, Chamomile Roman, Chamomile German, Coriander Seed, Dill, Fennel, Ginger, Juniper, Lavender, Lemon, Marjoram, Peppermint, Rose, Rosemary, Sage and Spearmint can help. A gentle massage over the stomach with a soothing and comforting essential oil such as Chamomile Roman, Lavender or Marjoram is recommended. Alternatively make a hot compress using these essential oils can be put over the stomach. Drinking Chamomile, Fennel and peppermint herbal infusions can sometimes bring relief Make a hot compress of
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