A Must-Know Guide to Heartburn

To understand fully what heartburn constitutes it is necessary to know a little about the biological structure of the mouth and the throat. The pharynx is located at the back of the mouth and leads to the esophagus. The esophagus extends till the stomach. Heartburn is a burning sensation or pain, in that part of the esophagus that is located just below the breastbone. Sometimes, when the digestive system is not working too well, some of the content from the stomach ends up in the mouth by a process called regurgitation. Most of this contains gastric acid and thus causes heartburn. Though heartburn originates in the chest it often spreads to the throat and even to the jaw. In severe cases heartburn can imitate the symptoms of asthma and cause chronic coughing.

Contrary to what the name suggests, heartburn does not mean one's heart is on fire. In fact though the hydrochloric acid often comes back to the esophagus through what is medically called the cardiac sphincter, even this terminology is misleading as the sphincter in case has no connection to the heart. It's more likely that heartburn got its name from the fact that the sensation seems to occur around the area of the heart. Medically though, the condition goes by the name of gastro esophageal reflux disease.

The sphincter is supposed to remain closed once food has been swallowed. Peristalsis or the constant and rhythmic movement of the digestive tract helps food pass through the sphincter and remain below, it's only due to one or more of the abnormal situations mentioned below that regurgitation occurs causing heartburn:

1. Medical condition called Hiatus Hernia - In this a part of the stomach protrudes into the thorax, (cavity containing the heart and lungs), through a tear in the diaphragm. One common symptom of this is heartburn.

2. Psychophysiological illness - Excessive stress or fatigue can lead to psychological distress and the physiological manifestation often comes in the form of heartburn.

3. Cardiac Arrest - Though we have earlier studied how heartburn has nothing to do with the heart, the sensation itself can often be indicative of a cardiac arrest.

4. Certain food - This is the commonest cause of heartburn. Some common food items like soda pops, spicy curries, fruits or vegetables containing citrus acid, excessively hot, dry or fatty food, garlic, some grains and even wine are known to comprise that list.

Heartburn or gastro esophageal reflux disease (GERD) is diagnosed by physicians mostly on the basis of the symptoms. Tests are rarely required for this. In a few cases though, doctors may recommend one of the following.

1. Ambulatory PH Monitoring - A probe is introduced into the esophagus via the nose and left for a period of 24 hours. This records the level of acidity in the esophagus and if the patient corroborates an increased acid level with a compliant of heartburn, GERD is suspected.

2. Upper Gastrointestinal Series - Patient drinks barium solution and is X rayed following that. As barium shows up on X ray, an unusually large quantity of it helps to confirm the condition as GERD or heartburn.

3. Manometry - This test uses a pressure sensor to check the pressure on the sphincter. If there is an irregularity in the normal pressure, heartburn is often suspected.

4. Endoscopy - A fairly common procedure these days, it allows the doctor to visually examine the inside of the esophagus for abnormalities that may indicate GERD or heartburn.

5. Biopsy - This is recommended by the physicians mostly in situations where they suspect further complication. It involves removing a tiny part of the esophagus and testing it for malignancy.

Once heartburn is diagnosed, the treatment can follow different routines. In most cases heartburn is an easily curable condition and responds well to medicines