Heartburn

Signs and Symptoms

Heartburn is a burning pain in the lower breastbone that may travel toward your neck. It also is associated with regurgitation of food and liquid into your mouth and a bitter or acidic taste.

Heartburn, also known as acid indigestion, is actually a common symptom of an underlying condition called gastroesophageal reflux (GERD) or acid reflux. In addition to heartburn, symptoms of GERD may include:

• Persistent sore throat
• Hoarseness
• Chronic cough
• Asthma
• Chest pain
• Feeling like there is a lump in your throat

Diagnosis

Talking with your doctor about your symptoms may be enough for him or her to make a diagnosis of gastroesophageal reflux (GERD). However, additional tests may be recommended to determine its severity, including:

• Upper GI Endoscopy — An endoscope is a device consisting of a flexible tube and a mini camera. In endoscopy, this device is introduced through the mouth to view the esophagus, stomach and upper small intestines.

• Upper GI Series — These are a series of X-rays that examine the esophagus, stomach and small intestine. The X-rays are taken after you have swallowed a barium suspension, which coats the lining of the upper gastrointestinal tract. A radiologist then looks for irregularities in the linings, which can help diagnose a variety of digestive problems.

• Esophageal Manometry — This test measures the motor action of the lower esophageal sphincter and esophageal body. A catheter measures esophageal pressure and records the duration and sequence of contractions.

• Esophageal pH Monitoring — This is a test to measure the frequency and duration of stomach acid that enters the esophagus.

Treatment

If you have ever experienced occasional heartburn associated with gastroesophageal reflux (GERD), you are probably familiar with the popular over-the counter antacids that neutralize stomach acid and relieve heartburn symptoms. However, these medications will typically not work if your heartburn is more frequent and severe. Other medications, which work to prevent reflux and block acid production, are available for more severe cases of heartburn.

In addition, lifestyle and dietary modifications are recommended and may relieve symptoms in some patients. A surgical procedure called fundoplication to tighten the lower esophageal sphincter muscles, or LES muscles, may be an alternative to drug therapy.

Recently, less invasive endoscopy techniques have been developed to tighten the barrier between the esophagus and the stomach. However, the safety and effectiveness of these new alternatives to surgery are still being determined.