Name of the Condition

• Heartburn (Acid Indigestion)

Summary

• Heartburn is a burning sensation in the chest, typically caused by acid reflux, where stomach acid travels back up into the esophagus. It can be an occasional nuisance or a symptom of a more severe condition like GERD (Gastroesophageal Reflux Disease).

Causes

• Heartburn is commonly caused by the backflow of stomach acid into the esophagus. This can result from eating large meals, lying down after a meal, consuming certain foods or drinks (such as spicy foods, alcohol, or coffee), smoking, or being overweight or pregnant.

Risk Factors

• Risk factors include obesity, pregnancy, smoking, eating large meals or lying down right after a meal, consuming certain foods and drinks, stress, and some medications like aspirin or ibuprofen.

Symptoms

• The primary symptom is a burning pain in the chest typically occurring after eating, which might be worsened by lying down or bending over. Other symptoms can include a sour taste in the mouth, difficulty swallowing, and a chronic cough.

Diagnosis

• Diagnosing heartburn often starts with a medical history review and physical examination. If needed, further tests like an upper endoscopy, ambulatory acid (pH) probe tests, or esophageal motility testing might be conducted.

Treatment Options

• Treatment can include lifestyle modifications and over-the-counter antacids, H2-receptor blockers, or proton pump inhibitors. In more severe cases, prescription medications or surgery might be recommended to help reduce or prevent acid reflux and manage symptoms effectively.

Prognosis and Follow-Up

• With appropriate treatment and lifestyle changes, heartburn can often be well-managed. Chronic heartburn should be monitored as it can lead to complications like esophagitis or, rarely, Barrett's esophagus. Regular follow-ups with a healthcare provider are important for managing symptoms and preventing complications.

Complications

• If untreated, heartburn can lead to gastroesophageal reflux disease (GERD), esophagitis, esophageal strictures, or Barrett’s esophagus, which increases the risk of esophageal cancer.

Lifestyle & Prevention

• Lifestyle changes to manage or prevent heartburn include maintaining a healthy weight, avoiding foods and drinks that trigger reflux, eating smaller meals, quitting smoking, and not lying down immediately after eating. Elevating the head when sleeping can also help mitigate symptoms.

When to Seek Professional Help

• Immediate medical attention is necessary if you experience severe chest pain, especially if it comes with shortness of breath or jaw/arm pain. Regular heartburn sufferers should consult a healthcare provider to evaluate and address underlying causes.

Additional Resources

• Resources include the American Gastroenterological Association (gastro.org), Mayo Clinic (mayoclinic.org), and patient support groups like the International Foundation for Gastrointestinal Disorders (iffgd.org).

Tips for Medical Coders

• Ensure the use of correct ICD code R12 for heartburn. Be detailed when documenting associated symptoms or complications to provide accurate coding. Avoid confusing heartburn with conditions like GERD or other gastrointestinal disorders, which have different codes.