Heartburn is  also known as pyrosis  cardialgia, or acid indigestion.

It is  an uncomfortable warm and burning sensation in the chest, usually  behind the sternum  and is more common immediately after eating.

Cause
In spite of the term, the condition has got nothing to do with heart conditions.

Heart burn is linked to acid reflux from the stomach.

When we ingest food, it is taken to the stomach for digestion.

The esophagus is a long tube about 10 inches  in  adults that connects throat to the stomach. When food is swallowed,  a wavelike motion occurs  in the muscles lining the esophagus to propel the food towards the  stomach.

On reaching the end of the esophagus the food passes through  lower esophageal sphincter (LES), a ring of muscle  before it enters  the stomach. LES is like a  one way valve that opens inward to allow entry into the stomach and closes when food has entered the stomach.

Pressure exerted on the valve from the stomach only further seals it.

Sometimes, due to a malfunctioning LES, acid reflux and heartburn occur.

Some LESs don’t form a tight seal when closed, and others will relax randomly when there is still work to be done. When the LES relaxes with food still in the stomach, pressure from the fullness of the stomach or  physical movement  can force the contents back up  into the  esophagus.

The pain of heartburn is the irritation or damage taking place to the esophagus by the refluxed stomach acid.

It is common for people to have heartburn occasionally.

Gastroesphageal reflux disease is most common cause of heartburn.

Following habits are known to increase risk of heartburn

• Foods like coffee, alcohol, tomatoes, fatty or spicy foods, and chocolate.
• Smoking
• Tight clothing
• Medical conditions like hiatus hernia, peptic ulcer, obesity, neurosis etc.

Signs and symptoms of Heartburn

Signs and symptoms of heartburn include:

• An uncomfortable sensation of warmth or burning in the chest lasting for few minutes to few hours [ After eating, or during sleep]
• Worsening of the pain on lying down or bending over
• Burning sensation in the throat
• Sensation of food sticking in the middle of the chest or throat

Diagnosis

Most of the the diagnoses are based on clinical history and examination.

Investigations

• Barium Swallow X-ray
• Endoscopy
• Esophageal pH monitoring
• Esophageal motility testing
• Esophageal manometry

Prevention

Following measures can reduce the risk of developing heartburn.

• Loosing weight
• Quit smoking
• Smaller meals
• Take evening meals at least  three hours before going to bed
• Avoid food triggers – some foods and drinks may trigger heartburn in some patients.
• Raise head end of your bed slightly

Treatment

Following drugs are commonly used for ailment

• Antacids  neutralize stomach acid and provide rapid relief.
• H-2-receptor blockers – they work more slowly than antacids, but provide longer relief.
• Proton pump inhibitors – these block the production of acid, giving damaged esophageal tissue time to repair itself’.