What Is Heartburn
Regardless of its name, heartburn has nothing to do with the heart, completely. (Some of the symptoms, however, are similar to those of a heart attack or heart disease.) but it has something to do with the digestive system. It is an irritation of the esophagus that is caused by stomach acid.
With gravity's help, a muscular valve called the lower esophageal sphincter, or LES, keeps stomach acid in the stomach. The LES is located where the esophagus meets the stomach -- below the rib cage and slightly left of center. Normally it opens to allow food into the stomach or to permit belching; then it closes again. But if the LES opens too often or does not close tight enough, stomach acid can reflux, or seep, into the esophagus and cause a burning sensation.
Intermittent heartburn isn't dangerous, but chronic heartburn can indicate serious problems and can develop into gastroesophageal reflux disease (GERD). Heartburn is a daily occurrence for about 10% of Americans and up to 50% of pregnant women. It's an occasional nuisance for 30% of the population.
What Causes It?
The basic cause of heartburn is an underactive lower esophageal sphincter, or LES, that doesn't tighten as it should. This could be the results from two things: too much food in the stomach (overeating) or too much pressure on the stomach (frequently from obesity or pregnancy). Certain foods commonly relax the LES, including citrus foods, tomatoes, onions, garlic, chocolate, coffee, alcohol, caffeinated products, and peppermint. Dishes that are high in fats and oils (animal or vegetable) often lead to heartburn, as do certain medications. Stress increases acid production and can cause heartburn. And smoking, which relaxes the LES and stimulates stomach acid, is a major contributor.
What Are the Treatments?
Taking over the counter antacids such as Pepcid AC, Tagamet HR, Axid AR, or Zantac 75 are what most doctors recommend for occasional heartburn. Sometimes, stronger or long-term antacid prescription medications may be needed. Occasionally, surgery is recommended to prevent reflux and heartburn. The primary objective is to identify the cause of the heartburn so it can be avoided in the future.
If heartburn symptoms persist, your doctor can turn to drugs such as Prevacid, Prilosec, Zegerid,Nexium, Protonix, or Aciphex to reduce the stomach's production of acid, or Reglan to make the stomach empty itself faster.
When all else fails, surgery may be required to repair the lower esophageal sphincter. This surgery can now be done using a laparoscope and requires only a short hospital stay.