Why do we have heartburn

Heartburn has been encountered by almost everyone throughout his lives. If this is an isolated case, it is not necessary to solve the situation in any way. However, if it is a chronic condition, it is advisable to see a doctor. It can be a serious disease, which in extreme cases can result in difficult-to-treat esophageal cancer. But why does heartburn occur in the first place and can we do something about it?

Heartburn causes the acidic contents of the stomach to return to the esophagus, in extreme cases to the oral cavity. Gastric acids react with the wall of the esophagus and we perceive this condition as a burning sensation that spreads in the middle of the chest. It is most often a manifestation of a disease called gastroesophageal reflux disease.^[1] It is relatively common in the western population with an incidence of 10 to 30 %. In East Asia, by contrast, it is less common, accounting for only about 3 to 8 % of cases.^[2]

Esophageal reflux disease is more common in the elderly population over the age of 50, which is mostly due to degradation of the esophageal-to-stomach transition area (gastroesophageal junction) and the lower esophageal sphincter.^[3] The disease can also be caused by an oesophageal hernia (hiatal hernia). Furthermore, it affects rather obese people and people with insufficient physical activity.^[2] Weakening of the esophageal sphincter can be caused by unsuitable diet, such as fatty and sweet foods, fresh bakery, alcohol, coffee, onions and garlic, etc.^[4][5]

Chronic heartburn can result in esophagitis, esophageal stricture, or Barrett's esophagus, the most severe form of esophageal reflux disease that can progress to cancer.^[6]

The disease is first treated by a change in lifestyle, which includes adjusting the diet, physical activities, preventing the lifting of heavy objects, adjusting the position during sleep and dinner at least 3 hours before going to bed. Furthermore, the disease is treated with drugs that promote intestinal peristalsis and the movement of food from the stomach, or reduce the aggressiveness of gastric juices. In case of persistent reflux, surgical treatment may be necessary.^[7]

We are unable to affect certain things in our lives, but some things we are. Lifestyle changes can help us in many ways and also in heartburn. Improving the composition of the diet and sufficient physical activity is also beneficial in preventing a number of other diseases.