Heartburn

• Heartburn is the most common symptom of gastroesophageal reflux disease (GERD)
• Heartburn is caused when stomach acid refluxes into the esophagus and causes irritation
• Treatment of heartburn can involve medications or minimally invasive surgery

Causes of Heartburn
Heartburn is the most common symptom gastroesophageal reflux disease (GERD). It is caused when the acid contained in stomach contents comes in contact with the fragile lining of the esophagus. This is what happens when the valve separating the stomach from the esophagus; the lower esophageal sphincter; stops working. The stomach lining is very “tough” and is meant to withstand the acid it normally contains. However, when reflux occurs, the acid coming in contact with the lining of the esophagus causes irritation. This irritation can be thought of as a burn; similar to a burn o the skin. This causes the pain and burning that is described as “heartburn.”

Symptoms of Heartburn
Although heartburn is actually a symptom in and of itself, it may be perceived in different ways by different people. Typically it is thought of as a burning feeling, starting in the upper abdomen and progressing upward into the chest, usually under the breastbone. Others may have a feeling of burning that is accompanied by a pressure sensation in the chest. Some even describe indigestion. Often, even in the same sentence, patients will interchange the terms heartburn and chest pain; actually having trouble describing exactly what they are feeling. These symptoms and their descriptions can be similar to what patients feel when they are having pain due to heart disease or even a heart attack. Although heartburn usually means GERD, it must be differentiated from the symptoms due to heart disease. Testing for GERD as well as heart disease may be required to sort this out.

Treatment of Heartburn
Heartburn is caused by acid in the stomach contents that reflux into the esophagus causing irritation. Two approaches are used to address this. The first and most common is medication to either neutralize the stomach acid or cause the stomach to make less of it. By removing or reducing the irritant from the fluid that is refluxing, irritation in the esophagus is reduced and the symptoms of heartburn are usually improved. However, under this scenario, the reflux continues but it just does not contain acid. The second approach is to actually restore the function of the valve between the stomach and the esophagus (LES) to actually stop the reflux. With a functional valve, the stomach still makes acid, but it stays where it belongs. If there is no acid refluxing into the esophagus, there is no heartburn. In order to restore LES function, a minimally invasive surgical procedure is required, several of which are available through the Heartburn Treatment Center.