Heartburn, also known as dyspepsia, is a common condition and many people search the internet to find information regarding this topic.

Heartburn Symptoms
Heartburn is described as a burning pain in the stomach that rises up towards the chest or towards the neck. Heartburn, a burning sensation or discomfort behind the breastbone or sternum, is the most common symptom of gastroesophageal reflux disease (GERD). Heartburn may be accompanied by regurgitation of gastric contents into the mouth or the lungs. Lung manifestations such as asthma, coughing, or intermittent wheezing and vocal cord inflammation with hoarseness occur in some patients.

Heartburn without a cause
Functional heartburn is defined as the presence of a burning sensation behind the sternum in the absence of pathologic gastroesophageal reflux. The underlying pathophysiology seems to be heterogeneous. In a subset of patients, esophageal hypersensitivity to physiologic esophageal acid exposure is involved, and this is likely to respond to intensive antireflux treatment. In the remaining patients, non-acid reflux, esophageal sensitivity, and psychological factors may be involved. Treatment options in these patients are limited owing to a lack of studies. Emerging therapies include antidepressants and relaxation therapy.

Natural Options for Heartburn:
Artichoke leaf extract has been tested.
Do not eat right before you sleep. Those who go to be bed within three hours after eating are many times more likely to suffer from heartburn as those whose dinner-to-bed time is four hours or longer.
See some of the information at GERD diet.

Heartburn Medication May not be Safe
Popular anti- heartburn medication such as proton-pump inhibitors that block stomach acid production heighten the risk of an increasingly common infectious form of diarrhea. Taking a heartburn medication such as AstraZeneca's Nexium or Losec or their generic versions significantly increases the risk of diarrhea blamed on the Clostridium difficile bacteria. Frequently prescribed anti-heartburn drugs called H2 antagonists that include GlaxoSmithKline's Zantac were found to double the risk of the bacterial diarrhea. The drugs reduce gastric acid, allowing for bacteria to multiply in the digestive system. Clostridium is the third-most common type of infectious diarrhea in patients aged 75 and older. Exposure to Clostridium difficile bacteria, which causes infection and inflammation of the intestine, previously occurred mostly during hospital stays, but cases have increasingly been contracted in community settings. While antibiotics formerly blamed for outbreaks of the illness have declined in use, the acid-blocking drugs have become steadily more popular to treat ulcers and conditions such as gastric reflux disease. SOURCE: Journal of the American Medical Association.
   Taking certain types of medication to deal with heartburn and excess stomach acid may increase the risk of cognitive impairment in the elderly. The drugs in question -- called histamine-2 receptor antagonists or H2As -- include popular medicines such as Zantac and Pepcid.
     Dr. Sahelian says: If you are on heartburn medication, remind your doctor to review your case periodically to make sure you are not taking a heartburn medication longer than you need to. Sometimes doctors forget the medicines they have prescribed to patients and continue prescribing them even if they are no longer needed.  

Heartburn drugs increase bone fracture
Heartburn drug use increases the risk for hip fracture. Proton pump inhibitors block the absorption of calcium which can decrease bone density and increase the risk for osteoporosis and bone fracture. The risk for bone fracture from the use of heartburn drugs increases with increasing age. One if four elderly who break a hip die within the following year. Those taking heartburn drugs may reconsider whether they really the drugs and if so they should consider adding additional calcium to their diet through calcium supplements.

Heartburn drugs
Aciphex, Nexium, Prevacid, Prilosec, Protonix.

Chronic Heartburn and Esophageal Cancer
Chronic heartburn appears to be associated with the nation's fastest-growing cancer, esophageal cancer. Some 3 million Americans are thought to have a type of esophagus damage from severe acid reflux that puts them at increased risk for the deadly cancer. There has been a six-fold increase in the last two decades in the main type of esophageal cancer.

