Heartburn - Medical Mystery

You say you have heartburn, but what does that mean? Is it serious? What causes it?

Your Physician’s Answer

Heartburn remains a mystery to physicians. They are not really sure what causes it. Yes, they know that “for some reason” the lower esophageal sphincter (LES) fails to function properly. That ring of muscle fails to keep the stomach’s contents where they belong and heartburn results. They don’t know, however, why the muscular ring fails to do its job. They have not yet discovered what causes the LES to do its job on a now-and-then rather than an always basis. Boiling it down, they do not understand heartburn.

Heartburn Expert’s Answer

Daniel DeMarco M.D., medical director of endoscopy at Baylor University Medical Center in Dallas, is a board-certified gastroenterologist. He is also the founder of Baylor Heartburn Center. Yet Doctor DeMarco made the following statement about heartburn in July 2007.

The current thinking is that the acid is refluxed upward because of temporary, inappropriate relaxations of the lower esophageal sphincter, the valve between the stomach and the esophagus.

In other words, acid flows back into the lower esophagus because something happens to the LES. We don’t know what that something is.

Heartburn and Weight

For years, physicians have suggested that weight loss might cure heartburn. Some studies found that it did. Other studies found the opposite. Dr. DeMarco confirmed that there is no real evidence that weight affects heartburn one way or another. Extra weight does cause, he said, increased pressure on the chest. However, people of normal weight experience the same increased pressure at times.

Excess weight seems not to be the cause of the LES weakness.

Heartburn and Trigger Foods

There are many who believe heartburn is caused by consumption of certain foods. Typically, Chinese food or spicy offerings are blamed. The reasoning is that such food triggers an increase in stomach acids, which then flow back into the esophagus, causing heartburn.

Even if food does trigger heartburn for some people, this is a result, not a cause. Proponents, including the National Heartburn Alliance (NHBA), still do not know what causes the LES to malfunction. If it malfunctions only when such food triggers are eaten, what is it about the food that causes the malfunction?

Heartburn and Stress

Stress is thought to cause heartburn for some people. Stress is the response our bodies, minds, and emotions make to unusual demands. A day of unusual demands at work may be followed by heartburn after the evening meal. Again, we are looking at the result, not the cause. Until researchers are able to show how stress causes the LES to malfunction, heartburn is still a medical mystery.

NOTE: It is believed that persistent, serious heartburn can lead to cancer of the esophagus. Please discuss your heartburn with a physician. The information here is for educational purposes only.