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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
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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.

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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

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.
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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.

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Reviewed by health care specialists at UCSF Medical Center.

Related Information

UCSF Clinics & Centers

Gastroenterology

Gastroenterology at Mount Zion
1701 Divisadero St., Suite 120
San Francisco, CA 94115
Phone: (415) 502-4444
Fax: (415) 502-2249
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Gastroenterology at Parnassus
350 Parnassus Ave., Suite 410
San Francisco, CA 94143
Phone: (415) 502-2112
Fax: (415) 514-3300
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Gastrointestinal Motility & Secretion Center
400 Parnassus Ave., Box 0310
San Francisco, CA 94143-0310
Phone: (415) 353-9383
Fax: (415) 353-2505
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