Heartburn

What Causes Heartburn?

In order to deal properly with heartburn we need to understand and — if possible — remove the underlying causes and risk factors.  We need to ask: "What else is going on inside the body that might allow heartburn symptoms to develop?"

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Accurate diagnosis of the factors behind heartburn consists of three steps:

Step 1: List the Possible Causative Factors

Identify all disease conditions, lifestyle choices and environmental risk factors that can lead to heartburn symptoms.  Here are eight of many possibilities (more below):
  • A Weight Problem
  • Food Allergies
  • Dehydration
  • Heart Disease*
  • Short Bowel Syndrome
  • Sleep Apnea
  • Crohn's Disease
  • Stomach Acid Deficiency
* symptoms can be very similar

Step 2: Build a Symptom Checklist

Identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
regular meal-related burping
extreme calorie restriction
severe flatulence
occasional runny nose
coffee consumption
significant meal-induced pain
significant abdominal pain
high caffeinated soda consumption
significant bowel movement changes
poor bodily coordination
regular episodes of diarrhea
numb/burning/tingling extremities
... and more than 160 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of heartburn symptoms:
Cause Probability Status
Short Bowel Syndrome 96% Confirm
Stomach Acid Deficiency 27% Unlikely
A Weight Problem 26% Unlikely
Food Allergies 1% Ruled out
Heart Disease** 1% Ruled out
Crohn's Disease 0% Ruled out
Sleep Apnea 0% Ruled out
Dehydration 0% Ruled out
* This is a simple example to illustrate the process
** Symptoms can be very similar

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate occasional problems caused by eating, regular problems caused by eating or frequent problems caused by eating, The Analyst™ will ask further questions including this one:
Have you suffered from Heartburn or Gastric Reflux? The main symptoms include burning at the top of the stomach, chest pain, and regurgitation of food and/or stomach acid.
Possible responses:
→ Not sure / don't know
→ No, definitely not
→ Past episode(s) now resolved
→ Current minor problem
→ Current major problem
Based on your response to this question, which may indicate absence of heartburn, history of heartburn or confirmed heartburn, The Analyst™ will consider possibilities such as:
Coronary Disease / Heart Attack

A mild heart attack may be mistaken for heartburn, and vice versa.

Crohn's Disease

Crohn's disease is a chronic ailment that causes inflammation and injury in the colon and other parts of the gastrointestinal tract, including the esophagus.

Dehydration

Dr. Batmanghelidj, author of Your Bodies Many Cries for Water, believes that in the same way we have a "hunger pain" signal, we also have a "thirst pain" signal in the body, and that it is called dyspepsia (heartburn).

Gastric/Peptic/Duodenal Ulcers

There is a relatively high prevalence of GERD amongst patients with duodenal or gastric ulcers.  Persistent dyspepsia/heartburn symptoms after eradication of H. pylori and ulcer resolution might suggest the treatment of GERD as a separate entity.  [Am J Gastroenterol 2000;95: pp.101-105]

Hiatal Hernia

Some doctors believe that some people suffer from GERD due to a condition called hiatal hernia.  Hiatal hernia causes burning and difficulty in swallowing.  Hiatal hernia and GERD can both cause heartburn.

Hydrochloric Acid Deficiency

Based on the clinical experience of doctors such as Dr. Jonathon Wright, MD, supplementing with hydrochloric acid sometimes relieves the symptoms of heartburn and improves digestion in individuals who have hypochlorhydria.  Unexplained bloating, belching and heartburn are frequently diagnosed as symptoms of hyperacidity and sometimes wrongly treated with antacids, when in fact the underlying problem is insufficient acid production.

Hypothyroidism

Gastrointestinal manifestations of hypothyroidism include GERD as a result of delayed emptying of the stomach.

... and also rule out issues such as:
Angina

Angina-like symptoms are sometimes due to heartburn, a much less serious condition.

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