Heartburn 101: Symptoms, causes, treatment & home remedies

Do you often have a strong burning feeling in your chest and throat? That could be heartburn, and if left unchecked can lead to serious health consequences.

It is a common condition that cannot be overlooked: according to medical practitioners, one in five Singaporeans regularly experience heartburn.

We will talk about what heartburn is, how you can tell whether you have heartburn, and ways that you can treat and prevent this condition at home.

What is heartburn?

Heartburn is linked to acid reflux, which happens when our stomach acids flow back into the oesophagus (gullet). Acid reflux can cause us to vomit or have heartburn.

You have a higher chance of experiencing acid reflux when you lie down or bend over soon after eating, or after you have had a heavy meal.

If you frequently have heartburn or other symptoms of acid reflux, the condition is known as gastroesophageal reflux disease (GERD) .

GERD is one of the most common diseases affecting the stomach and intestines throughout the world and is becoming more common in Southeast Asia.

Studies have found that between 2005 to 2010 GERD affected between 6.3 to 18.3 per cent of Southeast Asian people.

GERD affects the muscles separating the oesophagus and the stomach and is caused by hiatal hernia, where part of the stomach extends into the oesophagus. This can lead to damage or inflammation of the digestive tract.

Symptoms of heartburn

The following are signs that you may have heartburn:

• A strong burning feeling or tightness in your chest.
• A sour taste in your mouth. The taste comes from stomach acids which are travelling up your oesophagus.
• A sore throat or cough.
• Bad breath.
• Having more saliva than usual.

Differences between heartburn and heart attack

Despite its name, heartburn does not occur at the heart but in the lower chest cavity.

Heartburn is often mistaken for heart attack and the two can have similar symptoms, including a feeling of tightness in the chest and nausea.

However, the two have different causes and accompanying symptoms. Symptoms unique to a heart attack include light-headedness, cold sweat, and a rapid or irregular heartbeat.

A heartburn will appear after a large meal, while a heart attack tends to appear after strenuous physical activity.

Risk factors of heartburn

Below are some factors that might make you more likely to get heartburn:

• Being pregnant. When you are pregnant your body has a higher level of hormones like progesterone which relaxes smooth muscle. This includes the muscles separating the oesophagus and the stomach, making it more likely that you will get heartburn when you are pregnant.
• Being overweight. Obesity can increase the incidence of heartburn because of the pressure that excess belly fat exerts on the stomach, making a backflow of digestive juices more likely.
• Having a habit of smoking or heavy drinking.

Potential complications of heartburn

The constant backflow of digestive juices from the stomach can damage the lining of the oesophagus over time. This leads to a condition known as reflux esophagitis.

People with esophagitis may experience a persistent pain behind the breastbone and the condition can lead to ulcers in the oesophagus.

When ulcers heal, scarring known as strictures can remain along the oesophagus and make it painful to swallow. These strictures might require surgery to remove.

When a scarred oesophagus heals, it may not heal properly.

This leads to a condition known as Barrett’s oesophagus, where a type of cell typically found in the intestines grow instead of that regularly found in the oesophagus.

These cells can grow cancerous and lead to severe consequences for one’s health.

Heartburn treatment

If you consistently experience heartburn, you should consult your doctor.

They can prescribe over-the-counter medicines known as proton pump inhibitors (PPIs) that can prevent heartburn. These medicines can prevent reflux by reducing acid production in the stomach.

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This gives your oesophagus time to heal from inflammation by digestive acids and prevents long-term scarring.

Some possible side effects of PPIs include a higher risk of other conditions like pneumonia or stroke.

A study has found that 11.5 per cent of people who were on regular PPI medication had chronic kidney disease, compared to 8.5 per cent of those who were not.

It is important that you consult a specialist to know if medication is necessary and when to take it.

Home remedies for heartburn relief

There are some foods that we can easily find in our kitchens and pantries that can provide quick relief from the discomfort of heartburn. Here are four simple home remedies you can try:

Chamomile

Chamomile is known to soothe the digestive system.

Drinking a cup of chamomile tea may help to ease irritated muscles in the digestive tract.

Conversely, if you are an avid tea drinker, stay away from peppermint and spearmint teas as those can aggravate existing acid reflux symptoms.

Honey lemon

Though lemon juice is generally considered acidic, some lemon juice mixed with water and honey can form an alkaline drink which neutralises the acid in your stomach.

