Pyrosis is the medical term used to describe the symptom commonly known as heartburn, which is a burning sensation felt in the chest or throat. This discomfort occurs when stomach acid travels backward into the esophagus, the tube connecting the mouth and stomach. Although the term suggests a problem with the heart, pyrosis is strictly a digestive issue caused by acid reflux. The pain can be severe enough to be mistaken for a cardiac event.
The Mechanism of Acid Reflux
Pyrosis is directly caused by a failure in the body’s natural defense mechanism against stomach acid. The lower esophageal sphincter (LES) is a ring of muscle fibers that functions as a valve between the esophagus and the stomach, normally remaining tightly closed to prevent backflow. When the LES relaxes inappropriately or weakens, it allows the highly acidic contents of the stomach to reflux into the lower esophagus. The esophageal lining is not protected from this harsh acid, leading to irritation and the characteristic burning sensation. If this reflux occurs frequently, it may indicate a more chronic condition known as gastroesophageal reflux disease (GERD).
Common Triggers and Contributing Factors
Factors that contribute to acid reflux either weaken the LES or increase pressure in the stomach. Certain dietary choices are well-known triggers because they can relax the LES or stimulate acid production. Common culprits include:
- High-fat foods
- Spicy dishes
- Citrus fruits
- Tomato-based products
- Chocolate
- Caffeine
- Alcoholic beverages
Lifestyle habits also play a significant role in promoting pyrosis. Smoking is a notable factor, as the chemicals in tobacco can directly irritate the esophagus and decrease the LES’s ability to close effectively. Eating very large meals or lying down too soon after eating can increase pressure on the stomach, mechanically forcing acid past the sphincter. Physical conditions such as obesity and pregnancy also increase abdominal pressure, which can push the stomach contents back up into the esophagus.
Immediate Relief and Management
Relieving pyrosis symptoms involves both immediate measures to counteract the acid and long-term adjustments to prevent its occurrence. For quick relief of occasional symptoms, over-the-counter antacids containing ingredients like calcium carbonate work by chemically neutralizing the stomach acid already present. For more frequent or persistent pyrosis, other medications offer longer-lasting effects by reducing the amount of acid the stomach produces. These include histamine H2-receptor blockers, which decrease acid secretion, and proton pump inhibitors (PPIs), which are stronger and suppress acid production for a longer duration. Beyond medication, simple lifestyle modifications can significantly reduce the frequency of reflux episodes.
Eating smaller, more frequent meals and avoiding food consumption within three hours of bedtime allows the stomach to empty before lying down. Elevating the head of the bed by six to nine inches helps gravity keep stomach contents down, which is especially helpful for nighttime symptoms.