Heartburn, GERD, indigestion, reflux are all different words to describe the same underlying condition. The terms are usually used to specify severity and frequency of the symptoms, though they are often confused and misused. Let’s clear this up.
So what is heartburn?
Heartburn usually describes a burning sensation felt in the chest, though the term itself is misleading; heartburn has absolutely nothing to do with the heart. A person experiences heartburn when stomach acid is allowed back into the esophagus.
Why does it happen?
Just like a car going the wrong way in traffic, food and stomach acid traveling the wrong way in the esophagus causes problems. When stomach acid and sometimes food is allowed back in the esophagus it causes the burning, painful irritation, or the symptom commonly known as ‘heartburn.’
This usually happens when the lower esophageal sphincter (LES) is under too much pressure, is weakened or malfunctions all together. The LES connects the base of the esophagus to the stomach and is responsible for allowing solids and liquids into the stomach and keeping them from moving in the opposite direction.
Okay, so that’s what happens in your body when you have heartburn. But what actually causes it? Mild to moderate heartburn can be traced to:
Eating too much
Eating too fast
Eating before bed
The good thing is that in these cases most people will be able to deal with the discomfort by taking a few antacids and avoiding the behavior that brought it on.
How is heartburn different from GERD?
Gastroesophogeal Reflux Disease happens when the LES is weakened and malfunctions consistently, and not just when a person overeats or gulps down their food. If the LES cannot close completely after food empties into the stomach, acid backs up into the esophagus on a fairly regular basis, and not just when too much food enters the stomach too quickly.
GERD is caused by any number of factors, both lifestyle and physiological. Most people will develop GERD as a result of sustained poor eating habits that cause too much stress on the LES. Big meals of acidic or overly processed food over a long period of time will eventually wear the LES out and it will not function properly.
Some patients have GERD caused by abnormalities in the nerve or muscle functions in their esophagus or stomach. Some of these abnormalities may be spontaneous muscle action (peristalsis) in the esophagus or adult-ringed esophagus, a condition that causes rings on the esophagus and persistent trouble swallowing.
In 30 to 40 percent of people, GERD is hereditary, mostly through inherited muscular or structural problems in the stomach or esophagus. Genetic causes are especially common in people with Barrett’s esophagus.
What kind of damage can GERD do?
Stomach acid where it’s not supposed to be can cause all kinds of problems beyond burning pain. If the esophagus and the rest of the upper digestive tract is consistently saturated in acid, it can lead to:
Erosive esophagitis (erosion of the esophagus)
Severe narrowing (stricture) of the esophagus
Barrett’s Esophagus (pre-cancer of the esophagus)
Problems with teeth, throat and airway leading to the lungs
What can you do about it?
A bout or two of heartburn every once in a while is probably not going to cause too much harm. But if you experience heartburn several times a week, you should talk to your doctor.
If persistent heartburn becomes a problem, it’s best to keep a journal of your symptoms. The journal should note:
Severity of heartburn
When it starts and how long it lasts
Food eaten that day. (You want to try to pinpoint which foods may have caused the heartburn.)
Any physical activities
Medications you’re taking
The more information about your symptoms that you provide your doctor, the better you can be diagnosed and treated.
Can heartburn ever involve my heart?
No, but that doesn’t not mean you should ignore frequent chest pain under any circumstances. It could be caused by other conditions that can harm your heart. For example, patients who have had heart attacks often describe their first symptoms as ‘really bad heartburn’.
A.D.A.M., Inc. (2010, July 11). Acid Reflux Causes. Retrieved April 17, 2012 from http://www.healthcentral.com/acid-reflux/introduction-000085_2-145.html
American College of Gastroenterology, (2012) Acid Reflux Overview. Retrieved from http://patients.gi.org/topics/acid-reflux/