Food Not Always at the Heartburn of the Matter

If you can’t believe you ate the whole thing and are suffering a case of heartburn, don’t always blame it on the food.

Heartburn is an extremely common gastrointestinal symptom that most people experience at some time in their lives.

Sometimes it is caused by the food we eat; often, however, heartburn is a consequence of certain types of eating and drinking behavior, and smoking.

Heartburn, which for decades has spawned a growth industry dedicated to easing the pains of what most people call indigestion, is a burning sensation in the chest caused by a reflux of stomach acid into the esophagus.

The esophagus is normally protected from stomach acid by a valve-like sphincter that opens and closes to allow food to pass into the stomach and keep out acid.

Smoking can cause the sphincter to relax and become a lackadaisical doorman, allowing irksome acid to pass. Foods rich in fat such as chocolate and fried foods also relax the sphincter and are linked to heartburn.

Lying down after eating and snacking before bedtime may cause heartburn because gravity normally acts as a barrier to keep stomach contents from backing up into the esophagus. Eating too fast also might cause heartburn by overwhelming the sphincter and disrupting its mechanics. Obesity is another important cause of heartburn.

In most instances, fortunately, heartburn is not a serious problem and is easy to control with simple measures.

These measures include the avoidance of foods that promote reflux, eating smaller meals, not lying down just after eating, cessation of smoking and weight loss.

Over-the-counter antacids are usually effective in alleviating heartburn, although some people may require prescription medications to control their symptoms. Rarely, surgery is performed to tighten a loose, poorly functioning esophagus sphincter.

Heartburn can also be caused by slipped tissue that changes the anatomical position of the sphincter; behavior modification cannot improve this condition, known as hiatus hernia.

Other symptoms of acid reflux include a salty taste in the mouth, a sensation of a lump in the throat or difficulty in swallowing.

Another reason to avoid heartburn is that some forms of asthma are aggravated by acid reflux into the esophagus and respiratory system. This is frequently the cause of “nocturnal” asthma, or breathing difficulties that develop at night. If the reflux is treated, the asthma may improve.

Be aware, too, that heartburn also may be a symptom of other medical conditions such as ulcers or stomach inflammation, both of which require medical attention.

Finally, chest discomfort is not always caused by stomach acid reflux.

A discomfort in the chest similar to heartburn may also signal a heart attack or gallbladder problem, and medical evaluation should be sought to exclude these possibilities.