Medical information for patients

Heartburn

Heartburn is a discomfort or pain caused by the stomach contents regurgitating from the stomach up into the gullet (oesophagus). The oesophagus is not made to withstand acid and is thus irritated and inflamed when acid from the stomach refluxes into it. This is known as reflux oesophagitis.

Symptoms

The pain caused by the irritation of the oesophagus is a burning pain which you feel in the centre of the chest. There is often an associated awareness of acid and stomach contents in the back of the throat or mouth. Lying down or bending forwards tends to increase the symptoms.

Causes

The whole of the intestinal tract is in the form of a tube with muscles in the wall which move the food along (peristalsis). At the bottom of the oesophagus the muscles encircling the tube work rather like a valve to stop food going backwards. This is not a perfect valve, but in some people works less well than others:

Diagnosis

Your doctor may well make the diagnosis from the symptoms you describe, but may wish to investigate further.

Endoscopy is the most commonly used test and involves a fibre-optic tube which is passed down your throat, enabling your doctor to examine the oesophagus, stomach, and duodenum. If any abnormal areas are seen a sample may be taken and sent to a laboratory for analysis. Usually you are given an injection which makes you sleepy during the procedure and also tends to make you forget what went on.

Sometimes an X-Ray is used, in the form of a barium meal, which monitors the passage of a drink containing a heavy element which shows up the oesophagus and stomach in silhouette.

Treatment and prevention


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