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Heartburn: Heartburn Acid
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Heartburn... known as acid reflux, is the main symptom of GastroEsophageal Reflux Disease (GERD). Heartburn is a common problem, with more than half of all adults having symptoms at least monthly. Reflux occurs when the strong acid in the stomach abnormally rises up into the esophagus, causing discomfort. The damaging effects of acid can also result in the development of irritation, scarring, or even cancer of the esophagus. A malfunctioning muscle in the lower esophagus, the lower esophageal sphincter, is usually responsible for the symptoms of GERD. When this muscle is working properly, the esophagus is not exposed to acid, and reflux symptoms do not occur.
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Heartburn is a burning feeling in the middle of your chest caused by acid leaking upwards from the stomach into the esophagus, or swallowing tube. Doctors call this reflux esophagitis. Normally, the muscular esophagus acts like a one-way valve allowing food to enter your stomach after swallowing, but not letting anything go back up. When your esophagus is too loose where it connects to the stomach, strong stomach acid seeps back through the opening and causes heartburn. Because your esophagus doesn't have a protective lining like the stomach, it can be burned by the acid causing pain and sometimes damage. Heartburn can ... cause night time cough, wheezing, and in some cases difficulty swallowing food due to scarring of the esophagus.
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Heartburn actually has nothing to do with the heart. It is so called because of a burning sensation of the breastbone where the heart is located although some heart problems do have a similar sensation to heartburn. The term "heartburn" may come from the fact that hydrochloric acid from the stomach comes back up the esophagus because of a problem with the cardiac sphincter, a valve which misleadingly contains the word "cardiac" (an adjective referring to the heart) in its name.
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Heartburn in the absence of alarm or "red flag" symptoms is generally a benign disease and the PPI test remains an appropriate and widely utilized diagnostic strategy. The PPI test has a variable positive predictive value, ranging from 22% to 81%.107, 108, 109, 110, 111 Meta-analyses of the PPI test in diagnosing GERD by Numans et al.112 reported a sensitivity of 78% (95% CI 0.66–0.86) and a specificity of 54% (95% CI 0.44–0.65). However, the study was seriously hampered in that there were insufficient data to determine if the variations in PPI dosages and durations of therapy affected the sensitivity of the test. A similar strategy can ... be applied to patients with symptoms of NCCP. Wang et al.,113 in a meta-analysis, reported that the PPI test had a 80% sensitivity (95% CI 71–87%) and 74% specificity (95% CI 64–83%) for acid-induced NCCP.
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Heartburn (or reflux or oesophageal reflux) is very common. Almost everyone has it at some time. It is a feeling of discomfort or burning or even pain felt rising up from the lower chest into the neck. Some people call it indigestion. Heartburn is due to stomach acid rising up into the oesophagus, where it can cause pain and inflammation.
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Heartburn can be treated with surgical or non-surgical methods. Non-surgical treatment includes medication and changes of behavior and diet. This approach involves taking an anti-reflux medication, keeping a reasonable weight, and eating correctly (small meals; not eating before bed; avoiding fatty/spicy foods; and avoiding caffeine, alcohol, and nicotine). Surgical treatment for heartburn is usually performed when patients still have heartburn despite non-surgical treatment. The experts ... state that patients younger than sixty who require daily medication to control their heartburn symptoms are probably better off having the surgery, due not only to the relative high cost of long-term medication use, but also to the increased risk of serious complications from prolonged acid reflux.
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