Heartburn

Burning retrosternal discomfort due to irritation of the esophageal mucosa caused by gastroesophageal reflux of acidic gastric contents into the distal esophagus, typically occurring after meals or during nighttime.

Causes

• Gastrointestinal and functional causes

  • Delayed gastric emptying (gastroparesis)

  • Impaired esophageal clearance

• Mechanical and anatomical factors

  • Obesity

  • Pregnancy

  • Hiatal hernia

  • Increased intra-abdominal pressure

• Dietary factors

  • Heavy meals, fatty/spicy foods, citrus fruits, tomatoes, chocolate, coffee, alcohol

• Lifestyle factors

  • Tobacco smoking

  • Lying down shortly after eating

  • Postprandial exercise

• Medication-related causes: NSAIDs, antihypertensive medications

• Psychological: Anxiety, stress