Heartburn is a burning sensation in the chest, typically behind the breastbone, which can sometimes rise into the throat. This common symptom occurs when stomach acid flows back into the esophagus, the tube connecting the mouth to the stomach. While many experience occasional heartburn, this article focuses on persistent, chronic issues. Understanding its causes is key to finding relief.
Beyond Occasional Discomfort
Occasional heartburn links to dietary choices or habits. Persistent heartburn frequently stems from ongoing lifestyle patterns that consistently trigger symptoms. Regular consumption of fatty, spicy, or acidic foods can irritate the esophageal lining. Beverages like caffeine and alcohol also contribute by relaxing the muscular ring that prevents acid reflux.
Large meals or eating close to bedtime can prolong stomach acid presence in the esophagus. Smoking can weaken the esophageal sphincter, allowing acid to escape. Tight clothing that puts pressure on the abdomen may push stomach contents upward. These habits prevent esophageal healing, leading to persistent symptoms.
Underlying Medical Explanations
Persistent heartburn often indicates an underlying medical condition. Gastroesophageal Reflux Disease (GERD) is a common chronic form of acid reflux where the lower esophageal sphincter (LES) doesn’t close properly, allowing frequent stomach acid flow into the esophagus. This constant acid exposure leads to irritation and inflammation.
A hiatal hernia can also contribute to persistent heartburn. This occurs when a portion of the stomach pushes up through the diaphragm, making acid reflux easier. Esophagitis, inflammation of the esophagus, often results from chronic acid exposure, causing persistent burning and discomfort.
Certain medications may also induce or worsen heartburn. NSAIDs, for example, can irritate the stomach lining and reduce its protective mucus barrier, potentially leading to acid reflux. Some blood pressure medications or muscle relaxants can also relax the LES, increasing acid backflow. Less commonly, Helicobacter pylori (H. pylori) infection, which causes stomach inflammation, might contribute to persistent heartburn symptoms.
When to Seek Professional Guidance
Persistent heartburn can signal a serious underlying condition requiring medical attention. Consult a healthcare professional if heartburn occurs more than twice a week, even after over-the-counter remedies. Specific “red flag” symptoms also warrant immediate medical evaluation.
Difficulty swallowing (dysphagia) or painful swallowing (odynophagia) should prompt a doctor’s visit. Unexplained weight loss, persistent nausea or vomiting, black, tarry stools, or vomiting blood are serious symptoms requiring urgent medical care. Ignoring these warning signs or self-treating severe heartburn can delay diagnosis and appropriate management of serious health concerns.
Managing Persistent Heartburn
Managing persistent heartburn involves lifestyle adjustments and, when necessary, medical interventions. Dietary modifications are a primary step, including smaller, more frequent meals. Identifying and avoiding trigger foods that worsen symptoms, such as high-fat foods, chocolate, or mint, can also provide relief.
Maintaining a healthy weight can reduce abdominal pressure and lessen reflux. Elevating the head of the bed by six to eight inches during sleep can also help gravity keep stomach acid down. Quitting smoking is important, as nicotine can relax the LES and increase acid production.
Over-the-counter antacids provide temporary relief by neutralizing stomach acid. H2 blockers reduce acid production and offer longer-lasting relief. For persistent symptoms, prescription proton pump inhibitors (PPIs) are often prescribed. PPIs block acid production more effectively and help heal the esophageal lining.