Heart burn is a painful sensation one experiences when there is reflux of food or acid from the stomach into the esophagus or food pipe. It may be accompanied by sensation of nausea , bilious vomiting and or bloating of the abdomen. Everybody does experience heart burn sometimes or other and are familiar with that unpleasant sensation. But some people unfortunately experience it regularly which is troublesome. 

It occurs when the sphincter at the lower end of the esophagus fails to prevent reflux of contents of the stomach in the esophagus.

Heart burn can occur due to excess consumption of food and or water. In hurry, some people tend to swallow big mouthfuls of food without chewing it properly. In this case the stomach has to do extra work to deal with the unchewed lumps. This may cause reverse peristalsis from the stomach, i.e. some regurgitation of the food from stomach to the food pipe, thus resulting in heart burn. In some people it occurs due to wearing very tight clothing or even with change of posture like lying down or bending over.

Obesity and pregnancy also cause heart burn due to increase in the intra-abdominal contents. Some drugs like pain killers can also induce heart burn in an individual. Tobacco smoking and alcohol are also responsible for this condition.

In some individuals it can occur due to anatomical defects like incompetence of the lower esophageal or upper gastric sphincter. Hiatus hernia is yet another condition causing persistent burning pain in the chest. In this there is herniation of part of the stomach from a hole in the diaphragm.

Diagnosis of heart burn is established by endoscopy and barium meal examinations which help to show whether heart burn is due to some physical problem or is simply functional.

Treatment of physical problems causing heart burn is feasible through surgery. But prevention and treatment of heart burn due to other conditions is simple.

One should take small frequent meals. A heavy meal provokes heart burn due to the load put on the stomach. At other times, because of no food entering inside, the acid present in the stomach is not neutralised. This tends to reflux causing heart burn. Taking sips of cold milk intermittently is very useful for people suffering from heart burn as milk also neutralizes the acid from the stomach. Alcohol, soda beverages and smoking should be avoided as they tend to result in heart burn.

Obese people should try to lose weight to get rid of this condition. Pregnant women feel better when they deliver the baby because then the pressure of abdominal contents is reduced and heart burn is cured.

One should try to avoid wearing very tight clothes. A person should be able to identify foods and drinks that induce heart burn and should try to avoid them. Mostly it is the foods with much oil, high carbohydrate and sugar and or spices which induce heart burn.

Those suffering from chronic heart burn due to hiatus hernia or functional causes should sleep with the head end of the bed slightly elevated. This position helps to prevent reflux of acid and hence heart burn.

Regarding treatment, antacids (drugs neutralizing the acid of the stomach) provide some relief in the symptom.

But they should not be used for a long time. Because, when used for long time they suppress the symptoms and mask any underlying disease causing this problem. Besides this, antacid tablets or syrups tend to cause constipation or diarrhea as adverse effect. Other drugs which are used for treating patients with heart burn are those which reduce the production of acid in the stomach by different mechanisms. With corrections in life style one can easily prevent heart burn.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital