Burning chest discomfort, persistent cough, and asthma-like symptoms are a few of the symptoms of heartburn. Shared by more than 40 percent of Americans, chronic heartburn or gastroesophageal reflux disease (GERD), is a common cause of chest and abdominal discomfort. Ten percent of these people have daily symptoms, which can be short-lived or long-term. Chronic causes of heartburn can decrease quality of life. Determining the cause of chronic symptoms is a primary goal when symptoms cannot be controlled and should be managed by a physician.
Anatomical
Lower esophageal sphincter (LES) is a muscle that normal regulates foods flow into the stomach after swallowing. Abnormal relaxation of this muscle provides an opening for the acidic fluid of the stomach to travel in the opposite direction, thus, causing symptoms of heartburn. Relaxation of this muscle is caused by anatomical, pharmacological, and lifestyle effects according to American Family Physician.
Hiatal hernia is an abnormality in which the upper portion of the stomach is located above the diaphragm. Working in conjunction with the LES, the diaphragm is a secondary measure for applying pressure to the muscle. Outpouching of the stomach through the diaphragm removes the secondary barrier, preventing the LES from contracting completely. Therefore, fluid content is able to reach the more sensitive areas of the digestive tract. Hiatal hernias are caused by increased abdominal pressure or strain, obesity, pregnancy, and constant coughing. Eighty percent of people with heartburn are estimated to have hiatal hernias.
Habits
Health and lifestyle habits affect the muscles of the digestive system, such as consuming tobacco and alcohol. Nicotine and alcohol promote LES relaxation and causes direct irritation to the esophageal lining. Nicotine also reduces saliva production, which neutralizes acid, therefore increasing risk of heartburn symptoms. Doctors recommend patients who suffer from excessive heartburn to stop smoking in order to find relief.
Diet
Diet is a common culprit as a cause of heartburn. Ingesting foods that exacerbate acidity will cause heartburn symptoms. These include foods such as tomatoes, chocolate, fried foods, spicy foods, and fatty foods all exacerbate the condition. Caffeine causes relaxations of the LES muscle. These foods are referred to as triggers and should be avoided.
Diabetes
Delays in digestion contribute to heartburn symptoms. Increased duration of food content in the stomach produces an increased amount of acid. Damage to nerves that assist in the normal emptying of gastric (stomach) contents is seen in diabetics with uncontrolled disease. Management of glucose in diabetics may prove to be a strategy in heartburn control.
Medications
Medications may cause heartburn symptoms. Some known medications associated with heartburn include calcium channel blockers, antihistamines and theophylline. All block smooth muscle, thus affecting the lower esophageal sphincter. Discussing symptoms with a primary care physician is a first step in improving symptoms. Switching to an alternative medication may be an option.
Weight
Increased weight gain, as seen in pregnancy and obesity, may also contribute to symptoms of heartburn. Compression of the stomach increases abdominal pressure and promotes the backward flow of stomach contents. Controlling weight may help to relieve heartburn symptoms significantly.
