Heartburn is a burning pain starting behind the breastbone and radiating upwards. The hydrochloric acid from the stomach leaks into the esophagus and causes heartburn. Occasional heartburn due to rich food or other lifestyle causes is classified as mild or episodic. Heartburn occurring twice or more in a week is moderate or frequent. Everyday problems even with a proper diet and lifestyle is severe or chronic. Five to 15 percent of heartburn sufferers suffer from chronic heartburn. Chronic heartburn is caused by the lower esophagus sphincter muscle tone becoming weak, or eroded by stomach acid, and the one-way valve is unable to seal the acid inside the stomach. It can also be caused by other factors like motility problems, high stress, the lining of esophagus becoming sensitive, and constant medication for other chronic conditions. In some extreme cases, the mere act of bending down will bring acid into the esophagus. If the chronic condition prevails for long, it may lead to difficult conditions like difficulty in swallowing, coarseness of the throat, chronic laryngitis, respiratory problems like asthma or pneumonia, severe cough, and others. Before chronic heartburn is diagnosed it is important to rule out more serious diseases which cause heartburn only as a symptom. These include hiatal hernia, GERD, peptic ulcer, gall bladder disease, gastritis and a tear in the esophagus. Investigation for these ailments needs extensive equipment and specialists. Chronic heartburn is treated with strict lifestyle changes, which include modifying eating and sleeping habits, avoiding stress, stopping smoking, reducing weight, avoiding pressure on the stomach, and exercising. Over-the-counter medication with antacids, H2 blockers and proton pump inhibitors can be used as short- and medium-term relief from heartburn. But the major goal of the physician will be to prescribe and manage it in the long term. Treatment for chronic heartburn involves total commitment from the patient to comply with the physician's advice and take the prescribed medication until the physician stops it. If all else fails to overcome chronic heartburn, surgery may be the last resort. This is done to tighten the LES muscles and prevent acid from leaking into the esophagus. |
