Heartburn: Causes, Symptoms, Treatment, and Cost

Burning pain or discomfort in the upper chest and mid-chest, possibly involving the neck and throat, may worsen when lying down.

There are 10 types of Heartburn which are listed below:

• Gastroesophageal Reflux Disease (GERD): Lower esophageal sphincter dysfunction is the root cause of GERD, a persistent digestive condition. Heartburn, regurgitation, trouble swallowing, and chest discomfort are all symptoms. Changes in lifestyle, medicine, and surgery may all be part of the treatment plan.
• Acid Reflux: As stomach acid runs back up into the esophagus, it may cause symptoms including Heartburn, regurgitation, and swallowing problems.
• Peptic Ulcers: Peptic ulcers are sores that develop on the lining of the stomach, small intestine, or esophagus. They are often brought on by nonsteroidal anti-inflammatory medication usage or an infection with the bacterium Helicobacter pylori (NSAIDs).
• Hiatal Hernia: The hiatus, a gap in the diaphragm that divides the chest cavity from the abdominal cavity, is where a hiatal hernia develops when a portion of the stomach protrudes up into the chest. Heartburn, regurgitation, and swallowing issues are possible symptoms.
• Barrett's Oesophagus: Long-term gastroesophageal reflux disease is often the cause of Barrett's esophagus, a disorder in which the lining of the esophagus is replaced with tissue that resembles the lining of the intestine (GERD). It may raise the possibility of getting esophageal cancer.
• Non-Erosive Reflux Disease (NERD): Acid reflux is referred to as Non-Erosive Reflux Disorder (NERD) when there is no obvious esophageal lining damage. It may result in symptoms including Heartburn, regurgitation, and swallowing problems.
• Functional Heartburn: Functional Heartburn is a type of Heartburn where there is no underlying medical condition or visible damage to the esophageal lining. It may result in symptoms including regurgitation, regurgitation, and a burning sensation in the chest.
• Biliary Reflux: Biliary reflux is a condition where bile, a digestive fluid produced by the liver, flows back up into the stomach and esophagus. It may result in symptoms including nausea, Heartburn, and stomach discomfort.
• Supragastric Belching: Supragastric belching is a condition where the air is repeatedly sucked into the esophagus and then rapidly expelled, causing loud belching sounds. It can be a form of excessive belching and is often associated with anxiety or stress.
• Gastroparesis-associated Reflux Disease (GARD): Gastroparesis-associated Reflux Disease (GARD) is a type of acid reflux where delayed gastric emptying due to gastroparesis leads to increased acid and bile reflux into the esophagus, causing symptoms such as Heartburn and regurgitation.

Some other risk factors include:

• Weak or relaxed lower esophageal sphincter (LES): The LES is a ring of muscle located at the bottom of the esophagus that acts as a barrier between the esophagus and stomach. When the LES is weak or relaxed, stomach acid can leak back up into the esophagus, causing Heartburn.
• Eating large meals or lying down after eating: Eating large meals can put pressure on the LES, causing it to relax and allowing stomach acid to flow back up into the esophagus. Lying down after eating can also increase the likelihood of Heartburn, as gravity is no longer helping to keep stomach acid in the stomach.
• Being overweight or obese: Being overweight or obese can put pressure on the stomach, causing stomach acid to leak back up into the esophagus.
• Pregnancy: Pregnancy can cause changes in hormones and pressure on the stomach, which can lead to Heartburn. Smoking: Smoking can weaken the LES and increase the production of stomach acid, making it more likely for stomach acid to flow back up into the esophagus.
• Certain foods and drinks: Certain foods and drinks can trigger Heartburn, including spicy or fatty foods, chocolate, alcohol, and caffeine. These foods and drinks can weaken the LES and increase the production of stomach acid.
• Certain medications: Certain medications can also contribute to Heartburn, including aspirin, ibuprofen, and certain muscle relaxants. These medications can irritate the lining of the esophagus and increase the production of stomach acid.
• Hiatal hernia: A hiatal hernia occurs when part of the stomach pushes up through the diaphragm into the chest. This can cause the LES to become weak, allowing stomach acid to flow back up into the esophagus.

