Reflux, Heartburn Pain

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What is it?  

Heartburn is a digestive problem that affects many people. About 30 per cent of adults experience occasional heartburn, while 10 per cent experience heartburn everyday. About 25 per cent of pregnant women have heartburn or related symptoms. Most people suffer from heartburn occasionally, usually after a meal. How do you know when your condition is considered chronic? If you have heartburn once a month, it's considered mild. If you have heartburn once a week, it's moderate. It's when your heartburn occurs daily that it's considered to be severe.

Heartburn typically begins with a burning sensation that starts in the upper abdomen and moves up into the chest. It often makes its way to the back of the throat, and sometimes up into the jaw, arms and back. It usually feels worse when lying down or bending forward.Heartburn (reflux) gets its name from chest pains caused by stomach acid that washes up into the oesophagus. This chest pain issometimes confused with angina (heart pain).

Generally, heartburn should not be a cause for concern. Continual bouts of heartburn, however, can be a symptom of a more seriouscondition and you should seek medical attention. Severe heartburn causes burning and chest pain that may travel from your diaphragm to your throat. It may be accompanied with a sour taste and the sensation of food re-entering your mouth. Frequent or severe heartburn may limit daily activities and lead to further complications, such as ulcers in the oesophagus.


What causes it?  

In the vast majority of cases, heartburn is a symptom of Gastroesophageal Reflux (GERD). Reflux is the regurgitation of acid stomach contents back into the oesophagus and is the cause of heartburn. It occurs when stomach fluids containing acid and digestive enzymes back up past the valvelike sphincter that separates the stomach from the esophagus, causing pain. Distress from heartburn is common after a rich or fatty meal. 

Heartburn can also be triggered after consuming acidic foods, drinking alcohol or coffee, smoking, eating chocolate or after taking aspirin. 

Obesity, pregnancy, anxiety or depression, stress and tension can also cause heartburn.

Heartburn may also be triggered by lying down, prescription medications, diabetes, hiatal hernias, peptic ulcers and some autoimmune disorders.  


It can also be caused by:  

  • Eating large meals

  • Eating too quickly

  • Exercising soon after eating

  • Laying down right after eating

  • Eating shortly before bedtime

  • Pressure on the stomach (including frequent bending over, lifting or tight clothes)  


Common treatments  

Mild cases of heartburn can be managed through a change of diet, over-the-counter antacids or weight loss. Even those who suffer from moderate heartburn can often find relief with these remedies. But for five to 15 per cent of adults who suffer from severe heartburn, these remedies give only partial or temporary relief. 

Antacids usually bring immediate relief. The active compounds buffer the accumulated acid in the stomach. This helps reduce or eliminate the burn that is felt in the oesophagus. If a single dose does not work, the problem may be more severe, and consulting a doctor should be considered. 

People who have high blood pressure or who are on a sodium-restricted diet should not take antacids containing sodium bicarbonate because of its high sodium content. Likewise, people with kidney stones should not take calcium carbonate antacids because the calcium can accelerate the problem. And in some cases, antacids should not be mixed with certain medications. Calcium carbonate antacids will initially quell acid buildup, but because they contain calcium, this antacid can cause an increase in stomach acid. 

There is also a wide range of prescription and over-the-counter drugs available to treat reflux. These work by reducing the amount of acid the stomach produces, thus reducing the quantity of acid refluxing into the oesophagus. Others are muscular stimulants that act by tightening the lower oesophageal sphincter. While these drugs give relief, they don't cure the condition.

So people with frequent or chronic reflux may need regular medications. In severe cases, surgery is an option. This involves a surgeon tightening the lower oesophageal sphincter. However, most people who have surgery still have to take drugs. Therefore, surgery is usually only recommended as a last resort.

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About Pain does not provide medical advice, diagnosis or treatment