Honey also has soothing properties that can help to calm your gastrointestinal tract.

Ginger

Ginger is known for its anti-inflammatory properties and has been commonly used as a folk remedy for acid reflux.

A cup of ginger tea can help to relieve heartburn symptoms.

Low-fat milk

Milk can serve as a buffer between our digestive juices and our stomach linings to prevent the damage and discomfort from acid reflux.

The fat in milk can aggravate our stomachs, so it is recommended to drink low fat or non-fat milk instead.

Nonetheless, none of these ways of relieving heartburn are a substitute for regular medication.

Please consult your medical provider if you frequently experience heartburn and they can prescribe you medicines that can help you manage your condition.

How to prevent heartburn

Besides consulting a doctor and seeking medical treatment, you can take to change your lifestyle with simple steps to reduce your chance of getting heartburn.

Here are nine ways that you can try to prevent heartburn on your own:

Avoid going to bed soon after meals 

You are more prone to getting heartburn when you bend over or lie down soon after eating. To avoid heartburn, try to wait for a few hours before taking a nap or going to bed after meals.

Avoid carbonated drinks

Carbonated beverages such as soft drinks and sparkling water can make you burp, forcing air out from the stomach through the oesophagus.

For people with GERD, the muscles separating the stomach from the oesophagus are weaker and digestive juices are more likely to escape along with gas.

Drink plain water instead of sparkling water wherever you can and avoid consuming fizzy drinks and other foods that can make you burp.

Avoid strenuous physical activity after eating 

Vigorous exercise soon after your meals can exert pressure on your stomach which makes it more likely that digestive juices will backflow into the oesophagus.

Do not do strenuous physical activity soon after eating, especially those which require you to bend over.

On the other hand, a light stroll after your meals can help to aid digestion and increase blood circulation.

Eat less foods that can trigger heartburn

Spicy and acidic foods, as well as foods that are high in fat, are common triggers of heartburn episodes.

Foods that often trigger heartburn include alcohol, cheese, caffeine, citrus fruits like oranges and grapefruits, chocolate and fatty meats like ham and bacon.

Limiting your intake of such foods can help to prevent heartburn from happening.

Eat more foods that are good for your stomach 

Besides avoiding foods that can lead to heartburn, you should also add more foods in your diet that aid your digestion and can help you have a stronger digestive system.

For example, probiotics found in fermented foods like yoghurt and cultured milk drinks can promote the growth of healthy bacteria in our gut.

Eating more foods that are high in fibre can also help prevent heartburn by preventing you from overeating.

Such foods include oatmeal, brown rice, root vegetables like sweet potatoes and carrots, and vegetables like asparagus and broccoli.

Alkaline foods, which have a high pH in comparison to acidic foods which have a low pH value, can also prevent reflux. Some common alkaline foods include bananas, melons, cauliflower, and nuts such as almonds and walnuts.

Keep a food diary 

While there are foods that are widely understood to trigger heartburn more easily, it is useful to keep tracks of which foods tend to lead to heartburn in your case.

Keeping a journal of what you eat and when can help you identify common causes of heartburn so that you can avoid those triggers in the future.

Limit the portion size of your meals 

Large meal sizes can cause heartburn more easily as it increases the pressure on your stomach to produce more digestive juices to digest the larger quantity of food.

It may be helpful to have more frequent and smaller portions of food instead of one large portion at mealtimes.

Stop smoking

Smoking increases your risk of heartburn because the nicotine found in tobacco relaxes the valve between the oesophagus and the stomach.

When the valve is relaxed, the muscles become less able to keep digestive juices from flowing back to the oesophagus from the stomach.

Reducing the number of cigarettes that you smoke can prevent heartburn from occurring as frequently.

Stopping your smoking habit also has other positive health effects, including reducing your risk of lung cancer and high blood pressure.

Prop your head up when you lie down in bed 

Lying completely flat on our backs, especially just after a heavy meal, can increase the chance of experiencing heartburn.

To reduce the chance of getting heartburn, you can try to adjust your posture by elevating your head when you go to bed.

The recommended bed height to reduce incidents of heartburn is six to eight inches. You can increase the height of your bed by using a wedge pillow, a bed riser, or an adjustable bed.

Wear loose clothing to bed 

Tight clothing places pressure on the stomach which increases the chance of acid reflux.

Wearing loose-fitting clothing when you’re about to go to bed can improve blood circulation and ease the stress placed on your stomach.

This article was first published in Homage.