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Alternative namesPyrosis; Non-cardiac chest pain
DefinitionHeartburn is a painful burning sensation in the esophagus, just below the breastbone. The pain often rises in your chest and may radiate to your neck or throat.
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.
Sometimes GERD is related to a hiatal hernia. This is when part of the stomach protrudes upward through a hole in the diaphragm, putting pressure on the LES. Heartburn can also be a side effect of many different medications.
Such drugs include:
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. If you take an occasional aspirin or ibuprofen for headache or mild pain, try acetaminophen instead.
Heartburn can also be caused by esophageal spasm .
Pay attention to heartburn and treat it, especially if you feel symptoms often. Over time, ongoing reflux can damage the lining of your esophagus and cause serious problems. The good news is that making changes to certain habits can go a long way to preventing heartburn and other symptoms of GERD.
The following tips will help you avoid heartburn and other GERD symptoms. If these measures are not working, talk to your doctor.
First, avoid foods and beverages that can trigger reflux, such as:
If you still do not have full relief, try over-the-counter medications:
Call your health care provider if
Call 911 if:
Call your doctor if:
If your heartburn is from GERD, it is generally not difficult to diagnose. Your symptoms, what you eat and drink, medications you are taking, and your lifestyle are usually enough to make a clear diagnosis. If the diagnosis is unclear to your doctor, one or more tests may be performed.
First, your doctor will perform a physical examination and ask questions about your heartburn, such as:
If self care has not been successful, your doctor may consider prescribing you medications to reduce acid secretion. These are stronger than the medications available over the counter. Any sign of bleeding will require a more complicated treatment plan. For hiatal hernia, surgery may be necessary.
Update Date: 9/8/2003Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma. and Senior Medical Editor, A.D.A.M., Inc. Previously reviewed by Andrew J. Muir, M.D., M.H.S., Division of Gastroenterology, Duke University Medical Center, Durham, NC. Review provided by VeriMed Healthcare Network (11/9/2002).
Last updated: Tue, 06 Jan 2009 00:20:03 GMT