What Causes Heartburn? What Helps Heartburn?

Heartburn is a commonly experienced symptom that is often not taken seriously. Almost everyone has experienced heartburn at some point in their life. Overeating during dinner or having a very spicy or fatty meal can lead to heartburn. However, heartburn can also indicate a serious medical condition. In most cases, lifestyle changes and over-the-counter medications can easily manage heartburn issues.

What Causes Heartburn?

Heartburn is defined as a discomforting burning sensation in the lower chest area caused by stomach acid moving upwards through the esophagus. The stomach is connected to the esophagus through a junction known as the lower esophageal sphincter. After food enters the stomach, this sphincter closes unidirectionally, preventing stomach contents from flowing back into the esophagus. In some cases, the lower esophageal sphincter may not function properly, allowing stomach contents to escape into the esophagus. Stomach contents include acids and enzymes that aid in food digestion. The stomach lining is resistant to these enzymes and acids. When stomach acid passes into the esophagus, it irritates the lining, leading to a burning sensation. Heartburn is actually a symptom of a condition known as gastroesophageal reflux disease (GERD).

What Are the Symptoms of Heartburn?

The most common symptom of heartburn is a burning sensation in the chest and throat area. This feeling can last for a few minutes or several hours. Other symptoms of heartburn include:

• A burning sensation in the chest after eating or when lying down at night
• Increased pain when bending over or lying down
• A sour, bitter, or salty taste at the back of the throat
• Difficulty swallowing
• The sensation of food being stuck in the center of the chest or throat.

Sometimes, heartburn symptoms can be so severe that they mimic those of a heart attack. However, a heart attack is typically characterized by a feeling of tightness and pressure in the chest. Heartburn is often a sign of acid reflux and may accompany the following additional acid reflux symptoms:

• Burping
• Nausea
• Regurgitation (the swallowing of food returning to the throat undigested)
• Bloating
• Hiccups
• Chronic cough
• Sore throat
• Laryngitis (inflammation of the esophagus).

What Helps Heartburn?

The following lifestyle changes may help prevent and treat heartburn:

• Following a balanced and sufficient diet program
• Stopping food intake at least 2-3 hours before bedtime
• Lying down with the head elevated
• Avoiding tight-fitting clothes that constrict the body
• Not engaging in strenuous activities such as heavy lifting
• Avoiding foods that are high in caffeine, fat, and spices that may irritate the stomach
• Maintaining an ideal body weight
• Exercising regularly
• Eating small meals frequently to keep stomach volume at a certain level.

These lifestyle changes can reduce the severity of heartburn, but they may not be effective if there is another underlying cause. Heartburn is commonly experienced during pregnancy due to hormones and the increasing abdominal volume applying pressure on the stomach. It is important to avoid using medications without consulting a doctor during pregnancy for the health of both the baby and the mother.

How Is Heartburn Diagnosed?

Heartburn is a feeling. Usually, a doctor diagnoses heartburn by evaluating the symptoms experienced by the patient. In cases of mild heartburn, over-the-counter medications and lifestyle changes can help manage the condition without the need for in-depth investigation. However, in cases of chronic and severe heartburn, a doctor specializing in gastrointestinal issues may request the following tests to determine the underlying health condition causing the heartburn:

• Endoscopy: A system with a mini camera at the end of a tube is used to examine the inner surface of the esophagus and stomach. The examination is conducted from the esophagus to the upper part of the small intestine.
• Esophageal pH Test: A wireless capsule is placed in the esophagus to determine whether stomach acids are passing through and causing damage. The information from this capsule is analyzed to assess the condition of the esophagus.

What Are the Risk Factors for Heartburn?

Heartburn is a common condition. Overfilling the stomach or consuming a heavy, fatty meal can lead to heartburn. Individuals who are obese, those with gastroesophageal reflux disease (GERD) or hiatal hernia, those who wear tight clothing, and pregnant women are among the at-risk groups for heartburn. Additionally, the following conditions may pose a risk for heartburn:

• Aging: As people age, the lower esophageal sphincter muscle, which prevents food from passing back into the esophagus, weakens. Stomach contents, including enzymes and acids, can easily move into the esophagus, causing heartburn.
• Weight Gain: Increased body weight can lead to higher internal pressure in the stomach, resulting in heartburn. Additionally, consuming more food than the stomach can digest may also cause burning sensations.
• Certain Medications: Some medications, such as blood pressure medications and birth control pills, may contribute to heartburn by increasing stomach acid levels.

