Heartburn seems to be a common occurrence these days. The reason you may be experiencing symptoms of burning in your chest is often because sometimes your stomach acid can find its way into your esophagus and cause these burning sensations.
The symptoms of heartburn can include burning pain, the taste of acid in your mouth, cough, nausea, throat pain and sometimes even vomiting. Anatomy is partly to blame – your body normally likes to function in an environment where your acid base balance is close to neutral. In order to help you to digest food, however, your stomach creates a very acidic environment, close to the acidity level of a lemon. Most of the time, your body is able to keep this acid where it belongs, contained within your stomach. There is a valve-type area at the bottom of your esophagus called your lower esophageal sphincter (LES). The interesting thing to remember is that the LES is not truly a valve that fully closes – it actually is just a few muscles from your diaphragm (the muscles that help you breathe), located near the bottom of your lungs, that come together imperfectly to try to hold the contents of your stomach where they belong. This is all important to know so that you can understand why heartburn occurs.
The causes of heartburn can be a variety of things such as issues that increase the production of acid in your stomach, as well as structural problems that can allow acid to come back up, or reflux into your stomach. The term GERD, refers to this process of gastro (stomach) esophageal reflux—also referred to as heartburn. Foods such as chocolate, caffeine and alcohol can cause your stomach to increase the production of acid. Over the counter medications such as ibuprofen or aspirin can also irritate the stomach lining thus worsening your symptoms. Smoking and eating foods too high in fat, as well as consumption of peppermint, can cause your LES to relax too much, thus allowing too much acid to enter your lower esophagus.
A hiatal hernia is a term used to describe an issue where the structure of your LES won’t close tightly enough. This can occur spontaneously or can be caused by pregnancy or obesity, due to too much pressure on the muscles of the LES, making it open too much to keep your stomach contents in place. The bottom line is that heartburn or GERD is not an ideal situation to allow to persist as over many years, too much acid in your lower esophagus can cause changes in the cells that line your esophagus. Over time, these cell changes can lead to cancer, so it’s important to not ignore persistent symptoms of heartburn and indigestion, as your symptoms might be telling you to see your doctor, especially if you are getting symptoms several days of the week.
The treatments for heartburn and indigestion depend on the causes and how long you have had symptoms. Most of the time, you probably just ate too much of something that was too high in fat so your stomach became overwhelmed, too full and overflowed. A treatment to consider would be to stay upright and even take a gentle 30 minute walk to help with digestion. Don’t exercise too aggressively just after eating though, as that can shunt blood to your muscles and away from your stomach which can actually prolong your time for digesting food. If your symptoms persist, an acid neutralizer pill like calcium carbonate based product can help to relieve your discomfort, as can plain old-fashioned water which can help to dilute the stomach acid. Of course, there are also over the counter acid blocking pills to try but those can take a few hours to be effective. If you find you are having symptoms of heartburn more than once or twice a month, you may need to look at your diet and lower your intake of fats and trigger foods and decrease the amount of food you eat at one time. Weight loss if you are overweight and avoiding alcohol and caffeine for a while can also help. Also, try to not eat 2-3 hours before going to bed as laying down after you eat can put pressure on your LES and cause symptoms.
If your symptoms persist in spite of these small changes, it might be time to check in with your doctor.
Until next time, here’s to the best of your health!
Elizabeth Salada MD, MPH
Internal Medicine and Wellness