The most common symptom of Heartburn is a burning sensation in the chest and throat. This burning sensation is often accompanied by a sour or bitter taste in the mouth, as well as regurgitation of food or liquid. Other symptoms of Heartburn may include:

• Chest pain: Heartburn can cause chest pain that may feel like a squeezing or pressure sensation in the chest. This pain can sometimes be mistaken for a heart attack, so it's important to seek medical attention if you're unsure.
• Difficulty swallowing: Heartburn can cause difficulty swallowing, as the burning sensation and irritation in the esophagus can make it feel like food is getting stuck.
• Nausea: Some people may experience nausea or vomiting along with Heartburn.
• Coughing or wheezing: Heartburn can irritate the throat and lungs, leading to coughing or wheezing.
• Sore throat: Heartburn can cause a sore throat or hoarseness, as stomach acid can irritate the throat.

You can prevent Heartburn by following these measures:

• Steer clear of meals and drinks that cause triggers including fried or fatty foods, coffee, wine, and spicy foods.
• Often eat smaller meals.
• Never lay down just after eating. Before laying down, wait at least two to three hours.
• Raise your bed's head by 6 to 8 inches.
• Quit smoking.
• Avoid tight-fitting clothing that puts pressure on the abdomen.
• Maintain a healthy weight.
• The use of NSAIDs like aspirin and ibuprofen should be restricted or avoided.
• Use relaxation methods to reduce stress, such as yoga, meditation, or deep breathing exercises.
• If necessary, seek medical treatment for underlying conditions such as gastroesophageal reflux disease (GERD).

The tests for Heartburn may include;

• Endoscopy: Endoscopy can be used to diagnose Heartburn by allowing a doctor to examine the lining of the esophagus and stomach for signs of inflammation, irritation, or other abnormalities. An endoscope (a thin, flexible tube with a camera and light at the end) is put through the mouth, through the esophagus, and into the stomach during the operation. For further testing, tissue samples (biopsies) may also be collected.
• pH monitoring: pH monitoring is used to diagnose Heartburn by measuring the acidity levels in the esophagus over some time using a small, wireless device that is inserted through the nose and into the esophagus. It helps determine if acid reflux is causing the symptoms of Heartburn.
• Barium swallow: A barium swallow is a test used to diagnose Heartburn by taking X-rays of the esophagus and stomach after swallowing a liquid containing barium. The barium makes the esophagus and stomach visible on X-ray images, helping to identify abnormalities such as ulcers, strictures, or other structural issues that may be causing Heartburn.

If left untreated, frequent or severe Heartburn can lead to complications over time. Here are some possible complications of Heartburn:

• Esophagitis: Esophagitis is inflammation of the esophagus, which can be caused by repeated exposure to stomach acid. This can lead to pain when swallowing, bleeding, and even scarring of the esophagus.
• Barrett's esophagus: Barrett's esophagus is a condition where the cells in the lining of the esophagus change and become abnormal, which can increase the risk of developing esophageal cancer.
• Stricture: Over time, repeated exposure to stomach acid can cause the esophagus to become narrow, making it difficult to swallow.
• Respiratory problems: Stomach acid that flows back into the throat and lungs can cause respiratory problems, such as asthma, chronic cough, or pneumonia.
• Dental problems: Frequent exposure to stomach acid can cause erosion of tooth enamel, leading to dental problems such as cavities, sensitivity, and tooth loss.
• ncreased risk of osteoporosis: Long-term use of certain Heartburn medications, such as proton pump inhibitors (PPIs), can increase the risk of osteoporosis, a condition that weakens bones and increases the risk of fractures.

The following are some natural/home remedies for Heartburn:

• Before going to bed, have a warm milk beverage with a dash of cardamom powder.
• Chew on a piece of fresh ginger root or drink ginger tea.
• Sip on a cup of chamomile tea after meals.
• Buttermilk should be poured into a glass after adding 1 teaspoon of coriander seed powder.
• Prepare a mixture of 1 teaspoon each of carom seeds and cumin seeds. Chew it after meals.
• Take a teaspoon of baking soda in a glass of warm water.
• Eat a banana to neutralize gastric acid since it is naturally alkaline.
• Drink some slippery elm tea, which may ease Heartburn symptoms and the digestive system.
• Chew on a few fennel seeds, which can help reduce acid reflux.
• Eat smaller meals and avoid consuming large amounts of food at once.

• The following foods are suggested for people with Heartburn: Bananas, melons, and apples are examples of non-citrus fruits that may be consumed due to their low levels of acidity.
• Due to their low acid content, vegetables like broccoli, cauliflower, and green beans are safe to eat.
• Lean proteins such as chicken, fish, and turkey can be consumed in moderation.
• Whole grains such as brown rice and oatmeal can be eaten as they are less likely to trigger Heartburn.
• You may have low-fat dairy items like milk, yogurt, and cheese, but only in moderation.
• As they have anti-inflammatory effects and may aid with Heartburn symptoms, ginger, and chamomile tea can be ingested.
• Beans, lentils, and chickpeas are examples of foods rich in fiber that may be eaten, but in moderation.
• Water and coconut water can be consumed to stay hydrated.
• Caffeine, alcohol, and carbonated beverages should all be limited or avoided since they may make Heartburn symptoms worse.

These foods should be avoided for Heartburn:

• Spicy and fatty foods: These meals often increase the formation of stomach acid, which may make Heartburn symptoms worse.
• Citrus fruits: Citric acid present in citrus fruits can irritate the esophagus and lead to Heartburn.
• Tomato-based products: Since they are so acidic, tomatoes and tomato-based foods like ketchup, spaghetti sauce, and others might make you feel Heartburn-y.
• Carbonated drinks: Carbonated drinks like soda, beer, and sparkling water can increase stomach pressure and cause Heartburn.
• Fried foods: Due to their high-fat content and potential to prolong stomach emptying, fried meals may cause acid reflux and Heartburn.
• Chocolate: Caffeine and theobromine, which are found in chocolate, might relax the lower esophageal sphincter and aggravate Heartburn.
• Alcohol: Alcohol may cause Heartburn by loosening the lower esophageal sphincter and boosting the production of stomach acid.
• Mint: Although mint is known for its digestive properties, it can aggravate Heartburn and acid reflux by relaxing the lower esophageal sphincter.

The best treatment for Heartburn Treatment are:

• Fundoplication: To strengthen and stop reflux, this surgery includes wrapping the upper portion of the stomach around the LES.
• LINX Reflux Management System: This is a newer procedure that involves placing a ring of magnetic beads around the LES to strengthen it and prevent reflux.
• Endoscopic treatments: These minimally invasive procedures involve using an endoscope to place devices or inject substances at the LES to improve its function and prevent reflux.
• Esophagectomy: This is a more invasive surgery that involves removing part or all of the esophagus in cases where there is severe esophageal damage or the risk of developing esophageal cancer.

Gastroenterologist: You may speak with a gastroenterologist or a general practitioner about Heartburn. Heartburn and gastroesophageal reflux disease are among the digestive problems that gastroenterologists specialise in (GERD).

Several types of medications can be used to treat Heartburn. The choice of medication depends on the severity and frequency of the symptoms, as well as any underlying conditions. Here are some of the best medicines for Heartburn:

• Antacids: Antacids are over-the-counter medications that work by neutralizing stomach acid. They provide quick relief for mild to moderate Heartburn symptoms. Common antacids include calcium carbonate (Tums) and magnesium hydroxide (Maalox).
• H2 blockers: H2 blockers are medications that work by reducing the amount of acid produced by the stomach. They can provide longer-lasting relief for moderate to severe Heartburn symptoms. Common H2 blockers include ranitidine (Zantac) and famotidine (Pepcid).
• Proton pump inhibitors (PPIs): PPIs are medications that work by blocking the production of stomach acid. They are used to treat more severe cases of Heartburn or gastroesophageal reflux disease (GERD). Common PPIs include omeprazole (Prilosec) and esomeprazole (Nexium).
• Prokinetics: Prokinetics are medications that work by speeding up the movement of food through the digestive system. They are used to treat conditions such as GERD and gastroparesis, which can cause Heartburn symptoms. Common prokinetics include metoclopramide (Reglan) and domperidone (Motilium).

