Heartburn
Definition
Heartburn is a painful burning sensation in the esophagus, just below or behind the breastbone. The pain often rises in your chest and may radiate to your neck or throat.
Alternative Names
Pyrosis; Non-cardiac chest painCauses
Almost everyone has occasional heartburn. If you have frequent, ongoing heartburn, you may have gastroesophageal reflux disease (GERD).
Normally, when food or liquid enters your stomach, a band of muscle at the end of your esophagus (called the lower esophageal sphincter or LES) closes off the esophagus. If this muscle fails to close tightly enough, stomach contents can back up (reflux) into the esophagus. This partially digested material is usually acidic and can irritate the esophagus, causing heartburn and other symptoms.
Heartburn is more likely to occur if you have a hiatal hernia, which is when the top part of the stomach protrudes upward into the chest cavity. This weakens the LES and makes it easier for acid to reflux from the stomach into the esophagus.
Heartburn can be brought on or worsened by pregnancy and by many different medications.
Such drugs include:
- Calcium channel blockers for high blood pressure
- Progestin for abnormal menstrual bleeding or birth control
- Anticholinergics (e.g., for sea sickness)
- Certain bronchodilators for asthma
- Tricyclic antidepressants
- Dopamine for Parkinson's disease
- Sedatives for insomnia or anxiety
- Beta blockers for high blood pressure or heart disease
If you suspect that one of your medications may be causing heartburn, talk to your doctor. NEVER change or stop medication you take regularly without talking to your doctor.
References
DeVault KR, Castell DO. Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2005;100:190-200.
Smith L. Updated ACG Guidelines for Diagnosis and Treatment of GERD. Am Fam Physician. 2005; 71(12): 2376-2382.
Fass R. Predictors of heartburn during sleep in a large prospective cohort study. Chest. 2005; 127(5): 1658-1666.
McCarthy D. Living with chronic heartburn: insights into its debilitating effects. Gastroenterol Clin North Am. 2003; 32(3 Suppl): S1-S9.
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