The heartburn feeling

The heartburn feeling

My two-cents Rx

With BENJ S. BANGAHAN, M.D., FPCP, FPCCP

Heartburn is that burning-like sensation that is usually felt under the sternum, the flat bone at the front  side of the chest, usually radiating upward from below the rib area. It is not related to the heart, but most likely it was initially mistaken to be from it, since, anatomically, the heart is within the area, though, actually it is in the precordial area, slightly more to the left of the sternum. Nonetheless, this must have been the reason for the term heartburn, which somehow got unaltered, despite the later more accurate information.

The fact is, heartburn is brought about by the upward flow of stomach contents, which include a substantial amount of hydrochloric acid; it reaches the gullet, called technically esophagus. The effect of the strong hydrochloric acid on the gullet,

 sometimes even causing tissue damage, is what produces the sensation of burning. No wonder this event has been considered as the predominant symptom of gastroesophageal reflux disease, sometimes abbreviated as GERD.

GERD is rather common, although it is generally believed that most patients suffer only mild symptom. In another statistics, about one-third of adults have been estimated to have occasional heartburn, and about 10% of patients suffer the symptom daily. In most patients, heartburn occurs when the muscle at the end of the esophagus, called esophageal sphincter, the one responsible for the opening and closing of the esophagus, undergoes occasional spontaneous transient relaxation, creating a way for the gastric contents to flow up. Outpatient management usually has been helpful.

In other cases, some degree of tissue damage due to the acid have been appreciated. The event may be exacerbated by intake of food, bending  or lying down. Lifestyle modification, therefore, can ameliorate the symptom, like, avoidance of eating about two hours before lying down, elevation of the head of the bed to ensure that the head is always higher than the abdominal area in order to minimize the recurrence, weight loss, and avoidance of tight clothing around the waist.

There are some signs that accompany GERD that must be considered alarming. Difficulty of swallowing or dysphagia, substantial weight loss and accompanying anemia are reasons for seeking the help of a doctor in order to discover the reason for their presence, so immediate medical management can be initiated. These signs may signify the presence of a condition that needs immediate diagnosis by a doctor, whose diagnosis and medical management may obviate its morbidity. Possibilities are, stricture of the esophageal sphincter, esophageal ulcer, and maybe even cancerous process. 

 Māassalāma.

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