Изжога: причины, симптомы и диагностика.

Burning sensation mainly due to gastric acid in the esophagus
the medical condition

Heartburn, also known as pyrosis, cardialgia or acid indigestion, is a burning sensation in the central chest or upper central abdomen. Heartburn is usually due to regurgitation of gastric acid (gastric reflux) into the esophagus. It is the major symptom of gastroesophageal reflux disease (GERD). Other common descriptors for heartburn (besides burning) are belching, nausea, squeezing, stabbing, or a sensation of pressure on the chest. The pain often rises in the chest (directly behind the breastbone) and may radiate to the neck, throat, or angle of the arm. Because the chest houses other important organs besides the esophagus (including the heart and lungs), not all symptoms related to heartburn are esophageal in nature. The cause will vary depending on one's family and medical history, genetics, if a person is pregnant or lactating, and age. As a result, the diagnosis will vary depending on the suspected organ and the inciting disease process. Work up will vary depending on the clinical suspicion of the provider seeing the patient, but generally includes endoscopy and a trial of antacids to assess for relief. Treatment for heartburn may include medications and dietary changes. Indigestion is sometimes defined as a combination of epigastric pain and heartburn. Heartburn is commonly used interchangeably with gastroesophageal reflux disease (GERD) rather than just to describe a symptom of burning in one's chest.

Intestinal ulcers – generally secondary to other conditions such as H. pylori infection or cancers of the gastrointestinal tract. Pain often improves with eating. Duodenitis – inflammation of the small intestine. May be the result of several conditions.

Pancreatitis – can be autoimmune, due to a gallstone obstructing the lumen, related to alcohol consumption.

Pernicious anemia – can be autoimmune, due to atrophic gastritis.

Relief of symptoms 5 to 10 minutes after the administration of viscous lidocaine and an antacid increases the suspicion that the pain is esophageal in origin. This however does not rule out a potential cardiac cause as 10% of cases of discomfort due to cardiac causes are improved with antacids.

Esophageal pH monitoring: a probe can be placed via the nose into the esophagus to record the level of acidity in the lower esophagus. Because some degree of variation in acidity is normal, and small reflux events are relatively common, esophageal pH monitoring can be used to document reflux in real time. Patients are able to record symptom onset to correlate lower esophageal pH with time of symptom onset.

Manometry: in this test, a pressure sensor (manometer) is passed via the mouth into the esophagus and measures the pressure of the LES directly. Endoscopy: the esophageal mucosa can be visualized directly by passing a thin, lighted tube with a tiny camera known as an endoscope attached through the mouth to examine the oesophagus and stomach. In this way, evidence of esophageal inflammation can be detected, and biopsies taken if necessary. Since an endoscopy allows a doctor to visually inspect the upper digestive tract the procedure may help identify any additional damage to the tract that may not have been detected otherwise. Biopsy: a small sample of tissue from the oesophagus is removed. It is then studied to check for inflammation, cancer, or other problems. H2 receptor antagonists or proton pump inhibitors are effective for the two most common causes of heartburn (e. g. gastritis and GERD)
Antibiotics are used if H. pylori is present.

In the case of GERD causing heartburn symptoms, surgery may be required if PPI is not effective. Surgery is not undergone if functional heartburn is the leading diagnosis.

About 42% of the United States population has had heartburn at some point.