Heartburn, also known as acid reflux or acid indigestion, is caused by the passing of the stomach’s contents back to the esophagus. The stomach acid irritates the inner lining of the esophagus, causing pain in the upper abdomen area and the chest. This pain can be misinterpreted as heart disease, and so, it is important to get medical attention at the onset of irritation and pain in these areas.

Medical attention should be sought when:

• Symptoms of heartburn occur more than twice a week
• There is difficulty swallowing — a condition termed dysphagia
• There is a sensation of nausea and vomiting
• One has difficulty eating and undergoes unexplained weight loss
• Over-the-counter medications are not effective in quelling the symptoms

Diagnosis
Diagnosis of heartburn begins with a complete history of the patient and physical examination. In a large number of cases, this examination is enough for the physician to start the treatment. Sometimes more tests are required.

X-ray tests use barium meal or other contrast material to determine if there is inflammation or irregularities on the esophagus wall. This test can also show if the esophagus has the regular rhythmic wave-like movements (peristalsis) that push food down from the gullet into the stomach.

An endoscope with a camera may be inserted into the esophagus to view its lining and the stomach for inflammation and ulcers. Advanced endoscopes are used to obtain small bits of the lining to check for pre-cancerous or cancerous cells.

If the above tests are not conclusive, pressure tests (manometry) and acid measurements (pH levels) are used. These tests are unconventional and not commonly used, but are opted for if the symptoms are not typical.

Diagnosis needs to be carefully done, as the symptoms of heartburn can also indicate more serious conditions such as chest wall pain, pneumonia, pulmonary embolus, and heart attacks. Diagnoses should rule out these conditions before confirming heartburn.

Treatment
Treatment for heartburn consists of lifestyle changes and medication. Minor lifestyle changes such as eating smaller portions; but more frequently, not eating just before bedtime, and avoiding caffeine, alcohol, aspirin, and ibuprofen are helpful. Stopping smoking is also a must. To help keep the acid in the stomach and avoid reflux, one should use a high enough pillow so that the head is raised while sleeping.

Antacids and anti-histamines are the types of medication used to treat heartburn. The former coats the lining of the esophagus and neutralizes stomach acids whereas the latter blocks the action of histamine. Proton pump inhibitors (PPIs) too, inhibit the production of acid in the stomach. Surgery may be suggested in extreme cases, wherein the reflux causes wheezing and hoarseness, and medication alone does not provide relief. Foods like bananas, fresh ginger, turmeric, and chamomile tea are natural antacids and help reduce the production of excessive stomach acid. Aloe vera is known to lower blood sugar levels, so it is advisable to consult a physician before using it even though it is a common home remedy for heartburn.