Heartburn is first and foremost symptom that shows up in many gastroesophageal diseases. Gastroesophageal reflux disease (GERD) is a major disease caused by acid regurgitation. Heartburn is a common discomfort experienced occasionally by everyone. But when the reflux episodes repeat more than two weeks, then it becomes a symptom of many gastroesophageal diseases like esophagitis, esophageal cancer, dyspepsia, Barrett’s esophagus and heart diseases. The burning sensation and acid regurgitation is highly experienced during sleep, especially if one lie on his/her back. Proper care in diet and medication help to get rid of the discomforts caused by heartburn in our daily life activities
Possible Health Consequences on Health
There can be several health consequences of heartburn. Some of the most common ways heartbun can impact health are as follows:
Functional heartburn is not related to gastroesophageal reflux. It is a gastrointestinal disorder, which is an episodic retrosternal burning sensation. It is observed in nonerosive reflux disease. In endoscopic diagnosis, no esophagitis is noticed. Functional heartburn is classified into several subgroups. The identification of different subgroups of functional heartburn based on the history of clinical studies not achievable by doctors at present. Because the pathophysiological reason of functional heartburn is not known till now. The response to antireflux treatments is very limited in functional heartburn disorder. The absence of esophagitis in endoscopy clearly reveals that reflux related symptoms are absent in functional heartburn. It is identified that the prescription of a standard dose of proton pump inhibitors (PPI) and an increased dose of PPI in addition with pain modulators doesn’t cure functional heartburn.
Prolonged heartburn and acid regurgitation causes esophagitis. The inner membrane tissues of the esophagus are damaged by prolonged acid regurgitation and this result in irritation in esophagus. Any inflammation, swelling or irritations in the esophagus are generally termed as esophagitis. Eosinophilic esophagitis is an autoimmune disorder which also causes the irritation in esophagus. Smoking, alcohol consumption, intake of medications (eg: corticosteroids, tetracycline) increase the risk of esophagitis. The symptoms of esophagitis are cough, difficulty and painful swallowing, heartburn, hoarseness, sore throat and ulcer. Esophageal infections caused by yeast, helicobacter pylori (bacteria which causes peptic ulcer), viruses like herpes can also cause esophagitis. Eosinophilic esophagitis is caused by severe infiltration of eosinophils (a type of white blood cells) into the esophagus. It is unresponsive to acid blockage. It mimics gastroesophageal reflux disease. Based on the amount of mucosal eosinophils, eosinophilic esophagitis is differentiated from reflux esophagitis. The symptoms are heartburn, swallowing difficulty, esophageal strictures, and dysphagia. The cytokines released by the eosinophils are assumed to cause inflammation in the tissues of the esophagus. This irritation is the main reason for the condition of eosinophilic esophagitis.
Barrett’s esophagus is condition developed by the replacement of esophageal tissues by goblet cells present in the stomach due to acid regurgitation. The stomach acid causes inflammation in the lining of the esophagus. Men are more susceptible to barrett’s esophagus than women. Prolonged heartburn and GERD causes Barrett’s esophagus. It can develop into adenocarcinoma (cancer). The treatment of Barrett’s esophagus mainly focuses in removal of the harmful tissues developed in the esophagus. The laser device Photodynamic therapy along with drugs and surgery techniques are used for the treatment. The process of replacement of esophageal tissue cells to cells of the stomach is termed as intestinal metaplasia. 1.6 to 6.8 percent of people have the Barrett’s esophagus disease. It is majorly caused to people who are above 50 years and it is rarely caused to children. The squamous epithelial cells in the esophagus are replaced by lumnar epithelial cells present in the stomach. Presence of lumnar epithelium in the gastroesophageal junction reveals the incidence of Barrett’s esophagus. It is noticed that bacterial infection, especially Helicobacter pylori can decrease the risk of Barrett’s esophagus. High intake of fruits, vegetables, vitamins and frequent use of aspirin and nonsteroidal anti-inflammatory drugs reduce the risk of development of Barrett’s esophagus.
Esophagus cancer develops in the tissue lining of the esophagus. Cancer is a condition of abnormal cell growth. Cancer is also termed as malignant tumor. Barrett’s esophagus disease increases the development of esophageal cancer. It develops in the inner lining of the esophagus and extends towards other tissues. There are two main types of esophageal cancer-Squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma is found in the squamous cells in the lining of the upper esophagus. Adenocarcinoma develops in the glandular cell lining of the lower esophagus. Esophageal cancer is an uncommon cancer caused to people who are above 60 years. Men are more susceptible than women. Adenocarcinoma causes the release of mucus and other fluids. The symptoms of esophageal cancer are
- Chest pain
- Difficulty in swallowing food and liquid
- Acid and food regurgitation
- Vomiting of blood
- Weight loss
- Hoarseness and cough
The major cause of squamous cell esophageal cancer is smoking and high level of alcohol consumption. But adenocarcinoma is more common esophageal cancer, which develops from the Barrett’s esophagus disease. The causative factors develop esophagitis and increased cell turnover that initiates the tumor growth. It has been identified that esophageal cancer is the sixth leading cause of death worldwide in case of all cancer diseases. Esophageal cancer’s pathophysiology is unknown till now. Several epidemiological studies have shown that obesity and esophageal cancer are parallel. Increase in obesity show a threefold increase in incidence of esophageal cancer. Experimental studies in animals also reveal that nitrosamines a carcinogen present in tobacco can induce esophageal cancer. Cessation of smoking and diet control can improve and prevent the incidence of esophageal cancer.
Pain and discomfort in the upper abdomen define the condition of dyspepsia. It is also called as indigestion. The symptoms are bloating, nausea, heartburn and recurrent pain in the upper abdomen. The discomfort is felt right after a meal and experience fullness in the stomach after a full meal. The reasons of incidence of dyspepsia are alcohol consumption, intake of spicy and fried food, smoking and high caffeine intake. The subgroups of dyspepsia are ulcer-like, non-ulcer (functional) dyspepsia, dysmotility-like, reflux-like and unspecified dyspepsia. Functional dyspepsia is also observed in children. In ulcer-like dyspepsia, upper abdomen pain is reduced by food and antacid therapy. In functional dyspepsia, the symptoms prolong from atleast three to six months. Helicobacter pylori infections can also incidence dyspepsia. Effective treatments for functional dyspepsia are very limited. Antacids, antispasmodics and prokinetics drugs provide relief for the symptoms of dyspepsia.
Heartburn causes many health consequences. The causes of these consequences are unhealthy dietary habits, obesity, bacterial infection, smoking and alcohol consumption. Heartburn is observed as the first symptom of all these gastroesophageal disease. These diseases are diagnosed by esophageal endoscopy, x-ray and pH monitoring in the esophagus. Treatments like proton pump inhibitors, antibiotics, prokinetics drugs and surgery provides relief from all these gastroesophageal disease. Healthy diet habits prevent the aggressiveness of these diseases.