Heartburn: Prevention & Relief

Instructor: Artem Cheprasov
Heartburn is a pretty common problem. So, how do we treat it? It turns out there is more than one way, and this lesson explains how you can prevent heartburn and how the most common treatment options work.

Heartburn in People

Pretend you're on a car ride with good old Uncle Jack today. Uncle Jack is obese, eats large and greasy meals, and loves spicy food. He keeps complaining of a burning pain in his chest and starts popping antacids like crazy. Why? This lesson tells you why as it explores heartburn prevention and relief.

What Is Heartburn?

Heartburn is nothing more than a symptom. This isn't a minimization. It's just a fact. It's a subjective experience, one of burning pain behind the breastbone. Obesity, eating large meals, eating greasy meals, and spicy food can either cause or exacerbate heartburn. Poor Uncle Jack checks all those of, doesn't he?

The root reason for heartburn isn't too hard to understand. When Uncle Jack chows down on a spicy bacon-wrapped burger, his mouth chews the food. Then he swallows it. This food passes from the mouth and into the esophagus. Down it travels through the esophagus and towards the stomach. Right as the esophagus meets the stomach, there's a muscular band of tissue called the lower esophageal sphincter (LES) that opens up to let the burger into the stomach. Once the piece of burger passes through the LES, the LES closes. That's what should happen when everything is hunky-dory.

But with obesity, pregnancy, various drugs, large meals, and much more, the LES may abnormally relax or open up. This allows stomach acid to move into the esophagus. This stomach acid chemically corrodes the internal lining of the esophagus, which is painful to say the least. This burning pain is thus called heartburn.

The LES is located at the juncture of the esophagus and stomach
Digestive system

Heartburn Prevention and Relief

Since Uncle Jack doesn't want any burning pain, what can he do to prevent it? First, he may need to cut back on certain foods that may trigger heartburn, such as alcohol and caffeinated beverages, which can cause the LES to improperly relax. He should avoid eating large meals to decrease the pressure on the LES. He should eat smaller meals that are more evenly distributed throughout the day instead. Additionally, he can try helping himself along with gravity. Lying down horizontally may increase pressure on the LES and trigger heartburn. So, Uncle Jack may want to try sleeping with his upper body elevated a bit with some pillows.

But what if Uncle Jack still has some heartburn? How can we relieve this painful burning sensation? Uncle Jack has already provided us with one answer: antacids. An antacid works by chemically reacting with stomach acid in such a way that it neutralizes it, much like water neutralizes a fire. However, an antacid can't work forever because the stomach continuously produces stomach acid. Thus, people sometimes have to pop antacids to get long-lasting relief.

Like I just implied, the stomach is a factory. It doesn't just digest food. It also produces things, including acid. Logically, how else can we minimize the cause of heartburn (the acid)? Well, we can shut off the tap, so to speak. We can stop the stomach from secreting stomach acid. We do this with various drugs, including proton pump inhibitors. These drugs inhibit (stop or minimize) the pumping out of protons (acid) by your stomach. Examples of these drugs include Prilosec (omeprazole) and Nexium (esomeprazole).

Another kind of drug that decreases the secretion of stomach acid is known as an H2 blocker. This is a drug that blocks histamine receptors in the stomach. Histamine binds to these receptors and increases the secretion of stomach acid. If we block these receptors, histamine can't bind them, and thus the amount of stomach acid that's secreted is minimized. Examples of these drugs include Pepcid AC (famotidine) and Zantac (ranitidine)

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