Heartburn and Gastroesophageal Reflux Disease (GERD)

Heartburn facts

Despite its name, heartburn has nothing to do with the heart (although some of the symptoms are similar to a heart attack). Heartburn is an irritation of the esophagus caused by acid that refluxes (comes up) from the stomach. Heartburn is also a symptom of more serious gastroesophageal reflux disease, or GERD.

When swallowing, food passes down the throat and through the esophagus to the stomach. Normally, a muscular valve called the lower esophageal sphincter (LES) opens to allow food into the stomach (or to permit belching); then it closes again. Then the stomach releases strong acids to help break down the food. But if the lower esophageal sphincter opens too often or does not close tight enough, stomach acid can reflux or seep back into the esophagus, damaging it and causing the burning sensation we know as heartburn.

Not only can stomach acid in the esophagus cause heartburn, but it can also cause ulcers, strictures (narrowing) of the esophagus, and cancer of the esophagus.

Most people have felt heartburn at one time or another. In fact, the American Gastroenterological Association reports that more than 60 million Americans experience heartburn/GERD symptoms at least once each month. Though uncomfortable, heartburn does not usually pose a serious health problem for most people.

However, if heartburn symptoms occur frequently and persistently, it may be a sign of a more serious problem, such as gastroesophageal reflux disease (GERD). GERD is a chronic reflux of acid into the esophagus. Left untreated, GERD can cause a host of complications, including esophagitis, esophageal ulcers, hoarseness, chronic pulmonary disease, and Barrett's esophagus (a change in the lining of the esophagus that increases the risk of developing cancer of the esophagus).

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Heartburn and Pregnancy

Medical Author: Jay W. Marks, MD
Medical Editor: Melissa Conrad Stöppler, MD

"Doctor Jay! What can I do? I'm burning up!"

Linda was 7 months pregnant and the heartburn was overwhelming. To her, it seemed constant. She couldn't lie down at night. The discomfort of her bulging belly was nothing in comparison.

Linda has a lot of company. Heartburn (a symptom of gastro-esophageal reflux disease or GERD) occurs in one-quarter to one-half of all pregnant women. It usually begins in the first or second trimester of pregnancy and continues throughout the remainder of the pregnancy. Fortunately, the heartburn is usually mild and intermittent, but frequently enough, it is troublesome or severe. Complications of GERD (esophageal bleeding, trouble swallowing, loss of weight, etc.) are uncommon. In non-pregnant circumstances, heartburn is easily and successfully treated since there are several types of medication that are highly effective in relieving heartburn. The problem is that we do not know how safe these medications are for the developing fetus, and no one is going to test them in pregnant women to find out! About the best we can do is test them in pregnant animals at doses much higher than would ever be used in humans.

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