Heartburn (Acid Reflux) | What It Is, Causes, Symptoms, Complications & Treatment Options

The term “heartburn” refers to the burning sensation that you (and millions) feel in your chest behind the breastbone (sternum). Along with this feeling, you may also feel a sour (or bitter) taste in your throat and mouth. This sensation usually occurs or worsens after eating or lying down. It usually lasts from a few minutes up to hours. But, despite the name, it doesn’t affect your heart.

Heartburn is a fairly common symptom that millions all over the world experience. You may be one of these millions who know how it is an unpleasant feeling.

Heartburn isn’t a disease; it’s a symptom that indicates a problem with stomach acid. Generally, it is just discomfort, and most people can control it by modifying their lifestyle and over-the-counter (OTC) medications. But, frequent and prolonged heartburn may indicate more severe diseases, such as GERD (gastroesophageal reflux disease). Also, people with heart disease or who are at risk of heart attack should pay attention to this feeling because it is similar to the symptoms of a heart attack.

Diagnosis of heartburn requires knowing the underlying cause that may be dangerous. It includes history taking, physical examination, and investigations to confirm the cause and assess the severity of heartburn.

Management of heartburn depends on its cause. Generally, OTC medications can relieve it. If they failed, your doctor would prescribe other drugs and order further investigations to reach the underlying cause. Lifestyle modifications are essential for the management plan for heartburn that corrects many of its triggers.

  • Now, let’s dig into the details of this common condition. It’s usually occasional, but you should know when to worry about this feeling and see your doctor. 

First, to understand how and why heartburn occurs, you should understand the physiology of stomach acid and how it can lead to heartburn.

Stomach acid

You eat your food through the mouth, and then it travels through the esophagus to reach the stomach. The esophagus is a long tube that connects the mouth and stomach. At its lower end, there is a valve called the lower esophageal sphincter (LES). It allows the food to reach the stomach and then closes to keep the stomach contents down.

Then, the stomach secretes a potent acid (HCL) to begin food digestion. Your stomach can naturally tolerate this acid without getting injured because its wall includes cells that secrete a protective mucous layer.

But, your esophagus isn’t the same; it doesn’t have protection against stomach acid. The stomach acidic mixture damages its unprotected wall and causes inflammation. When the LES can’t close properly (due to any cause), the stomach contents -including the acid- goes back into the esophagus. This condition is acid reflux, which causes heartburn.