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When I first came across the term "heartburn", I thought it is some kind of heart disease as it is associated with the word "heart". However, after browsing through dictionary, I then realized that it has nothing to do with the heart.

The term "heartburn" may come from the fact that hydrochloric acid from the stomach comes up the esophagus because of a problem with the cardiac sphincter, a valve that contains the word "cardiac" (an adjective referring to the heart) in its name. In reality, when heartburn occurs, there is a burning sensation of the breastbone where the heart is located. Such sensation somewhat similar to that is found when some heart problems occur.

Heartburn is defined as an unpleasant "burning" sensation arising from the upper tummy, going upwards to the chest, neck, throat, angle of the jaw and back. The symptoms are intermittent in nature and usually occur after taking food, bending forward or lying in a recumbent position. This condition is often the result of stress, eating highly spiced food, or eating rich foods like greasy sauces and casseroles.

Stress can create imbalances in the entire body. Usually, there will be an increase in acid production, which will help stir up havoc in the gastrointestinal tract. Hydrochloric acid (or HCI) in the stomach helps break down the food you eat. Too much or too little HCI interferes with the digestive process, creating gastrointestinal symptoms such as heartburn, stomach cramps, and gastric ulcers.

Growing older or lack of exercise may cause too little acid production. On the other hand, too much acid production can be the result of stress; overuse of Aspirin and over-the-counter non-steroid anti-inflammatory medication, such as ibuprofen. Overeating and even wearing too tight a belt can also be the causes.

How do you know whether you have too little or too much acid? A simple test may give you answer! When you start to feel discomfort after eating, swallow a tablespoon of lemon juice or apple cider vinegar. If the pain subsides, you probably have too little stomach acid. If the pain increases, you should suspect that you have an excess of HCI.

Nevertheless, heartburn is not always caused by too much acid. It can occur in a full or empty stomach. Acid can reflux back up to the esophagus, causing heartburn as you chew your food. However, acid can also build up when your system is empty, waiting for food; there is an overflow of digestive acids, or enzymes, that have been produced but have nothing to do.

If a person experiences heartburn symptoms several times a week, he or she probably has gastro-esophageal reflux disease (GERD).

GERD is a disease in which acid from the stomach flows upwards into the esophagus, causing irritation and occasional damage to the lining there. Abdominal pain, taste of acid in the throat, difficulty in swallowing, food getting "stuck" over the chest, excessive belching, persistent sore throat, perception of "lump in throat" irrespective of swallowing, chronic cough, persistent hoarseness of voice, nausea and bloating may be found in a person who suffers GERD.

Those with classical symptoms of GERD and without any alarming features may initially be treated with medications for which the proton pump inhibitor is the most effective. Other medications like antacids, alginates, promotility drugs, histamine type-2 receptor antagonist might also help to relieve the symptoms.

A good response to 2 weeks of proton pump inhibitor may also include an endoscopy where a small, flexible tube is passed through the mouth into the esophagus and stomach. This procedure assesses the extent of damage to the esophageal lining and tissue specimens can be obtained for evaluation.

The other common test to evaluate the esophagus is known as Barium meal. Patients are required to swallow a thick paste of barium while taking X-rays. The barium will coat the esophagus and show abnormalities.

Nevertheless, the most sensitive test to diagnose GERD is to use a 24-hour esophageal pH, where information can be obtained by nasal insertion of a catheter or simply “clipping” a capsule to the lower esophagus via an endoscopy.

Read More: Home Remedies for Heartburn: 20+ Food Items from Your Kitchen

For severe cases, surgery may need to be carried out. The outcome is usually good though complications like difficulty in swallowing, gas bloating, and diarrhea might happen.

If the heartburn symptoms are not very serious, lifestyle modifications may perhaps be used though the evidence for this is rather subjective. Things like quit smoking; avoid specific food, which precipitates the heartburn symptoms; avoid over-eating and have smaller meals instead; avoid late meals and do not lie down for 2 to 3 hours after eating; reduce weight (may help obese patients); and raise the head of one’s bed by 6 to 8 inches.