That burning sensation in your heart is something we have all experienced and you can attest to it being rather uncomfortable. This very common sensation manifests in the chest and while the term might suggest it’s related to the heart, heartburn is actually a digestive issue related to acid reflux.
If you ever wondered what the underlying cause of heartburn is, it’s not what you think. Let’s explore heartburn, its causes, treatment options, and how to prevent it.
What is heartburn?
Heartburn occurs when stomach acid backs up into the oesophagus (the tube that connects your mouth and stomach). The oesophagus doesn’t have the protective lining that the stomach does, so the acid can irritate its sensitive tissue, leading to a burning sensation, discomfort, or even a sour taste in the mouth.
Common causes of heartburn
Dietary triggers
- Spicy foods: Hot peppers and other spicy ingredients can irritate the oesophagus and promote acid production.
- Fatty or fried foods: These take longer to digest and can increase the likelihood of acid reflux.
- Caffeine: Coffee, tea, and certain sodas can relax the lower oesophageal sphincter (LES), allowing acid to escape the stomach.
- Alcohol: Like caffeine, alcohol can relax the LES, making reflux more likely.
- Citrus fruits and juices: Oranges, lemons, and grapefruits are acidic and can trigger heartburn.
- Tomato-based products: Foods like pasta sauce, ketchup, and salsa are acidic and can provoke symptoms.
Lifestyle factors
- Overeating: Eating large meals puts pressure on the stomach, which can push acid into the oesophagus.
- Lying down after eating: This makes it easier for stomach acid to flow back into the oesophagus, causing heartburn.
- Smoking: Tobacco use weakens the LES, increasing the risk of acid reflux.
- Obesity: Excess weight can put pressure on the abdomen, forcing acid into the oesophagus.
- Pregnancy: Hormonal changes and the growing foetus can both contribute to acid reflux and heartburn during pregnancy.
Medical conditions
Gastroesophageal reflux disease (GERD): Chronic acid reflux can lead to GERD, a more severe and persistent form of heartburn.
Hiatal hernia: A condition where part of the stomach pushes through the diaphragm into the chest, increasing the likelihood of acid reflux.
Delayed stomach emptying: When the stomach takes longer to empty its contents, acid can build up, leading to reflux.
Treating heartburn and GERD
Over-the-counter (OTC) medications
Antacids: These work quickly to neutralise stomach acid and provide short-term relief (e.g., Gaviscon, Eno).
H2 blockers: Drugs like ranitidine or famotidine reduce the production of stomach acid and are effective for longer-lasting relief.
Proton pump inhibitors (PPIs): Medications like omeprazole and lansoprazole block acid production more effectively and are used for more persistent heartburn or GERD.
Prescription medications
If OTC medications don’t provide relief, doctors may prescribe stronger versions of H2 blockers or PPIs.
Surgery
In severe cases, surgical options like fundoplication can tighten the LES, preventing acid reflux. Surgery is typically reserved for those with GERD or when medications and lifestyle changes aren’t enough.
Precautions and lifestyle changes
While medications can help, many people manage heartburn by making lifestyle and dietary adjustments.
- Eat smaller, more frequent meals: Instead of large meals, try eating smaller portions throughout the day to prevent excessive stomach pressure.
- Avoid trigger foods: Identify foods that cause heartburn and limit or eliminate them from your diet. Keeping a food diary can help.
- Don’t lie down immediately after eating: Wait at least two to three hours before lying down or going to bed after a meal to give your body time to digest.
- Elevate the head of your bed: Elevating your head (at least six inches) can help prevent stomach acid from travelling into the oesophagus.
- Maintain a healthy weight: Reducing excess weight can relieve pressure on the abdomen and decrease the likelihood of reflux.
When to call the doctor
If you experience heartburn more than twice a week, or if your symptoms persist despite making lifestyle changes, you should consult a healthcare professional. Persistent heartburn could be a sign of GERD or other serious health conditions that require medical intervention.
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