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Every time we eat, our food is chewed, swallowed and pushed down our oesophagus — the tube that connects our mouth to our stomach. At the base of the oesophagus, a ring of muscles relaxes to let food in, and tightens to prevent stomach acid from escaping. Occasionally, even in healthy individuals, stomach acid is inadvertently pushed back up into the oesophagus, where it can cause a burning sensation in the chest or throat.
This is known as heartburn, and in most people, it can be relieved by taking over-the-counter antacid medicines which neutralise stomach acid or simply waiting.
When conventional treatments don't work, is surgery or medication the better option for heartburn? Listen to the interview with Stuart Spechler on the Health Report. When it occurs more than twice a week, or is severe, it's usually thought to be GORD — and the result of a "leaky valve mechanism at the end of the oesophagus". For people with persistent heartburn, avoiding certain foods and drinks that trigger reflux can help to reduce symptoms.
Health professionals recommend lifestyle changes , including losing weight, quitting smoking, eating smaller meals, and avoiding food before vigorous exercise, and two or three hours before sleeping. But to create a long-lasting reduction of stomach acid, people are also usually prescribed a course of PPIs.
One alternative to PPIs is surgery to fix the leaky valve mechanism in the oesophagus — but the evidence hasn't been clear as to whether surgical intervention is better than medication. To find out, Dr Spechler and his colleagues put it to the test, comparing medicines that reduce stomach acid, drugs that relax the muscles in the throat, and throat surgery. The causes of heartburn are many and varied, Dr Spechler said, and not specific to reflux disease either.
There's a food allergy problem that involves the oesophagus that can also give you heartburn.
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The researchers also found a "substantial minority" of patients who believed their heartburn could not be helped with PPIs were simply not taking their medicines correctly. In order to inhibit them, the cells have to be active — they have to be actively making acid when the drug is in the bloodstream. Dr Spechler said as soon as the researchers explained how to take the medication correctly — 30 to 60 minutes before meals — many patients with GORD did in fact get relief. Want even more science, health and tech?
Join the conversation on Facebook. Whatever the cause of heartburn, Dr Spechler said it was important to correctly identify, to avoid unnecessary or ineffective treatment. Among the 78 patients found to have GORD that was truly unresponsive for PPIs, the researchers found surgery was the most effective solution, both for acid and non-acid reflux. And those patients did very, very well with the operation," he said.
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This causes an uncomfortable burning feeling in your chest that can move up to your neck and throat. You may also have a bitter or sour taste in the back of your throat. Heartburn can last from a few minutes to several hours, and often feels worse after you eat. Occasional heartburn is common, and can usually be relieved by over-the-counter antacids.
Eating chillies can trigger heartburn.
The condition is also known as acid reflux, gastroesophageal reflux GERD , acid indigestion, and reflux. If you have heartburn often and it is severe, you may have gastroesophageal reflux disease GERD. It's located where the esophagus meets the stomach -- below the rib cage and slightly left of center.
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Normally, with the help of gravity, the LES keeps stomach acid right where it should be -- in your stomach. When it's working right, the LES opens to allow food into your stomach or to let you belch, then closes again. But if the LES opens too often or doesn't close tightly enough, stomach acid can seep into the esophagus and cause a burning sensation. If your LES doesn't tighten as it should, there are often two things that contribute to the problem. One is overeating, which puts too much food in your stomach. Another is too much pressure on your stomach, often due to obesity , pregnancy , or constipation.
Meals high in fats and oils animal or vegetable often lead to heartburn , as do certain medications. Stress and lack of sleep can raise how much acid your stomach makes and can cause heartburn.