What is the Heartburn?

Heartburn is a pain behind the breast bone, often described as ‘burning’ in quality. Pain can also be felt at the same level in the mid-line of the back. Most people suffer from heartburn at one time or another. In fact heartburn has nothing to do with the heart - it is a digestive problem. Heartburn is generally related to meals and posture and can often be relieved by remedies for indigestion.

Pain from the heart is also felt in the chest and sometimes in the upper abdomen. There are two kinds of heart pain. The first, angina, is a pain in the chest due to a temporary shortage of oxygen being carried in the blood to the heart muscle. Angina should be suspected if the chest pain is brought on by exercise and relieved by rest. The second is the more severe and prolonged pain of a heart attack. A heart attack should be suspected if the pain is felt intensely in the centre of the chest, spreading perhaps to one or both arms (especially the left) and into the lower jaw; or feels like a heavy pressure or is ‘vice-like’.

What Causes Heartburn?

Acid is present in the stomach to digest food. Heartburn occurs when small amounts of this acid rise up into the gullet (oesophagus) - the tube which carries food from the mouth to the stomach. This is called reflux.

The gullet, unlike the stomach, does not have a protective lining. So when it is exposed to the acid, it can become inflamed and painful.]

Why Doesn't Everyone get Heartburn?

At the bottom of the gullet there is a muscle which, by its contraction, acts as a barrier to keep the acid in the stomach. If this doesn’t work properly, reflux occurs. The reason why this muscle fails to work properly is not fully understood.

Some known factors that can lead to heartburn include:
eating large meals, especially near bedtime
being overweight
bending a lot
wearing tight clothing around the waist.

Heartburn Diagnosis

Your doctor may well make the diagnosis from the symptoms you describe, but may wish to investigate further. 

Endoscopy is the most commonly used test and involves a fibre optic tube which is passed down your throat, enabling your doctor to examine the oesophagus, stomach, and duodenum. If any abnormal areas are seen a sample may be taken and sent to a laboratory for analysis. Usually you are given an injection which makes you sleepy during the procedure and also tends to make you forget what went on. 

Sometimes an X-Ray is used, in the form of a barium meal, which monitors the passage of a drink containing a heavy element which shows up the oesophagus and stomach in silhouette.


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