What is HEARTBURN?
- Heartburn (Gastroesophageal Reflux Disease-GERD) is a sensation of warmth or burning located in the chest or high in the epigastrium with radiation into the neck and occasionally to the arms.
- Occasional heartburn is common in normal persons, but frequent and severe heartburn is generally a manifestation of esophageal dysfunction.

Causes of HEARTBURN
- Heartburn (GERD) is caused by  the reflux of the gastric acid and intestinal contents back up the esophagus causing burning sensations, esophageal mucosal damage and in some cases, mucosal erosion (erosive esophagitis).
- Many factors may promote heartburn by reducing lower esophageal sphincter (LES) tone, delaying gastric emptying, increasing acid secretion, or impairing the gastroesophageal pressure gradient.

Factors that may reduce lower esophageal tone possibly causing heartburn:
- Certain beverages and foods such as alcohol, chocolate, caffeine, fatty or greasy foods, spearmint, peppermint.
- Medications such as anticholinergics, beta-agonists, calcium channel blockers, narcotics, tricyclic antidepressants and estrogens/progestin containing medications.
- Smoking, delayed gastric emptying, overeating, obesity, motility disorder, lying down and tight-fitting clothing.

Symptoms of HEARTBURN
- Burning, water brash (hyper-salivation), belching, and regurgitation are the most common symptoms. 
- These symptoms are typically resolved with antacids.
- Daily symptoms can occur in 10% of the adult population, however infants/children may experience symptoms as well.
- 25% of pregnant women experience heartburn due to increased estrogen/progestin levels that decrease the lower esophageal sphincter tone and an increase in abdominal pressure due to the increased size of the uterus.
- Chest pain, not typical of heartburn, may resemble anginal pain.

Treatment of HEARTBURN
- The goals of treatment are to stop the patient’s symptoms and discomfort, decrease the recurrence and duration of heartburn attacks, promote the healing of any injured mucus membranes, and prevent any complications.
- Specific foods which aggravate the condition should be avoided.
- Overweight patients should try to lose weight and smokers should quit smoking.
- Lying down or bending over immediately after eating should be avoided.
- Loose fitting clothing should be worn around the stomach area.
- Eating should be avoided late at night or just before bedtime and raising the head of the bed may help reduce symptoms.
- OTC antacid products can be used for mild cases of heartburn. (Specific products may be recommended by a physician or pharmacist.)  Prescription medications may be used for moderate and severe cases.

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This information is of a general nature and may not apply to your special circumstances. If you have specific questions, please contact your physician or an appropriate health care professional.  These monographs are counseling aids for healthcare professionals only and are not to be used as a reference to diagnose or treat medical conditions.          Copyright 2005 RXinsider LTD