Heartburn

Heartburn or pyrosis is a painful burning sensation in the esophagus, just below the breastbone. The pain often rises in the chest and may radiate to the neck or throat.

Pathophysiology

It is caused by the failure to close the lower esophageal sphincter (LES) at the top of the stomach. This allows stomach contents, now mixed with gastric acid, to return into the esophagus. This return is also known as reflux, and may progress to gastroesophageal reflux disease (GERD) if it occurs frequently. Peristalsis, the rhythmic wave of muscular contraction in the esophagus, normally moves food down and past the LES.

Treatment

If heartburn occurs when lying down, raising the head with pillows or sitting up frequently provides relief. Avoidance of certain foods shortly before bedtime is frequently advised to avoid future attacks.

Antacids, H2-receptor antagonists and proton pump inhibitors are used (in that order) to treat heartburn.

See also

• Acid indigestion