Heartburn, also known as gastroesophageal reflux (GERD), is a common condition accompanied by symptoms such as belching, acid reflux, nausea, and coughing and is often associated with poor digestion.
Usually without symptoms, heartburn can lead to difficulty sleeping as lying down promotes the rise of stomach acid from the stomach to the esophagus. While adjusting the diet and avoiding certain foods can provide relief, in some cases, it may not be sufficient. So, what are the causes of this disorder?
Causes of Heartburn
The causes of heartburn can vary, with some being temporary and resolving on their own, while others can persist for a lifetime. Common causes include:
- Gastroesophageal reflux: This condition requires an accurate diagnosis to determine the appropriate therapy. Proton pump inhibitors, such as pantoprazole, esomeprazole, lansoprazole, and rabeprazole, are commonly used, but they may not be effective for alkaline reflux rather than acidic reflux. It is essential to evaluate the type and frequency of reflux, as well as the presence of esophageal lesions or alterations in the cardia, the valve between the stomach and esophagus that prevents reflux of gastric juices or food from the stomach into the mouth. Gastroscopy and PH-impedance testing are recommended examinations for gastroesophageal reflux;
- Hiatal hernia: This condition occurs when a portion of the stomach protrudes from the abdomen into the chest through a hole in the diaphragm. Hiatal hernia can be symptomatic or asymptomatic but cannot be cured by dietary changes alone. The same applies when hiatal hernia is associated with gastroesophageal reflux;
- Esophagitis and gastritis: Gastroprotectants, or anti secretives, are valuable medications for esophagitis and gastritis. However, they should only be taken for limited periods. It is advisable to consult a gastroenterologist to determine the most suitable gastroprotectant, the duration and dosage of therapy, and, if necessary, multiple cycles throughout the year. Improper use of gastro protectants without medical indication or follow-up examinations increases mortality risk and osteoporotic fractures and reduces blood magnesium and vitamin B12 levels.
While dietary changes such as avoiding or limiting spices, coffee, alcohol, chocolate, fried and highly seasoned foods, adopting frequent small meals, and quitting smoking can help alleviate heartburn and stomach discomfort, they may not always be enough.
Specific drug therapy, along with lifestyle and dietary modifications, may be required to address conditions and diseases associated with heartburn, such as:
- Gastroesophageal reflux
- Gastroesophageal sphincter incontinence
- Hiatal hernia
- Alterations in the tone of esophageal and gastric muscles
- Gastric ulcer
Therefore, it is vital to consult a gastroenterology specialist to determine the underlying causes of gastric burning and, if necessary, undergo specific endoscopic examinations such as gastroscopy.