Heartburn, Acid Reflux, GERD-Mayo Clinic



Understanding the Anatomy of Heartburn

Most people experience occasional heartburn, yet it is often unrecognized or misunderstood. Knowing the basics about what heartburn is can help you get proper diagnosis and treatment.

Heartburn is a symptom, not a condition. Despite its name, it has nothing to do with the heart — though the chest pain associated with it can be mistaken for a heart attack. While heartburn is commonly thought of as a burning feeling in the chest, the sensation can occur anywhere from the upper abdomen to the neck.

Heartburn is the result of stomach acids refluxing into the esophagus, the swallowing tube that connects the throat to the stomach. Sometimes the acids can travel further up into the throat or mouth. Everybody produces stomach acid and refluxes to some degree, but some people don’t clear the acid as well or they’re more sensitive to it.

“The lower esophageal sphincter is a muscle between the esophagus and the stomach that regulates the passage of food or beverages from the esophagus into the stomach,” says Darrel Gray II, MD, MPH, assistant professor of medicine in the division of gastroenterology, hepatology, and nutrition at the Ohio State University Wexner Medical Center.

The lower esophageal sphincter (LES) acts as “a barrier to reflux, and in some people this barrier is either always weak or it’s weakened by factors like foods or medications,” according to David Greenwald, MD, the gastroenterology fellow program director at Montefiore Medical Center/Albert Einstein College of Medicine.

Symptoms can range from mild to moderate or severe. Besides a burning sensation, “some people also complain of hoarseness, nocturnal wheezing or coughing, or a sore throat,” says Dr. Gray. “Commonly, people complain of an acid taste in their mouth.”

“Heartburn can occur after eating, or when people are lying down or bending over,” says Dr. Greenwald. Calcium channel blockers, hormone therapy, birth control pills, and any medications that cause the LES to relax can trigger it.

Heartburn may signal other digestive issues. “The feeling of heartburn can accompany rare disorders of the esophagus like achalasia, which affects how food is moved to the stomach,” says Prashanthi Thota, MD, a gastroenterologist at Cleveland Clinic.

During a recent conversation with gastroenterologist Jennifer Christie, MD, of Emory Healthcare, we discussed how age is related to reflux. “We know that as we age and as our population ages, there’s an increased prevalence of reflux disease. But it’s interesting, in the elderly, they don’t necessarily have worse symptoms, but they are at risk for developing more damage to the esophagus.”

Obesity increases the risk of reflux because excess weight puts more pressure on the abdomen. A hiatal hernia, in which part of the stomach pushes up through the diaphragm, can allow acids to reflux into the esophagus.

Even pregnancy can lead to heartburn because “the expanding uterus puts physical pressure on the stomach…[and] hormones that are needed to maintain the pregnant uterus tend to diminish lower esophageal sphincter pressure,” Greenwald says.

“Heartburn and indigestion can be difficult to differentiate,” says Dr. Thota. “Heartburn is discomfort in the chest, while indigestion is discomfort in the upper abdomen.”

Indigestion, also known as dyspepsia, refers to stomach discomfort usually associated with consuming greasy, fatty foods and eating too much or too quickly. It’s not related to stomach acid, though heartburn can be one of its symptoms. Indigestion can be caused by an underlying condition, so it’s important to see a doctor if you have persistent or recurring abdominal pain.

If you experience heartburn more than twice a week or if your heartburn persists despite taking medication for it, it may be gastroesophageal reflux disease (GERD).

Symptoms that may indicate GERD include:

  • Dysphagia (difficulty swallowing)
  • Weight loss
  • Symptoms that have been ongoing for more than five years
  • Blood in the stool (or if the stool is black)

If untreated, GERD can cause inflammation of the esophagus, or esophagitis, and lead to serious complications.

“There’s no clear delineation between what’s heartburn and what’s gastroesophageal reflux disease,” says Greenwald. If you have chronic heartburn, see your primary care doctor or a gastroenterologist.






Video: GASTRO-OESOPHAGEAL REFLUX DISEASE explained!

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Date: 06.12.2018, 16:40 / Views: 72473