The Leading Causes of Heartburn

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Heartburn is a burning sensation in your stomach that spreads into your throat or chest, and is experienced by almost everyone at some point. Many of the leading causes of heartburn are actually due to lifestyle factors that can be modified.

The Esophageal Sphincter Is Important

Your esophagus, or food tube, is one big muscle that extends from your mouth to your stomach. The muscle or esophageal sphincter that is responsible for preventing stomach contents from backing up into the stomach can become weak or leaky leading to heartburn symptoms. Most, but not all, causes of heartburn are related to their impact on the esophageal sphincter.

The leading causes of heartburn include:

  • Smoking: Smoking does a number of things that can lead to heartburn. First, smoking appears to weaken the esophageal sphincter making it more likely that heartburn will occur. Second, smoking increases production of acid in the stomach and decrease production of saliva that can neutralize acid. Quitting smoking can decrease heartburn symptoms, especially if you have a number of the other causes or risk factors.
  • Alcohol: As with smoking, alcohol relaxes the esophageal sphincter and can increase the risk of heartburn.
  • Medications: A number of different medications can lead to heartburn symptoms. Some examples include:

o Nonsteroidal anti-inflammatory drugs (NSAIDs) - Common pain relievers.

o Calcium channel blockers - High blood pressure treatments.

o Hormone replacement therapy - Common treatment for menopausal symptoms.

o Antibiotics - Used to treat infections.

o Iron pills - Treatment of anemia.

o Bisphosphonates - Treatment of osteoporosis.

  • Obesity: Obesity can make heartburn worse. Losing weight appears to decrease heartburn symptoms.
  • Eating habits: Laying down after eating, eating just before bed, or bending over after eating all increase risk of developing heartburn. Additionally, certain types of foods can increase the risk of heartburn. Fried foods, caffeine, acidic fruits, and chocolate all weaken the esophageal sphincter and lead to heartburn symptoms.
  • Pregnancy: Generally, heartburn increases as pregnancy moves further along. As the uterus gets bigger, more pressure is placed on the stomach, resulting in increased pressure. The increased pressure results in more heartburn. This condition may not respond well to intervention, but should disappear after the pregnancy
  • Respiratory Conditions: Asthma and COPD are related to heartburn as patients with these conditions are more likely to develop heartburn compared to patients without these conditions.
  • Hiatal Hernia: This condition occurs when part of the stomach protrudes into the chest, impairs the esophageal sphincter, resulting in heartburn symptoms.
  • Tight Fitting Clothes: Tight belts or garments designed to make you look thinner like girdles, increase pressure in the stomach and increase risk of heartburn.

Heartburn- When Do I Need To Call My Doctor?

If you experience heartburn for more than 2 weeks or need to take over-the-counter medications to prevent or treat heartburn symptoms, you need to discuss this with a healthcare provider. Additionally, nausea, vomiting, losing weight, pain when swallowing, blood in the stool or worsening abdominal pain are also worrisome symptoms that require the attention of a physician.

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