Heartburn is a medical condition caused by stomach acids backing up into the esophagus. It can cause a burning sensation or feeling of discomfort or lead to more severe symptoms such as chest pain and difficulty swallowing. Several causes of chronic heartburn should be considered so that the proper medications and surgical interventions can be given.
Hiatal Hernia
Hiatal hernia is an opening in the diaphragm that allows the stomach to protrude into the chest cavity. In addition to belching, chest pain and nausea, hiatal hernia can also cause chronic heartburn. Small hernias usually do not need treatment, but larger hernias that cause severe symptoms may be treated with medication or surgery. The chronic heartburn caused by this type of hernia can be treated with H-2 blockers, antacids or proton pump inhibitors. H-2 blockers reduce the amount of acid produced by the stomach, which can reduce the occurrence of acid reflux. Antacids neutralize acidity in the stomach. Proton pump inhibitors also reduce the production of stomach acid, reducing acid reflux and improving the symptoms of hiatal hernia.
Pregnancy
Stomach acids are kept out of the esophagus with a valve that can tighten and relax. When this valve is unable to block the stomach acids from entering the esophagus, heartburn occurs. During pregnancy, rising levels of the hormone progesterone cause this valve to relax. This allows stomach acid to pass into the esophagus and irritate the esophageal lining. The pressure that the uterus puts on the stomach and intestines in the third trimester can also cause heartburn to occur.
Acid Reflux
Acid reflux and gastroesophageal reflux disease are causes of chronic heartburn. Gastroesophageal reflux occurs when the sphincter of the lower esophagus does not close properly, allowing the contents of the stomach to enter the esophagus. This causes the feeling of heartburn to occur. Gastroesophageal reflux disease (GERD) is more serious and is diagnosed if gastroesophageal reflux occurs more than twice per week.
Peptic Ulcer
Peptic ulcers are sores that occur in the inner lining of the stomach or first part of the small intestine. Normally, the stomach lining protects the stomach and small intestines from digesting themselves. When this function is disrupted, the protective shield is removed and strong digestive acids can eat through the linings of these organs. This is known as a peptic ulcer. One of the most common symptoms of this type of ulcer is heartburn.
Antacids can be used to treat this heartburn, but should not be taken within one hour before or two hours after drugs being used to treat the ulcer. Several other medications can be used to ease peptic ulcer symptoms. H-2 blockers and proton pump inhibitors are used to decrease the production of stomach acid and reduce irritation of the ulcer. Sucralfate forms a protective coating at the ulcer's base, which promotes healing of the tissue. Misoprostol can reduce the production of stomach acid and strengthen the stomach lining's resistance to acids. If an ulcer is caused by infection with H. pylori bactera, antibiotics may be used to treat the infection.
Gastroparesis
Gastroparesis, also known as delayed stomach emptying, is a medical condition in which the stomach takes too long to empty food into the intestines. In normal digestive function, the stomach moves food into the small intestine to be digested. The vagus nerve is responsible for controlling the muscular contractions responsible for this movement. When there is damage to the vagus nerve and the muscles of the digestive tract do not work properly, food moves slowly or does not move from the stomach. One of the symptoms of this condition is frequent heartburn.
People with gastroparesis may be advised to eat smaller meals more frequently. This can help reduce the feeling of fullness that is associated with this condition. Medications can also be administered to increase stomach contractions and move food out of the stomach more quickly. These drugs are known as prokinetics. Anti-emetics, which help reduce nausea and control vomiting, may also be administered to treat the symptoms of gastroparesis.
