More often, we experience a recurrent sensation of chest pain manifesting as a burning sensation in the central portion of the chest and the throat, usually starting from the uppermost and left-central part of the abdomen from where the burning sensation radiates upward into the central as part of the chest wall behind the --- bone. The combination of heartburn and acid regurgitation is the key towards medically diagnosing an individual as suffering from Heartburn Disease or what is also called Gastroesophagus Reflux Disease (GERD).
?Heartburn? can also be accompanied by a regurgitation of the acid produced inside the stomach back into the oesophagus, which is the food pipe that connects the mouth to the stomach. It is the irritating and corrosive effect of the acid (regurgitated into the esophagus from the stomach) that is experienced as heartburn and sometimes as an intense and very discomforting pain in the chest that can sometimes be confused as a heart attack.
One should however note that mild temporary heartburn caused by overeating acidic foods can happen to anyone, particularly when bending over, taking a nap, or engaging in lifting after a large meal high in fatty, acidic foods. Persistent gastroesophageal reflux disease however, may be due to abnormal biologic or structural factors, which include malfunction of the lower esophageal muscles, defects or injuries in the lining of the esophagus, peristalsis problems, over-acidic stomach contents, and other problems.
Malfunction of the lower esophageal opening (LES) muscles
The band of muscle tissue called lower esophageal sphincter/opening (LES) is responsible for closing and opening the lower end of the esophagus and is essential for maintaining a pressure barrier against contents from the stomach. If it gets weakened and loses tone, the LES cannot close up completely after food empties into the stomach; in such cases, acid from the stomach backs up into the esophagus. The LES is a complex area of smooth muscles and various hormones; dietary substances, drugs, and nervous system factors can affect its function.
Impaired Stomach Function
In one research study, over half of patients with heartburn disease showed abnormal nerve or muscle function in the stomach, which caused impaired motility, an inability of the muscles to contract normally. This causes delays in stomach emptying, increasing the risk for acid back-up.
About half of asthmatic patients also have GERD. It is not entirely clear however whether asthma is a cause or effect of the heartburn disease. Some experts speculate that the coughing and sneezing accompanying asthmatic attacks cause changes in pressure in the chest that can trigger reflux. Similarly, certain asthmatic drugs that dilate the airways may relax the lower esophageal sphincter and contribute to the heartburn disease.
It appears that genetic factors play a role in susceptibility to Barrett's esophagus, a condition that precedes the formation of cancer of the oesophagus, caused by very severe gastroesophageal reflux. It is also inferable that an inherited risk exists in most cases of heartburn diseases.
Foods that can weaken lower esophageal sphincter tone, hence predisposes one to develop heartburn disease, include garlic, onions, chocolate, fat, peppermint, spearmint, and coffee. Caffeinated drinks and decaffeinated coffee increase acid content in the stomach. Other acidic foods include citrus and tomato products. All carbonated beverages increase the risk for symptoms of heartburn disease by bloating the abdomen and causing pressure that forces acid to back up into the esophagus.
Alcohol and Smoking
Alcohol relaxes the LES muscles and also may irritate the mucous membrane of the esophagus. On the other hand, some studies have shown that small amounts of alcohol may actually protect the mucosal layer. Smoking can also reduce muscle function, increase acid secretion, reduce prostaglandins and bicarbonate production, and decrease mucosal blood flow.
Some studies have suggested that obesity increases acid in the esophagus, thereby significantly increasing the risk of heartburn disease. On the other hand however, in severely obese individuals, gastric bypass surgery, which shrinks the stomach, not only produces weight loss but also reduces the amount of acid and protects against heartburn disease.
Drugs that Increase the Risk for Heartburn disease
A number of drugs can cause the Lower Esophageal Sphincter to relax and function poorly. The chief culprit here are the common pain relievers known as Nonsteroidal anti-inflammatory drugs (NSAIDs) i.e. aspirin and aspirin-like drugs. However, such symptoms may not become evident until after about six months of regular use.
NSAIDs include the likes of aspirin, ibuprofen, naproxen, piroxicam, diflunisal, indomethacin, ketorolac, ketoprofen, diclofenac etc. Paracetamol (acetaminophen) is usually a good alternative for those who want to relieve mild pain and avoid NSAIDs.
At any rate, the aforementioned NSAID medications must not be taken in an empty stomach ? they are best taken just after meal or during meal.