The length of time it takes for Heartburn to go away varies on the condition's severity as well as personal variables including age, general health, and lifestyle choices. Moderate instances of Heartburn may go away in a few days to a week with the help of lifestyle modifications and over-the-counter drugs. Very severe instances may need prescription medicine, and recovery may take many weeks. Chronic Heartburn may require ongoing management with medication and lifestyle changes.

Heartburn treatment results vary based on the individual and the treatment used. Long-lasting relief may be achieved with some treatments while underlying causes need ongoing management. Proper treatment, management, and lifestyle changes help achieve long-term relief. Working with healthcare providers is necessary for a tailored treatment plan.

Several types of medications can be used to treat Heartburn. The choice of medication depends on the severity and frequency of the symptoms, as well as any underlying conditions. Here are some of the best medicines for Heartburn:

• Antacids: Antacids are over-the-counter medications that work by neutralizing stomach acid. They provide quick relief for mild to moderate Heartburn symptoms. Common antacids include calcium carbonate (Tums) and magnesium hydroxide (Maalox).
• H2 blockers: H2 blockers are medications that work by reducing the amount of acid produced by the stomach. They can provide longer-lasting relief for moderate to severe Heartburn symptoms. Common H2 blockers include ranitidine (Zantac) and famotidine (Pepcid).
• Proton pump inhibitors (PPIs): PPIs are medications that work by blocking the production of stomach acid. They are used to treat more severe cases of Heartburn or gastroesophageal reflux disease (GERD). Common PPIs include omeprazole (Prilosec) and esomeprazole (Nexium).
• Prokinetics: Prokinetics are medications that work by speeding up the movement of food through the digestive system. They are used to treat conditions such as GERD and gastroparesis, which can cause Heartburn symptoms. Common prokinetics include metoclopramide (Reglan) and domperidone (Motilium).

The cost of Heartburn treatment in India can vary depending on several factors, such as the severity of the condition, the type of treatment required, and the location of the hospital or clinic. Here are some estimated costs of Heartburn treatment in India:

• Over-the-counter (OTC) antacids: These are the most common treatment for occasional Heartburn and can cost between ₹50-200 per pack.
• Prescription medications: Prescription medications, such as proton pump inhibitors (PPIs) or H2 blockers, are often prescribed for more severe or frequent Heartburn. The cost of these medications can range from ₹500-2,000 per month.
• Endoscopy: If your doctor suspects that you have complications from Heartburn, such as esophagitis or Barrett's esophagus, they may recommend an endoscopy to examine the lining of the esophagus. The cost of an endoscopy can range from ₹5,000-15,000 depending on the location and facility.
• Surgery: In some cases, surgery may be required to treat severe Heartburn or complications such as a hiatal hernia. The cost of surgery can vary widely depending on the type of procedure and the location of the hospital, but it can range from ₹1,00,000-3,00,000 or more.

The side effects of Heartburn treatments can vary depending on the type of treatment used. Here are some possible side effects of common Heartburn treatments:

• Antacids: Antacids cause constipation or diarrhea, and long-term use can lead to electrolyte imbalances.
• Proton pump inhibitors (PPIs): They can lead to a higher risk of bone fractures, kidney damage, and certain infections, such as pneumonia and C. difficile.
• H2 blockers: Side effects of H2 blockers can include headache, dizziness, constipation, or diarrhea.
• Surgery: Risks associated with any surgical procedure, including bleeding, infection, and reaction to anaesthesia.