Doctor, why it burns in heart?

We commonly encounter this question and most of the people are young with severe anxiety due to their google search has landed them to think – it could be an “heart attack”, the word itself gives a sense of near death situation.

I would try to alleviate anxiety surrounding this symptoms and try to suggest remedies and management for this symptoms in this blog. This is for educational purpose and I strongly recommend to follow your doctor’s advice on this matter.

Question 1: What causes heart burn?

• Heart-burn is a symptom with various descriptions like retrosternal burning, chest pain, acidity, gas etc.
• GERD (Gastro Esophageal Reflux Disease) is commonest cause of heart burn where stomach acid comes up in esophagus and give rise to symptoms.
• Other causes like Peptic ulcer disease, Gastritis, Gastroparesis, Esophageal ulcer can give rise to heart burn

Question 2: Do I need any evaluation for heart burn?

• Your doctor can easily differentiate your symptoms of GERD from others
• We need to look into following ‘alarm symptoms’ which needs further evaluation:
  • Loss of appetite
  • Loss of weight
  • Recurrent vomitings
  • Blood loss in stool
  • Low hemoglobin
  • Feeling of lump in abdomen
  • Not responding to medicines

Question 3: What is Endoscopy and how it will help in heartburn?

• Endoscopy (Upper) is direct visualization of esophagus, stomach and duodenum by passing small tube through the mouth.
• Endoscopy can be helpful in proper diagnosis of GERD (with complications of GERD like ulcerations, esophagitis, stricture, mass) and also to differentiate it from other causes of heart burn.

Question 4: What are remedies for Heart burn?

• Avoid spicy food, soft drinks, Tea-coffee, chocolates
• Avoid late night dinner. Better to avoid lying down in bed for 2-3 hours after meals
• To elevate head end up by putting some bricks at head end of the bed.
• Don’t skip your breakfast and avoid prolonged fasting

Question 5: Do I need prolonged treatment?

• Most people will improve with medications which can reduce acid content of stomach, but feels recurrence of symptoms after stoppage of medication – Consult your doctor and avoid unnecessary self-medications
• Lifestyle modification as advised is useful to get rid of medications.

Question 6: How to differentiate it from cardiac pain?

• Cardiac pain many times gives similar symptoms, hence it advisable to get cardiac checkup once by doctor
• Avoid unnecessary anxiety once doctor has ruled out cardiac cause and stick to doctor’s advice.

Thanks and regards,

Dr Sandip P Shah

Consultant Gastroenterologist

GASTROPLUS Digestive Disease Centre and Advanced Endoscopy Clinic, Ahmedabad.

GASTROPLUS Team: Dr Sandip P Shah, Dr Ravindra Gaadhe, Dr Kunal Bhardwaj, Dr Ram Parihar