Heartburn overview: Difference between revisions
Jose Loyola (talk | contribs) |
Jose Loyola (talk | contribs) No edit summary |
||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
[[Heartburn]] or [[pyrosis]] is a painful or burning sensation in the [[esophagus]], just below the [[Sternum|breastbone]] (sternum) caused by regurgitation of [[gastric acid]]. | [[Heartburn]] or [[pyrosis]] is a painful or burning sensation in the [[esophagus]], just below the [[Sternum|breastbone]] (sternum) caused by regurgitation of [[gastric acid]]. The pain often rises in the [[chest]] and may radiate to the [[neck]], [[throat]], or angle of the [[jaw]]. [[Heartburn]] is also identified as one of the causes of chronic [[cough]], and may even mimic [[asthma]]. | ||
[[Heartburn]] main cause is [[gastroesophageal reflux disease]], and it is a symptom of that disorder, but it can also be mistaken with other causes of [[chest pain]], including life-threatening ones such as [[acute coronary syndromes]]. | [[Heartburn]] main cause is [[gastroesophageal reflux disease]], and it is a symptom of that disorder, but it can also be mistaken with other causes of [[chest pain]], including life-threatening ones such as [[acute coronary syndromes]]. | ||
==Historical Perspective== | |||
[[Heartburn]] was first medically described by Blount in 1656, who called the symptom "Dyspepsy". | |||
==Classification== | |||
There is no established system for the classification of [[heartburn]]. | |||
==Pathophysiology== | |||
The sensation of heartburn is caused by exposure of the lower [[esophagus]] to the [[acid]]ic contents of the [[stomach]]. Normally, the lower esophageal [[cardia|sphincter]] (LES) separating the [[stomach]] from the [[esophagus]] is supposed to contract to prevent this situation. If the [[sphincter]] relaxes for any reason (as normally occurs during swallowing), [[stomach]] contents, mixed with [[gastric acid]], can return into the [[esophagus]]. This return is also known as ''reflux'', and may progress to [[gastroesophageal reflux disease]] (GERD) if it occurs frequently. If this is the case, the [[gastric acid]] and [[pepsin]] now located in the [[esophagus]] can injure the [[tight junction]] proteins in the esophageal [[epithelium]]. This results in increased paracellular permeability and dilated [[intercellular space]] and [[edema]] in the [[submucosa]], which is amplified by an immunological mechanism mediated by inflammatory [[cytokines]]. | |||
==Causes== | |||
[[Heartburn]] is commonly caused by [[gastroesophageal reflux disease]] ([[GERD]]) or adverse reactions to various food and drugs, causing [[esophagitis]]. | |||
Life threatening causes of [[heartburn]] are far less common and include [[acute coronary syndromes]] and [[esophageal cancer]]. Very uncommon causes include [[CREST syndrome]] and [[Zollinger Ellison syndrome]]. | |||
==References== | ==References== | ||
Revision as of 14:12, 7 September 2020
|
Heartburn Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Heartburn overview On the Web |
|
American Roentgen Ray Society Images of Heartburn overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]
Overview
Heartburn or pyrosis is a painful or burning sensation in the esophagus, just below the breastbone (sternum) caused by regurgitation of gastric acid. The pain often rises in the chest and may radiate to the neck, throat, or angle of the jaw. Heartburn is also identified as one of the causes of chronic cough, and may even mimic asthma. Heartburn main cause is gastroesophageal reflux disease, and it is a symptom of that disorder, but it can also be mistaken with other causes of chest pain, including life-threatening ones such as acute coronary syndromes.
Historical Perspective
Heartburn was first medically described by Blount in 1656, who called the symptom "Dyspepsy".
Classification
There is no established system for the classification of heartburn.
Pathophysiology
The sensation of heartburn is caused by exposure of the lower esophagus to the acidic contents of the stomach. Normally, the lower esophageal sphincter (LES) separating the stomach from the esophagus is supposed to contract to prevent this situation. If the sphincter relaxes for any reason (as normally occurs during swallowing), stomach contents, mixed with gastric acid, can return into the esophagus. This return is also known as reflux, and may progress to gastroesophageal reflux disease (GERD) if it occurs frequently. If this is the case, the gastric acid and pepsin now located in the esophagus can injure the tight junction proteins in the esophageal epithelium. This results in increased paracellular permeability and dilated intercellular space and edema in the submucosa, which is amplified by an immunological mechanism mediated by inflammatory cytokines.
Causes
Heartburn is commonly caused by gastroesophageal reflux disease (GERD) or adverse reactions to various food and drugs, causing esophagitis. Life threatening causes of heartburn are far less common and include acute coronary syndromes and esophageal cancer. Very uncommon causes include CREST syndrome and Zollinger Ellison syndrome.