The ManicaPost
Dr Tendai Zuze Health matters
HEARTBURN is a flaming sensation in your chest, just behind your breastbone. Heartburn pain is often worse when lying down or bending over. Occasional heartburn is common and no cause for alarm. Most people can manage the discomfort of heartburn on their own with lifestyle changes and over-the-counter medications.
More frequent heartburn that interferes with your daily routine may be a symptom of something more serious that requires help from a doctor.
Symptoms of heartburn include a burning pain in the chest that usually occurs after eating and may occur at night or pain that worsens when lying down or bending over.
So what causes heartburn, well it occurs when stomach acid backs up into your oesophagus (the tube that connects your mouth to your stomach).
Normally when you swallow, your lower oesophageal sphincter — a circular band of muscle around the bottom part of your oesophagus — relaxes to allow food and liquid to flow down into your stomach. Then it closes again.
However, if the lower oesophageal sphincter relaxes abnormally or weakens, stomach acid can flow back up into your oesophagus, causing heartburn.
The acid backup may therefore be worse when you’re bent over or lying down.
Certain foods and drinks can trigger heartburn in some people, including: alcohol, fizzy drinks, black pepper, chocolate, coffee, fatty and fried food, tomato sauce, mustard, onions, orange juice and vinegar.
Some tests can be done to determine the extent of your heartburn, which, when the symptoms are interfering with your daily routine, is called gastroesophageal reflux disease(GORD).
An X-ray of your upper digestive system. Sometimes called a barium swallow or upper GI series, this procedure involves drinking a chalky liquid that coats and fills the inside lining of your digestive tract. Then X-rays are taken of your upper digestive tract.
Passing a flexible tube down your throat. Endoscopy is a way to examine the inside of your oesophagus.
During endoscopy, your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat.
The endoscope allows your doctor to examine your oesophagus and stomach. Your doctor may also use endoscopy to collect a sample of tissue (biopsy) for further testing
A test to monitor the amount of acid in your oesophagus. Ambulatory acid (pH) probe tests use an acid-measuring device to identify when, and for how long, stomach acid regurgitates into your oesophagus.
A test to measure the movement of the oesophagus. Oesophageal motility testing measures movement and pressure in the oesophagus.
The test involves placing a catheter through your nose and into your oesophagus.
Additional tests may be done to rule out other significant conditions.
Many over-the-counter medications are available to relieve the pain of heartburn. Options include:
Antacids that neutralise stomach acid. Antacids, such as MMT may provide quick relief. But antacids alone won’t heal an inflamed oesophagus damaged by stomach acid. Overuse of some antacids can cause side effects such as diarrhoea or constipation.
Medications to reduce acid production. Called H-2-receptor blockers, for example cimetidine, don’t act as quickly as antacids, but they provide longer relief.
Medications that block acid production and heal the oesophagus. Proton pump inhibitors, for example omeprazole, block acid production and allow time for damaged oesophageal tissue to heal.
You may also find heartburn relief by making small lifestyle changes. Consider trying to:
Maintain a healthy weight. Excess kilos put pressure on your abdomen, pushing up your stomach and causing acid to back up into your oesophagus.
Avoid tight-fitting clothing. Clothes that fit tightly around your waist put pressure on your abdomen and the lower oesophageal sphincter.
Avoid foods and drinks that trigger heartburn. Everyone has specific triggers. Avoid foods you know will trigger your heartburn.
Eat smaller meals.
Avoid overeating by eating smaller meals.
Don’t lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
Elevate the head of your bed. If you regularly experience heartburn at night or while trying to sleep, put gravity to work for you.
Place wood or cement blocks under the feet of your bed so that the head end is raised by fifteen or so centimetres. Raising only your head with additional pillows is not effective.
Don’t smoke. Smoking decreases the lower oesophageal sphincter’s ability to function properly.
Anxiety and stress can worsen heartburn symptoms.
Some complementary and alternative treatments may help you cope with anxiety and stress. If you are worried about heartburn please visit your doctor.
