Digestive Diseases: Heartburn and Gastroesophageal Reflux Disease (GERD)
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.
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 International Foundation for Functional Gastrointestinal Disorders reports that about 20%, or one in five, of Americans experience heartburn at least once a week. 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).
Reporting these symptoms to your doctor is usually all that is needed for your doctor to diagnose heartburn. However, your doctor may perform special tests such as endoscopy or pH monitoring to determine the severity of your problem or to monitor your treatment.
Various lifestyle and dietary factors can contribute to heartburn by relaxing the lower esophageal sphincter and allowing it to open, increasing the amount of acid in the stomach, increasing stomach pressure, or by making the esophagus more sensitive to harsh acids. These factors include:
Treating heartburn requires adjustments to your lifestyle, medications, and possibly surgery if your heartburn is due to GERD.
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