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Internal Medicine => Gastro Enterology => Heart Burn
Heart Burn
Heartburn, condition characterized by a burning feeling in the chest and a sour or bitter taste in the mouth. Heartburn typically develops when the acidic contents of the stomach flow back, or regurgitate, into the esophagus, the muscular tube that carries food from the throat to the stomach. Approximately one in ten adults experiences heartburn once a week. Heartburn is more common in pregnant women because of the pressure the expanding uterus exerts on the stomach.
Normally the contents of the stomach are held in place by the lower esophageal sphincter, a muscle at the lower end of the esophagus that allows food to pass into the stomach. If this muscle relaxes, or is too weak, the food can flow out of the stomach and back into the esophagus.
There are several reasons why the esophageal sphincter may relax. Substances found in some spicy foods, alcohol, or in cigarettes may cause the muscle to relax. Overeating or being overweight can increase pressure in the abdomen and stomach enough to weaken the muscle of the sphincter. In addition, the sphincter may be affected by a hiatal hernia, a condition in which a portion of the stomach protrudes through the same opening in the diaphragm that the esophagus passes through to connect to the stomach. Some medicines can weaken the lower esophageal sphincter, encouraging heartburn. These include oral contraceptives, asthma medications, and some heart medications.
Heartburn is generally diagnosed with a complete description of the symptoms. In severe cases, a physician may order a barium X ray of the stomach and esophagus to rule out other problems. Alternatively, a physician may examine the esophagus with an endoscope, an instrument that can view the interior of the digestive tract, and take tissue and fluid samples.
There are several treatments for heartburn. In mild cases, over-the-counter medications such as antacids can relieve occasional bouts. Chronic heartburn can be treated with medications that prevent the production of acid in the stomach. Several of these medicines are now sold over the counter; others are available only by prescription.
Lifestyle changes, such as quitting smoking or losing weight, also can alleviate or prevent heartburn. Sleeping with the head of the bed elevated 15 cm (6 in) helps prevent the stomach's contents from flowing back into the esophagus. Going to bed on an empty stomach, and cutting back on consumption of alcohol, fat, chocolate, and peppermint also can prevent heartburn.
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