Heartburn: triggers, causes and how to manage

Heartburn is a symptom of a wide range of diseases which may include stomach and intestinal ulcers.

Heartburn is a feeling of sharp, burning pain in the upper part of the stomach or lower part of the chest. It sometimes radiates toward the chest and throat.

Other causes of heartburn may include:

Gastritis: This is inflammation occuring in the stomach lining and is often caused by abuse of NSAIDs, alcohol or Helicobacter pylori infection.

Duodenal Ulcer: This type of ulcer occurs in the upper part of the small intestine, called the duodenum. Duodenal ulcers are more often caused by a bacterium Helicobacter pylori. Treatment is by eradication of this bacteria through the use of antibiotics in combination with acid-lowering medications.

Esophagitis: This occurs due to inflammation in the lining of the esophagus, the tube that connects the mouth to the stomach.

Gastroesophageal reflux disease (GERD): this is due to reflux of acidic content from the stomach into the esophagus, causing heartburn and acidic taste.

Hiatal hernia: this is when the stomach is pushed into the chest cavity due to a defect in the diaphragm. It can also cause heartburn and acid reflux.

Stress Ulcer: ulcer can occur in the stomach or duodenum as a result of physical stress, such as a serious illness or injury. Stress ulcers can cause bleeding and other complications.

Curling’s Ulcer: This type of ulcer can occur in the stomach or duodenum as a result of severe burns, and is caused by a decrease in blood flow to the digestive system.

Cushing Ulcer: This type of ulcer can occur in the stomach or duodenum as a result of a head injury or brain surgery, and is caused by an increase in stomach acid production.

Hepatitis or inflammation of the liver: inflammation can lead to sudden stretch of the liver tissues and elevation of toxic substances in the liver, which can manifest as heartburn.

Gastric or oesophageal cancers: These are rare, but can also cause heartburn and be mistaken for simple ulcers.

Other tumours or cancers that can trigger excessive acid production in the stomach (also very rare). For example, Gastrinoma.

It’s important to see a doctor and run further tests to identify the cause of heartburn.”Common things occur commonly” but you can’t be too sure what is causing your heartburn or what type of ulcer you have.

Lastly, let’s talk about the risk factors and triggers of gastrointestinal ulcers in general. Once you know them, it’s your responsibility to avoid them. The treatment may not be effective if you refuse to stay away from these triggers…

Eating certain foods: Some foods, such as spicy or fatty foods, chocolate, caffeine, and citrus fruits can trigger heartburn.

Fizzy drinks: soda is not your friend if you have ulcer. Stay away!

Large meals: Eating large meals or overeating can increase the likelihood of experiencing heartburn. Also, going to bed immediately after eating can trigger heartburn.

Alcohol: drinking is never good for anyone, let alone ulcer patients!

Pregnancy: Hormonal changes during pregnancy can relax the lower esophageal sphincter (LES), the muscle that controls the opening between the esophagus and stomach, allowing stomach acid to flow back into the esophagus. Of course, we can’t avoid pregnancy because of this, but we can take steps to manage it effectively. To prevent heartburn, prop up your pillows and avoid lying down immediately after eating. Also avoid the other triggers as discussed. New onset heartburn in the third trimester is a red flag and you must see your doctor immediately.

Obesity: Being overweight or obese can put pressure on the stomach and LES, leading to acid reflux and heartburn.

Medications: Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and some blood pressure medications, can cause heartburn as a side effect. These can be substituted with more stomach-friendly alternatives.

Smoking: Smoking can weaken the LES and increase the risk of acid reflux and heartburn.

Stress: Stress can cause the body to produce more stomach acid, leading to heartburn. During severe illnesses or after a traumatic accident, doctors normally prescribe anti-ulcer drugs to protect your stomach from coming down with stress ulcers.

In conclusion, heartburn is a symptom and not a disease in itself. It’s often due to gastrointestinal ulcers or acid reflux, but you need to see your doctor for clinical evaluation to determine the cause and the best course of action.

© Doctor KT