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Pyrosis (Heartburn)

A painful, burning feeling in the chest caused by stomach acid flowing back into the esophagus.

PubMed Health Glossary
(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases)

About Heartburn (Pyrosis)

Many people have heartburn every now and again after eating a large meal, and will be familiar with the unpleasant burning feeling in their chest, just behind their breastbone. It is normal to belch ("burp") after a meal too. Sometimes partially digested food comes back up into your throat or mouth from your stomach. This is known as regurgitation, and is associated with a sour taste in your mouth.

Up to 20 out of 100 people living in Western countries regularly have problems like heartburn or regurgitation. Although both of these can be unpleasant, they do not usually lead to other health problems. But if you have very frequent or severe heartburn, often have regurgitation, and feel that it is having a big effect on your everyday life, you may have what is known as "gastro-esophageal reflux disease", or GERD for short. "Gastro-esophageal" means "stomach and food pipe".

If someone has reflux, some of the contents of their stomach leak out and flow back into their food pipe (also known as "gullet" or "esophagus"), because the entrance to the stomach does not close properly. The passage between the food pipe and stomach is normally closed. It opens when the mixture of chewed food and saliva reaches the lower end of the food pipe. Once the food has entered the stomach, the lower end of the food pipe closes again. This ensures that the contents of the stomach do not flow back... Read more about Pyrosis

What works? Research summarized

Evidence reviews

Interventions for heartburn in pregnancy

Heartburn affects more than two‐thirds of women in late pregnancy. Usually it is not serious, but symptoms can be very distressing to pregnant women. There are many different interventions to relieve heartburn including advice on diet and lifestyle and a range of medicines (many of which are available over the counter without prescription). The review authors identified three randomised controlled trials including a total of 286 women focusing on three different heartburn medications. While the results of the individual trials were positive (women described some relief from symptoms), overall it was concluded that there is little information on the safety or effectiveness of drugs used to treat heartburn in pregnancy. More information is needed on this common and distressing condition.

Short‐term treatment with medications for heartburn symptoms

Patients with only mild or intermittent heartburn may have adequate relief with lifestyle modifications and with antacids, although other options are available. The two most commonly used drugs for treatment of heartburn are H2‐receptor antagonists (H2RAs) and proton pump inhibitors (PPIs). These drugs act by suppressing the release of acid from the stomach. This review found that in the short term PPIs relieve heartburn better than H2RAs in patients who are treated without specific diagnostic testing. Although the difference is smaller, this is also true for patients with gastro‐oesophageal reflux disease (GORD), who have a normal upper endoscopy . In summary, proton pump inhibitor drugs appear to be more effective than H2‐receptor antagonists for relieving heartburn.

Interventions for heartburn in pregnancy

This review aims to evaluate the effectiveness of interventions for relieving heartburn in pregnancy. Interventions include advice on diet, lifestyle modification, medications and complementary therapies.

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Summaries for consumers

Heartburn and GERD: How is GERD diagnosed?

If it is thought that someone might have GERD, treatment with a proton pump inhibitor can be tried out. If this relieves the symptoms, then it is very likely that GERD is causing them. Further tests might be necessary if there is no clear outcome or if the person has unusual symptoms.A lot of people have heartburn after large meals. Occasional acid reflux is normal too. But very frequent, severe heartburn or acid reflux can be a sign of gastro-esophageal reflux disease, or GERD for short. In GERD, some of the stomach contents flow back into the food pipe because the entrance to the stomach doesn't close properly.It is usually typical symptoms like these that make people seek medical advice. Sometimes people have an examination because of other symptoms, and then discover by chance that their food pipe is inflamed. The food pipe can become inflamed if the mucous membranes lining it are repeatedly exposed to acidic stomach juices.Describing your symptoms in as much detail as possible is important when it comes to diagnosing GERD:What symptoms do you have?Where exactly are they?How often do you have them?Do the symptoms occur after eating or when your stomach is empty?Do they get worse when you lie down?This information can help the doctor to find out whether the symptoms are being caused by GERD or by something else.GERD doesn't always cause obvious symptoms. For instance, someone might have GERD without having heartburn or acid reflux, or these symptoms may only be very infrequent or mild. Or they may have other, less typical symptoms, such as problems swallowing, a sore throat or a cough.

Interventions for heartburn in pregnancy

Heartburn affects more than two‐thirds of women in late pregnancy. Usually it is not serious, but symptoms can be very distressing to pregnant women. There are many different interventions to relieve heartburn including advice on diet and lifestyle and a range of medicines (many of which are available over the counter without prescription). The review authors identified three randomised controlled trials including a total of 286 women focusing on three different heartburn medications. While the results of the individual trials were positive (women described some relief from symptoms), overall it was concluded that there is little information on the safety or effectiveness of drugs used to treat heartburn in pregnancy. More information is needed on this common and distressing condition.

Short‐term treatment with medications for heartburn symptoms

Patients with only mild or intermittent heartburn may have adequate relief with lifestyle modifications and with antacids, although other options are available. The two most commonly used drugs for treatment of heartburn are H2‐receptor antagonists (H2RAs) and proton pump inhibitors (PPIs). These drugs act by suppressing the release of acid from the stomach. This review found that in the short term PPIs relieve heartburn better than H2RAs in patients who are treated without specific diagnostic testing. Although the difference is smaller, this is also true for patients with gastro‐oesophageal reflux disease (GORD), who have a normal upper endoscopy . In summary, proton pump inhibitor drugs appear to be more effective than H2‐receptor antagonists for relieving heartburn.

See all (37)

More about Pyrosis

Photo of an adult

Also called: Burning reflux, Acid indigestion

See Also: Gastroesophageal Reflux Disease, Esophageal Reflux, Dyspepsia

Other terms to know:
Esophagus, Lower Esophageal Sphincter, Stomach

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