How Is Heartburn Treated?

Occasional and mild heartburn can be treated with lifestyle changes and over-the-counter medications that reduce stomach acid. However, if there is a problem with the lower esophageal sphincter, this treatment may not be sufficient. For chronic heartburn, your doctor may recommend the following medications in addition to lifestyle changes:

• Antacids
  Antacids help neutralize stomach acid, preventing stomach contents from irritating the esophagus. They can also relieve symptoms such as gas and bloating associated with heartburn.
• Alginates
  Alginates, which are natural sugars found in seaweed, create a barrier between the acid in the stomach and the esophagus, preventing stomach contents from passing into the esophagus.
• Histamine Receptor Antagonists (H2 Blockers)
  H2 blockers decrease the acid level of stomach contents by blocking histamines that stimulate stomach acid secretion, thus helping to protect the esophagus.
• Proton Pump Inhibitors (PPIs)
  PPIs are powerful acid blockers that prevent stomach acid from entering the esophagus and are used especially in cases of severe heartburn or esophageal damage. They are effective medications for treating reflux.

In addition to these, the following medications may also be recommended for heartburn:

• Antibiotics or antiviral medications if heartburn is infection-related.
• Topical steroids to treat inflammation caused by heartburn.
• Low-dose neuromodulators.
• Hernia surgery if heartburn is caused by a hiatal hernia.

How Should People Experiencing Heartburn Eat?

Individuals experiencing heartburn should avoid foods and beverages that increase stomach acid, such as carbonated drinks, excessively fatty and spicy foods, fried foods, chocolate, coffee, and tomatoes. A sufficient and balanced nutrition program should be supported by regular physical activity to help control weight. You can help alleviate heartburn symptoms by adding the following foods to your diet:

• Melon and Banana: Melon and banana have lower acid content compared to other fruits.
• Oatmeal: Oatmeal, which is high in fiber, can help alleviate heartburn symptoms by contributing to the prevention of reflux.
• Bread: Whole grain breads such as whole wheat, rye, and bran bread can help prevent heartburn.
• Rice and Couscous: Especially black rice and whole wheat couscous, which are high in fiber, can support the treatment of heartburn.
• Green Vegetables: Green vegetables such as broccoli, asparagus, green beans, celery, cauliflower, potatoes, and parsley have low acid content.
• Lean Poultry, Fish, and Red Meat: Consuming meats such as chicken, turkey, and beef baked, grilled, or boiled helps meet daily protein needs without causing heartburn.
• Egg Whites: While egg yolks can cause heartburn, you can consume the white part of eggs, which is a good source of protein.

In addition to these, you can consume herbs like fennel, ginger, and aloe vera to support heartburn treatment. The causes of heartburn can vary from person to person. While some foods are thought to support heartburn treatment, it is important for the treatment to be personalized and the nutrition program to be tailored to the individual's habits.

When Should You See a Doctor for Heartburn?

If heartburn occurs more than twice a week, it may indicate an open sore, such as an ulcer, in the esophagus or stomach, or another condition. It is advisable to see a doctor if you experience the following heartburn symptoms:

• Difficulty swallowing and pain while swallowing
• Blood in stools
• Shortness of breath
• Dizziness
• Chest pain
• Pain radiating from the back to the shoulder

How to Prevent Heartburn?

• To prevent heartburn, you can consider the following recommendations:
• Avoid foods and beverages like carbonated drinks, coffee, excessively fatty foods, overly spicy foods, and chocolate.
• Do not lie down for at least 3 hours after eating.
• Sleep with your head elevated slightly.
• Avoid wearing tight clothing that creates pressure in the stomach.
• Eat small, frequent meals.
• Maintain an ideal weight.
• Engage in regular exercise.
• Heartburn is a mild stomach issue that can be prevented with simple lifestyle changes. However, chronic heartburn may signal a serious illness. If you frequently experience heartburn, it is important to visit the nearest healthcare facility without delay to protect your overall health.