Heartburn

Treatment

Heartburn, also called acid indigestion, is a very common digestive condition characterized by a burning sensation in the chest, just behind the breastbone. Heartburn really has nothing to do with the heart itself but rather originates from the stomach or the lower part of the esophagus.

At the bottom of the esophagus, there is a muscular ring called the lower esophageal sphincter (LES) that prevents stomach acid from flowing back into the esophagus. In some cases, the LES may not function correctly, permitting stomach acid to escape into the esophagus. This is known as acid reflux, and it can cause irritation and inflammation of the esophageal lining, resulting in a painful “burning” feeling.

Although everyone experiences heartburn similarly, women are more likely to describe their pain as sharp or burning, whereas men often describe it as pressure or squeezing in the chest.

Heartburn symptoms will vary from person to person, but is generally described as a burning sensation near the heart and in the throat. In addition, heartburn symptoms can include: 

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 Chest pain

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Sour or acidic taste in the mouth

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Bad breath

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Irritation of the throat

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Persistent coughing

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Difficulty swallowing

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Excessive belching

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Burning sensation behind the breastbone

Characterized by a burning sensation in the chest or throat, the most common cause of heartburn is gastroesophageal reflux disease or GERD, but can also be caused by: 

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Overeating

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Obesity or excessive weight

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Pregnancy

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Spicy, fatty, or acidic foods

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Coffee, tea, carbonated, or alcoholic drinks

In most cases, a heartburn diagnosis is based on the patient's description of symptoms and medical history. Doctors may recommend diagnostic tests if the symptoms persist or if there are concerns about underlying conditions like GERD. These tests may include an X-ray, endoscopy, pH monitoring, or imaging studies.

Heartburn treatment primarily focuses on relieving symptoms and preventing their recurrence. Common steps to manage heartburn include:

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Lifestyle changes such as avoiding trigger foods, losing weight, and quitting smoking.

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Over-the-counter antacids

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Elevating your head when sleeping

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Eating smaller, more frequent meals

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Choosing more bland and healthier meals.

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Avoid lying down immediately after eating.

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Esomeprazole (Nexium)

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Lansoprazole (Prevacid)

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Omeprazole (Prilosec)

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Pantoprazole (Protonix)

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Rabeprazole (Aciphex)

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Dexlansoprazole (Dexilant)

Many of the remedies for heartburn aim to reduce discomfort and irritation in the esophagus. Traditional methods and those developed by healthcare providers alike focus on keeping the stomach healthy, choosing foods that are easy to digest, and having habits that have historically helped. These can include: 

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Aloe very juice

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Apple cider vinegar

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Baking soda with water

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BRAT (bananas, rice, applesauce, toast)

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Probiotics

Ongoing management of heartburn symptoms focuses on improving bodily health, continuing healthy habits, and narrowing down the best diet that avoids bouts of acid reflux. Typically, these can include examples like: 

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Staying upright for at least two hours after eating.

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Avoiding large meals and late-night snacks.

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Elevating the head of the bed.

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Monitoring for signs of improvement or worsening symptoms.

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Gradually reintroducing trigger foods, if tolerated.

Heartburn prevention can often be enhanced or achieved by adopting healthy habits and making dietary choices. To reduce the risk of heartburn, consider the following:

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Avoid trigger foods like spicy or acidic items

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Eat smaller, more frequent meals

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Maintain a healthy weight

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Avoid smoking and alcohol

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Elevate the head of the bed

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Manage stress

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Consider dietary modifications in consultation with a healthcare provider

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