Heartburn (Dyspepsia)

Heartburn, or dyspepsia (dis-PEP-see-uh), is a broad term used to describe painful or otherwise uncomfortable feelings in the abdomen and sometimes extending into the chest and throat that occur after eating. Heartburn is also called acid indigestion. Symptoms of heartburn may include a burning sensation in the chest that moves toward the back of the throat after eating. The burning chest pain may especially occur when lying down after eating or when bending forward. The burning pain may be accompanied by a bothersome feeling that food is stuck partway down the esophagus (or food pipe).

Before or After?

Antacids, acid blockers, and protonpump inhibitors are three types of dyspepsia medications that individuals can buy without a doctor's prescription. These over-the-counter (OTC) medications work in different ways.

Antacids, which should be taken after a meal, neutralize the acids already present in the stomach. People usually feel better right away, but relief lasts only a few hours.

Histamine type 2 receptor blockers interfere with the action of histamine that signals stomach cells to produce acid.

Proton-pump inhibitors are especially effective because they destroy the enzyme that is responsible for making stomach acids in the first place. Because of this action, they can prevent heartburn from developing. Individuals usually take proton-pump inhibitors daily.

Lei's Story

Lei's grandfather always comes to her house for Sunday dinner. For several weeks in a row, he seemed uncomfortable after eating and did not lie down for his usual nap. Lei heard him talking to her father about heartburn. This scared Lei, who thought that her grandfather was having heart problems.

When Lei asked her grandfather what was wrong with his heart, he explained that people with heartburn, which is also called acid indigestion, often complain of a burning feeling in the chest, close to where the heart is located. Usually, however, heartburn has nothing to do with the heart. The discomfort in the chest and throat occurs when the stomach contents, which include acid and digestive enzymes * , move backward into the esophagus, or food pipe. This stomach juice escapes into the food pipe when the muscular valve between the stomach and esophagus relaxes. The acidic juice irritates the lining of the esophagus and results in a burning feeling in the chest. People sometimes mistake the feeling for a heart attack. The backup of stomach juice, which doctors call acid or gastroesophageal reflux, can also cause a bitter, sour taste in the throat and mouth. Heartburn usually occurs after a meal and can last for several hours, often becoming worse when the individual is lying down.

What Is Heartburn?

Heartburn is a type of dyspepsia. Dyspepsia comes from the Greek words for “bad digestion,” and it covers a wide range of stomach-related symptoms, including a burning or aching in the upper abdomen, heartburn, bloating, nausea, and vomiting. Symptoms typically return again and again. Heartburn is not in itself a disease but can be a symptom of more serious problems.




Heartburn occurs when the contents of the stomach move backward through the muscular valve called the lower esophageal sphincter and up into the esophagus.





Heartburn occurs when the contents of the stomach move backward through the muscular valve called the lower esophageal sphincter and up into the esophagus. The stomach's acid and digestive enzymes irritate the lining of the esophagus, causing a burning feeling in the chest and a bitter, sour taste in the throat and mouth.
Illustration by Electronic Illustrators Group. © 2016 Cengage Learning®.

While dyspepsia is quite widespread among adults, children rarely get it. They might feel indigestion after overeating, but children usually do not have heartburn or other types of dyspepsia.

By itself, dyspepsia is not a disease. Instead, it is a collection of uncomfortable symptoms that may arise because a person eats or drinks too much or is feeling stressed, anxious, or depressed. Nonetheless, a person who has recurring or frequent bouts of heartburn should see a doctor because this may be a sign of other disorders, including:

How Is Heartburn Diagnosed, Treated, and Prevented?

Heartburn is diagnosed in part by the patient's history of discomfort after eating. Doctors also use various tests to confirm heartburn or dyspepsia. Some of these help the doctor to rule out other possible conditions, while others test specifically for dyspepsia. With respect to heartburn and acid reflux, x-ray studies may show the reflux of swallowed material from the stomach into the esophagus. A pH probe may be placed within the esophagus to directly demonstrate that gastric acid is entering into the esophagus. A flexible endoscope * may be passed into the esophagus to observe the inflammation, or esophagitis, that has resulted.

Guidelines for preventing heartburn include:

See also Appendicitis • Gallstones • GERD (Gastroesophageal Reflux Disease) • Hernia, Gastrointestinal • Pancreatitis • Peptic Ulcer

Resources

Websites

Brubaker, Michelle. “GERD Study Offers Minimally Invasive Procedure at No Cost.” U.C. San Diego Health Newsroom, September 21, 2015. (accessed June 8, 2016).

Goldman, Bruce. “Some Heartburn Drugs May Boost Risk of Heart Attack, Study Finds.” Stanford Medical Center News, June 10, 2015. https://med.stanford.edu/news/all-news/2015/06/some-heartburn-drugs-may-boost-risk-of-heart-attack-study-finds.html (accessed September 21, 2015).

“Heartburn ‘Possible Cancer Sign’ Warning.” BBC News, January 26, 2015. http://www.bbc.com/news/health-30953825 (accessed July 16, 2015).

Mayo Clinic. “Diseases and Conditions: Heartburn.” http://www.mayoclinic.org/diseases-conditions/heartburn/basics/definition/con-20019545 (accessed June 8, 2016).

MedlinePlus. “Heartburn.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/heartburn.html (accessed July 16, 2015).

Organizations

American Gastroenterological Association. 4930 Del Ray Ave., Bethesda, MD 20814. Telephone: 301-654-2055. Website: http://www.gastro.org (accessed July 16, 2015).

National Institute of Diabetes and Digestive and Kidney Diseases. 9000 Rockville Pk., Bethesda, MD 20892-2560. Telephone: 301-496-3583. Website: http://www.niddk.nih.gov (accessed March 28, 2016).

* enzymes (EN-zimes) are proteins that help speed up a chemical reaction in a cell or organism.

* endoscope (EN-duh-skope) is a tool for looking inside parts of the body. It consists of a lighted tube and optical fibers and/or lenses.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)