Heartburn overview and Definition

Heartburn is termed as the burning sensation of the chest that can move towards the mouth and throat. This can include the gastroesophagel reflux disorder and acid reflux.

Structure of Heartburn

Structure of Stomach:

The stomach is an organ which aids in the digestive mechanism. It consists of fundus, body and pyloric region. Cardia is the first part and it is closest to the esophagus. Fundus is the uppermost part of the stomach. Body is the main part of the stomach. And the pyloric region is the last part od the stomach and it contains the valve which mediates the passage of food into the small intestine. Antrum is the lower portion of the stomach where the gastric fluids( acid) mixes with the food.


The pathogenesis of gastroesophageal reflux disorder is complex and it leads to the changes in reflux exposure, epithelial resistance and visceral sensitivity. The gastric refluxate creates the acidic environment and it is a noxious material (back diffusion of hydrogen ions into the esophagus)   that injures the esophagus and aggravates the symptoms. The exposure of the esophagus to this noxious material compromises the anti reflux barrier amd reduces the ability of the esophagus to clear and buffer the refluxate leading to reflux disease. The poor epithelial resistance or increased visceral sensitivity . reflus might develops via alterations in the balance between the aggressive and defensive forces. The direct of the acidic environment with upper respiratory tract results in bronchospasm.

Clinical signs & symptoms

Burning sensation in the chest

Regurgitation of the food materials

Breathing difficulties

Sensation of Belch

Sour or bitter sensation in the oral cavity



Differential Diagnosis

Blood test:

Patient with the stomach cancer  tends to show low levels of platelets, white blood cells, red blood cells.  This results in the aneamia in patients. Complete blood count might reveal whether the bleeding is occurring or not.

Computed tomography:

A CT scan takes three dimensional pictures of the abnormal tissues from different angles.

Magnetic Resonance Imaging:

A MRI scan uses the combination of the magnetic and radiowave frequency to view the abnormal tissues.

An dye is injected in the vein or the patient is asked to swallow the dye and the results are observed.


A sound waves to create the picture of the internal organs to find out if the cancer is spread or not.

Abdominal ultrasound:  with the patient symptoms it can be used to view the pancreas. But it cannot reveal the spread of pancreas.

Endoscopic ultrasound: in this method the doctor uses an ultrasound probe, and with the guidance of endoscope it is passed in to the small intestine and then into the pancreas to view the structures.

Barium Swallow:

The patient is asked to swallow the liquid Barium. Barium gets deposited in the lining of the stomach ,

esophagus and small intestine.

If X rays are taken at this time it might show some blockages in the stomach and other areas clearly.

Ambulatory acid probe test:

It is used to find how long the acid backs up into the esophagus. An acid monitor is placed inside the esophagus and it is connected to the computer that is wrapped around the patient waist or shoulder.

Esophageal motility testing:

It is used to measure movement and pressure in your esophagus.



The prognosis is good and often the people might recover from the symptoms. The preventive measures should be followed correctly .


The prevention include:

  • Not going to bed with a full stomach:

Taking meals at least three to four hours before you lie down. This gives your stomach time to empty and reduces the chances of experiencing heartburn overnight.

  • Avoiding overeating:

Eat the foods in smaller for 3-5 times instead taking the food at larger quantities.

  • Slowing down:

 Eating slowly can often help prevent heartburn. Avoid eating too fastly.

  • Wearing loose-fitting clothes:

 Belts and tight clothing can sometimes cause heartburn. By changing your wardrobe to avoid these items, you might be able to prevent having heartburn.

  • Avoiding certain foods:

 For many people, there are certain foods that trigger heartburn. Avoiding these foods can help. Try keeping a log of these foods so that you can watch out for them in the future. Your healthcare provider may also suggest that you avoid alcohol.

  • Maintaining a healthy weight:

Weight loss and maintaining correct body mass index can often help to relieve heartburn.

  • Not smoking:

 Nicotine can weaken the lower esophageal sphincter (the valve that separates your stomach and esophagus). smoking is not recommended for your general health, as well as the strength of this valve.

  • Sleeping on your left side:

 This may help digestion and the removal of acid from your stomach and esophagus more quickly.

  • Raising the head of your bed:

Make the head and chest level above the feet level. Place 6-inch blocks or books under the bed posts at the head of the bed. Do not use piles of pillows. They may cause you to put more pressure on your stomach and make your heartburn worse.

  • Planning your exercise to avoid heartburn:

 Wait at least two hours after a meal before exercising. If you work out any sooner, you may trigger heartburn. You should also drink plenty of water before and during exercise. Water aids digestion and prevents dehydration.