Hart Burn

Hart Burn, commonly known as heartburn or acid indigestion, is a burning sensation in the chest, just behind the breastbone. The sensation is typically caused by stomach acid flowing back up into the esophagus (the tube that carries food from the mouth to the stomach).

Causes:

Heartburn occurs when the lower esophageal sphincter (LES), a muscular valve at the bottom of the esophagus, relaxes inappropriately or weakens, allowing stomach acid to reflux into the esophagus. Several factors can contribute to this:

• Dietary factors: Certain foods and beverages, such as spicy foods, fatty foods, chocolate, caffeine, alcohol, and carbonated drinks, can trigger heartburn.
• Lifestyle factors: Smoking, being overweight or obese, and lying down soon after eating can increase the risk of heartburn.
• Hiatal hernia: A condition in which the upper part of the stomach bulges through the diaphragm (the muscle separating the chest and abdomen).
• Pregnancy: Hormonal changes and increased pressure on the stomach during pregnancy can lead to heartburn.
• Medications: Certain medications, such as NSAIDs (nonsteroidal anti-inflammatory drugs) and some blood pressure medications, can contribute to heartburn.

Symptoms:

The primary symptom of heartburn is a burning pain in the chest, which may worsen after eating, lying down, or bending over. Other symptoms may include:

• A sour or bitter taste in the back of the throat.
• Regurgitation of food or stomach acid.
• Difficulty swallowing.
• Chronic cough.
• Hoarseness.
• Bloating.
• Nausea.

Diagnosis:

Heartburn is usually diagnosed based on a person's symptoms. If heartburn is frequent or severe, or if other symptoms are present, a doctor may recommend further tests, such as:

• Endoscopy: A procedure in which a thin, flexible tube with a camera is inserted into the esophagus to examine the lining.
• Esophageal pH monitoring: A test to measure the amount of acid in the esophagus.
• Esophageal manometry: A test to measure the pressure in the esophagus.

Treatment:

Treatment for heartburn typically involves lifestyle changes and medication.

• Lifestyle changes:

  • Avoid trigger foods and beverages.
  • Eat smaller, more frequent meals.
  • Avoid lying down for at least 2-3 hours after eating.
  • Elevate the head of the bed while sleeping.
  • Maintain a healthy weight.
  • Quit smoking.
  • Avoid tight-fitting clothing.

• Medications:

  • Antacids: Neutralize stomach acid.
  • H2 blockers: Reduce the amount of acid the stomach produces.
  • Proton pump inhibitors (PPIs): Block acid production more effectively than H2 blockers.
  • Prokinetics: Help the stomach empty faster. (Less commonly used due to side effects)

In severe cases, surgery may be an option to strengthen the LES or repair a hiatal hernia.

Complications:

Chronic heartburn can lead to complications such as:

• Esophagitis: Inflammation of the esophagus.
• Esophageal stricture: Narrowing of the esophagus.
• Barrett's esophagus: A precancerous condition in which the lining of the esophagus changes.
• Esophageal cancer: A rare but serious complication of Barrett's esophagus.

Prevention:

Heartburn can often be prevented by making lifestyle changes and avoiding trigger foods and beverages.