Heartburn is a disease that occurs when gastric contents flow backward from the stomach into the esophagus. It is also termed reflux and gastroesophageal reflux disease (GERD) or pyrosis. Heartburn may or may not be associated with mucosal injury; that disease, termed esophagitis, is addressed in a separate article. Surveys suggest that as many as 25% to 40% of adults have experience heartburn once a month, while about 7% to 10% have daily heartburn. Heartburn occurs more often in males and in people over the age of 40 years.
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The cause of heartburn is excessive flow of gastric contents back into the esophagus. Normally, there is an occasional backflow into the esophagus with no symptoms. The acidic gastric contents, when present in large amounts, irritate the esophagus (usually the lower part) and cause the symptoms of heartburn.
Symptoms of heartburn usually consist of a sensation of burning or discomfort after eating, located in the middle of the lower chest underneath the sternum (breastbone). The discomfort may increase when bending over or lying flat on the back. Some people experience dysphagia (difficulty swallowing) or feeling like food is stuck in the lower esophagus while others may have a cough or respiratory discomfort, although these symptoms occur less frequently.
Bhupinder Anand, MD
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