What is the best treatment for heartburn?

Various factors should be reviewed when choosing an appropriate treatment, such as other medications you are taking, health problems you may have, the frequency and severity of your attacks and your own personal triggers. Your health care professional can help you to choose a product that fits your needs.

What does heartburn feel like?

The symptoms of heartburn vary widely and can be difficult to describe. However, people with heartburn generally describe one or more of the following symptoms:

a burning chest pain that begins at the breastbone and moves up toward the throat
a feeling that food is coming back into the mouth
an acid or bitter taste at the back of the throat
an increase in severity of pain when lying down or bending over

If you suffer from any of symptoms, your healthcare professional can help you choose a treatment that fits your needs.

What causes heartburn?

Stomach juices, which are produced by the stomach to help the body break down food, contain a powerful acid called hydrochloric acid. While the stomach is naturally protected from this potent acid, the esophagus does not share the same protective qualities as the stomach.

Heartburn is caused when this powerful stomach acid refluxes—or flows backward—into the esophagus. This generally occurs when the lower esophageal sphincter (or the LES)—the natural valve that keeps stomach acid in the stomach and out of the esophagus —does not do its job properly. When functioning normally, the LES opens like a door that allows food into the stomach but not back up the same way. However, at times the LES relaxes and it allows stomach acid flow upward into the esophagus. This relaxation exposes the esophagus to the harsh acid from the stomach and often results in the sensation known as heartburn.

Various lifestyle and dietary factors as well as certain medications can contribute to heartburn by increasing the relaxation of the LES, increasing the amount of acid produced in the stomach, increasing stomach pressure, or making the esophagus more sensitive to harsh acid. These triggers vary from person to person. The most common contributing factors include the following:

Eating/Dietary Habits

Eating foods such as citrus fruits, chocolate, peppermint, spearmint, tomatoes or tomato-based products, raw onions, garlic, black pepper, vinegar and fatty or spicy foods. Foods that are fatty or greasy slow down digestion which means that acid and food are in the stomach longer. This gives the acid a greater opportunity to move backwards into the esophagus. In addition, some foods, such as peppermint, spearmint and chocolate cause the LES to loosen or relax thus allowing acid to enter the esophagus.

Drinking beverages such as coffee, citrus juices, and caffeinated, carbonated or alcoholic beverages. Beer and beverages with caffeine such as coffee, tea and cola raise the level of acidity in the stomach, making stomach juices even more irritating. Citrus juices, spicy foods and tomato products directly irritate the esophagus.

Eating large portions — your stomach responds to large portions by producing large amounts of acid at one time. More stomach acid means a greater chance of acid reflux.

Eating before bedtime — acid levels are high after mealtime, and certain positions such as lying down make it easier for acid to move into your esophagus.

Certain positions

Lying down, especially after eating
Bending over

Medical reasons

Talk to your health care professional about alternatives if you suspect one of your medications may be contributing to your heartburn, but never stop taking any prescription medication without checking with your doctor.

Gastroesophageal reflux disease (GERD)

Pregnancy — Hormones (progesterone) produced during the first trimester of pregnancy can loosen the LES. In addition, as the body makes room for the growing baby, organs such as the stomach become pushed up into the abdominal cavity and increase the pressure on the LES. This increased pressure often results in acid reflux. If you're pregnant, consult your physician before taking any medication.

Hiatal Hernia — When a hiatal hernia is present, part of the stomach is moved up closer to the chest, moving the source of acid closer to the esophagus.

Taking certain medications — some prescription and over-the-counter (OTC) medications can contribute to heartburn. These commonly include high blood pressure and heart medications. Asthma medications can both lower LES pressure and stimulate acid production contributing to heartburn. Antibiotics can be irritating to the esophagus.



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