Heart Burn or Acidity

Heart Burn or Acidity is a very common problem these days. It is a sense of burning felt below the central bone of the chest (called Sternum). It usually radiates towards the mouth or throat – especially after heavy meals during weight lifting, bending over or just lying flat. This problem is very common and affects crores (ten millions) of people. The most common cause of heart burn is a disease called GERD (Gastro Esophageal Reflux Disease). Reflux or regurgitation or back flow of the stomach contents occur in this disease. This acid burns the unprotected wall of the esophagus – leading to pain under the breast bone.
The second most cause of heart burn is heart attack. The other causes may be disease of the esophagus (Esophageal inflammation, excessive movement or hyper motility, hypersensitive esophageal door or sphincter). Some of the lung diseases can also lead to symptoms of heart burn. This Acidity or acid burn is often confused with Heart attack.

Symptoms of Heartburn

• Nausea
• Dyspepsia (upper abdominal pain)
• Bloating (fullness of the abdomen)
• Belching and Indigestion. Many people get up in the night due to such acute pain from GERD.
• Water brush – sudden filling up of the mouth with bitter or salty fluid can also happen with heart burn.

Are there any common precipitating factors leading to heartburn?

Large meals, spicy food, citrus foods, high fat meals, colas, coffee, teas usually proceed heart burn condition. Meals close to the bedtime, beers and alcohol with meals increase night time symptoms of heart burn.

Regurgitation

Regurgitation (or reflux) is defined as the effortless return of the gastric contents into the esophagus and more frequently into the mouth. There is a distinct feeling of acid or bitter taste in the chest or mouth with regurgitation.
This is a very common problem is different from Vomiting – which is mostly voluntary. Regurgitation does not have any symptom of nausea or vomiting sensation.

What is the problem if the contents of the stomach regurgitates to the esophagus?

The gastric or Stomach contents have a good concentration of acid in it. But this acid cannot burn the stomach wall as they are protected by a layer of mucous. But the wall of the esophagus does not have this protection. So, the acid burns the lower end of the food pipe or esophagus – leading to this heart burn condition.

What measures can be taken to alleviate the symptoms?

Diet content modification, alteration of the diet habits, avoidance of drugs which promote acid formation, use of antacids(which neutralize the acid) and drugs which reduce the production of excess acid in the stomach (H2 receptor antagonists and proton pump inhibitors) are the main stream treatment for relief or symptoms. These drugs also help to heal the erosion or inflammation.