Heartburn

Heartburn, also known as acid indigestion, is a common symptom of gastroesophageal reflux (GERD) or acid reflux. You may experience GERD when acid contents in your stomach back up into your esophagus. This occurs when a muscle at the end of the esophagus, called the lower esophageal sphincter (LES), fails to operate properly. The LES opens when swallowing to allow the passage of food to the stomach and then closes to prevent food juices from returning, or refluxing, back into the esophagus.

The cause of heartburn is unknown, but certain factors may contribute to the condition. They include:

• Specific foods such as garlic, spicy foods and fried foods
• Smoking
• Caffeine
• Pregnancy
• Being overweight
• Alcohol
• Certain medications, such as nitrates and some muscle relaxants

A condition known as hiatal hernia also may contribute to heartburn. A hiatal hernia occurs when the upper part of the stomach is above the diaphragm, the muscle wall that separates the stomach from the chest. The diaphragm helps the LES keep acid from coming up into the esophagus. When a hiatal hernia is present, it is easier for the acid to come up.

Occasional heartburn doesn't mean you have GERD. Ten percent of the population experiences heartburn and other symptoms of GERD at least once a week. But heartburn that occurs more than twice a week may be considered GERD, which can lead to more serious health problems such as inflammation of the esophagus, or Barrett's esophagus, and lung problems.

At UCSF Medical Center experts treat heartburn with lifestyle and dietary modifications, medications, a surgical procedure called fundoplication to tighten the LES muscles and less-invasive endoscopic techniques.

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Reviewed by health care specialists at UCSF Medical Center.
Last updated February 14, 2008