Heartburn is a burning sensation in the lower chest. It is the main symptom of gastroesophageal reflux disease (GERD).
When you eat, food travels down the esophagus to the stomach. The muscle between the esophagus and stomach lets food enter the stomach. When this muscle weakens, stomach acid flows into the esophagus. This causes a burning sensation, called heartburn.
Other causes of GERD include:
These factors increase your chance of developing GERD. Tell your doctor if you have any of these risk factors:
Heartburn symptoms usually occur after overeating or lying down after a big meal. The symptoms may last for a few minutes or a few hours.
The severity of symptoms depends on the:
Symptoms include:
Other symptoms and complications of reflux include:
If reflux persists, the acid can damage the esophagus. Symptoms of esophageal damage include:
Heartburn can feel like heart attack pain. If you feel this pain, call 911 right away.
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
Treatment aims to decrease the number of episodes of heartburn and its complications. This focuses on:
Treatment may include:
Lifestyle changes may include:
Medications may include:
If symptoms are severe and you can't tolerate the medications, surgery may be an option.
The most common surgery for heartburn is fundoplication . The doctor wraps the stomach around the esophagus. This creates pressure on the muscle at the opening to the stomach. If you have a hiatal hernia, it can also be repaired at this time.
In some cases, the surgery can be done with smaller incisions, called laparascopy .
An advantage of endoscopic techniques is that they do not involve incisions in the skin. Instead, the doctor inserts a lighted device called an endoscope through the mouth and down the esophagus to reach the first part of the stomach. Through the endoscope, the doctor can perform one of a variety of procedures that decreases the backward flow of stomach acid into the esophagus, including transoral incisionless fundoplication.
If surgery or endoscopy is successful, you may not need to take heartburn medications anymore. Talk to your doctor about the best treatment for you.
Lifestyle changes can help prevent heartburn, including:
RESOURCES:
American College of Gastroenterology
http://www.acg.gi.org/
American Gastroenterological Association
http://www.gastro.org/
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov/
CANADIAN RESOURCES
Canadian Institute for Health Information
http://www.cihi.ca/
Health Canada
http://www.hc-sc.gc.ca/
References:
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American Gastroenterological Association website. Available at: http://www.gastro.org .
Conn HF, Rakel RE. Conn's Current Therapy 2001 . 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.
EsophyX receives FDA clearance for performing transoral incisionless fundoplication surgery. Medical News Today website. Available at: http://www.medicalnewstoday.com/articles/83410.php . Published September 24, 2007. Accessed August 19, 2009.
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Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/ . Updated May 2007. Accessed July 1, 2008.
Transoral incisionless fundoplication with EsophyX. Endogastric Solutions website. Available at: http://www.endogastricsolutions.com/esophyx_for-pt.htm . Accessed August 19, 2009.
Treating GERD. Ohio State University Medical Center website. Available at: http://medicalcenter.osu.edu/patientcare/healthcare_services/digestive_disorders/gerd_heartburn/diagnosing_treating_gerd/treating_gerd/Pages/index.aspx . Accessed August 19, 2009.
Understanding GERD. American College of Gastroenterology website. Available at: http://www.acg.gi.org/patients/gerd/word.asp . Published 2006. Accessed July 1, 2008.
9/30/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Jacobson BC, Moy B, Colditz GA, Fuchs CS. Postmenopausal hormone use and symptoms of gastroesophageal reflux. Arch Intern Med. 2008;168:1798-1804.
3/1/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Maalox Total Relief and Maalox liquid products: medication use errors. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm200672.htm. Published February 17, 2010. Accessed March 2, 2010.
Last reviewed September 2009 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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