Heartburn
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What is heartburn?
Heartburn is an irritation of your esophagus, which is the tube that connects your stomach to your throat. Heartburn is caused by stomach acid and leads to a burning discomfort in your chest behind your breastbone or in your upper belly. The pain tends to be worse after eating, in the evening, when lying down, or bending over. Intermittent heartburn is quite common and most people can control the discomfort with lifestyle changes and over-the-count medications. If your heartburn becomes more frequent or interferes with your daily life it may be a symptom of a more serious condition that could require medical attention.
What causes heartburn?
Heartburn happens when stomach acid backs up into your esophagus. Normally when you swallow a band of muscle around the bottom of your esophagus, called your lower esophageal sphincter (LES), relaxes and allows food and liquid to flow into your stomach, then the muscle tightens again. If your LES relaxes abnormally or becomes weak stomach acid can easily flow up into your esophagus (acid reflux) and cause heartburn. Some foods and drinks can trigger heartburn, common triggers include:
- Spicy food
- Onions
- Citrus fruits or products
- Tomatoes or tomato products
- Fatty or fried foods
- Peppermint
- Chocolate
- Alcohol, carbonated beverages, coffee or other caffeinated beverages
- Large or fatty meals
Other non-consumption related conditions that can increase your risk of heartburn include
- Pregnancy
- Being overweight or obese
How long does heartburn last?
Heartburn affects people differently. For some people, it may only last a few minutes, while for others heartburn may last for several hours. Having occasional heartburn should not be worrisome, however long-term heartburn, known as GERD (gastroesophageal reflux disease) can often lead to serious issues like:
- Long term cough
- Laryngitis
- Inflammation or ulcers of the esophagus
- Problems swallowing because of a narrow esophagus
- Barrett’s esophagus, which is a condition that can increase your risk of esophageal cancer
Diagnosis of heartburn
Heartburn is a common symptom of GERD, your doctor can typically diagnose you with heartburn after reviewing your medical history and symptoms. Your doctor could recommend testing to determine if your heartburn is caused by GERD. Testing could include:
- X-ray - with an x-ray your doctor can see the shape and condition of your esophagus and stomach
- Endoscopy - works to check for abnormalities in your esophagus with the use of a camera at the end of the endoscope. A biopsy can also be taken during your endoscopy if necessary
- Acid probe tests - this test is used to know when and how long stomach acid backs up into your esophagus. Your doctor will place an acid monitor in your esophagus which connects to a computer to monitor the reactions of your esophagus
- Esophageal motility testing - this type of testing measures the movement and pressure in your esophagus
Where can I get treatment for heartburn?
To receive treatment for heartburn you can make an in-person appointment with your healthcare provider. But, because heartburn can be diagnosed with your health history and symptom review you can simply schedule an appointment with an online doctor with the use of telemedicine. This is an extremely convenient option for those who have limited time in their schedules. Please see the following list of online companies that can treat your heartburn:
- MeMD
- Lemonaid Health
- PlushCare
- CallonDoc
- Evens
- Alpha medical
- Cabinet Health
- Carie health
How to treat heartburn
Heartburn can be treated with lifestyle changes and over the counter medication. If lifestyle changes and over-the-counter medications don’t work for you or you rely on them often you may need to talk to your doctor about further testing.
Over the counter medication
- Antacids - work to neutralize stomach acid, they provide quick relief but they ultimately will not heal an inflamed esophagus damaged by stomach acid. If you use antacids too often they can cause side effects like diarrhea or kidney problems. Common antacids include:
- Mylanta
- Rolaids
- Tums
- Maalox
- H-2 receptor blockers - work to reduce acid production. They don’t work as quickly as antacids but provide longer relief and decrease acid production from the stomach for up to 12 hours. Common H-2 blockers include:
- Cimetidine (Tagamet HB)
- Famotidine (Pepcid AC)
- Nizatidine (Axid AR)
- Ranitidine (Zantac 75)
- Proton pump inhibitors - work to block acid production and heal the esophagus. This medication is a stronger acid blocker than H-2 blockers and provide time for damaged esophageal tissue to heal. Common proton pump inhibitors include
- Lansoprazole (Prevacid 24 HR)
- Omeprazole (Prilosec OTC, Zegerid OTC)
Lifestyle Changes
- Maintain a healthy weight - Excess weight puts pressure on your stomach that could cause acid to back up into your esophagus
- Avoid tight-fitting clothing and belts - these will put pressure on your abdomen and LES
- Avoid heartburn triggering food and drink
- Avoid lying down after a meal - it is recommended to wait 2-3 hours after your meals
- Avoid eating late in the evening.
- Elevate the head of your bed - if you experience heartburn at night when you are trying to sleep you could place a wedge or blocks between your mattress and box spring to elevate the top half of your body. You could also simply raise your head up with extra pillows.
- Avoid smoking and alcohol
- Avoid eating large meals - eat small meals more frequently throughout the day
Heartburn can be terribly uncomfortable, but with advancements in technology today you are able to easily and affordably meet with a doctor with the use of telemedicine. There are many high-quality online healthcare companies that can set you up with an appointment with one of their trustworthy providers to discuss your symptoms of heartburn and make a personalized treatment recommendation for you. We have done the hard work for you and have compiled a list of the top online doctors that treat heartburn, check them out today!