Heartburn Research Update
Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial.
Aliment Pharmacol Ther. 2003 Dec;18(11-12):1099-105.
This study aimed to assess the efficacy of artichoke leaf extract in the treatment of patients with heartburn. In a double-blind, randomized controlled trial, 247 patients with heartburn were recruited and treated with either a commercial artichoke leaf extract preparation (2 x 320 mg plant extract t.d.s.) or a placebo. The primary efficacy variable was the sum score of the patient's weekly rating of the overall change in dyspeptic symptoms (four-point scale). Secondary variables were the scores of each heartburn symptom and the quality of life (QOL) as assessed by the Nepean Dyspepsia Index (NDI). RESULTS: Two hundred and forty-seven patients were enrolled, and data from 244 patients (129 active treatment, 115 placebo) were suitable for inclusion in the statistical analysis (intention-to-treat). The overall symptom improvement over the 6 weeks of treatment was significantly greater with artichoke leaf extract than with the placebo. Similarly, heartburn patients treated with artichoke leaf extract showed significantly greater improvement in the global quality-of-life scores (NDI) compared with the placebo-treated patients. CONCLUSION: The artichoke leaf extract preparation tested was significantly better than the placebo in alleviating symptoms and improving the disease-specific quality of life in patients with heartburn.

Artichoke leaf extract reduces mild heartburn in an open study.
Phytomedicine. 2002 Dec;9(8):694-9.
A recent post-marketing study indicated that high doses of standardised artichoke leaf extract (ALE) may reduce symptoms of heartburn. To substantial these findings, this study investigated the efficacy of a low-dose ALE on amelioration of dyspeptic symptoms and improvement of quality of life. The study was an open, dose-ranging postal study. Healthy patients with self-reported heartburn were recruited through the media. The Nepean Dyspepsia Index and the State-Trait Anxiety Inventory were completed at baseline and after 2 months of treatment with ALE, which was randomly allocated to volunteers as 320 or 640 mg daily. Of the 516 participants, 454 completed the study. In both dosage groups, compared with baseline, there was a significant reduction of all heartburn symptoms, with an average reduction of 40% in global heartburn score. However, there were no differences in the primary outcome measures between the two groups, although relief of state anxiety, a secondary outcome, was greater with the higher dosage. Health-related quality of life was significantly improved in both groups compared with baseline. We conclude that ALE shows promise to ameliorate upper gastro-intestinal symptoms and improve quality of life in otherwise healthy subjects suffering from heartburn.

Dyspepsia as a somatic expression of guilt: a case report.
Am J Clin Hypn. 2001 Jul;44(1):57-61.
A 58-year-old woman developed chronic, severe symptoms of heartburn, epigastric pain, and regurgitation that persisted for 2 years. She underwent a thorough evaluation and no organic cause was identified. Therefore, a diagnosis of dyspepsia was made. Her symptoms were refractory to pharmacological treatment. Upon further probing, the patient reported that the onset of her symptoms coincided with the death of her son of cancer 2 years earlier. She blamed herself for the death of her son and admitted to a need for self-punishment. A brief course of treatment using metaphors and hypnosis resulted in a complete resolution of her symptoms, which did not recur during a follow-up of 12 years. This is the first published report of the treatment of dyspepsia using hypnotic methods.

Heartburn Questions
Q. I know that tomatoes are not good for people suffering from heartburn or acid reflux. It's one of the foods to avoid. My question is whether taking a
lycopene supplement made from tomato extract would cause heartburn symptoms to worsen just like tomatoes do?
   A. I am not convinced that small amount of tomato consumption is harmful for those with heartburn. I have seen no indication that lycopene has any negative effects in those with heartburn symptoms.

Q. I suffer from heartburn every evening ! I was scoped several years ago and it showed gastritis but neg- for Helliobacter .I take Nexium every evening and it relieves it. I have cut out all strong alcohol, tomatoes, chocs, curries ets but still have my pint of Guinness.
 

Heartburn Medication