Heartburn In Teens: Causes, Symptoms, And Treatment

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Occasional heartburn in teenagers is not a cause of concern. This is not a cardiac symptom, and it is the regurgitation of stomach acid to the esophagus, causing burning pain in the chest and throat. It is also known as pyrosis or acid regurgitation. Usually, teens may experience heartburn after eating some foods or drinks, and it resolves without treatment in a short period. However, more frequent heartburn can signify gastroesophageal reflux disease (GERD) that requires medical evaluation.

Read on to know the causes, risk factors, symptoms, diagnosis, treatment, and prevention of heartburn in teens and when to seek medical care.

Signs And Symptoms Of Heartburn In Teens

The prominent symptoms of heartburn are burning sensation in the chest or throat and taste of acid or food in the mouth.

The following symptoms are often associated with heartburn (1):

• Sour taste
• Nausea
• Vomiting
• Halitosis (bad breath)
• Teeth damages
• Cough
• Abdominal discomfort
• Bloating, belching, and flatulence
• Trouble in swallowing
• Sore throat

Your teen may experience heartburn while lying down or bending after eating.

Although heartburn can be associated with a heart attack in adults, it may not apply to teens. This chest discomfort due to acid reflux can be alleviated with some over-the-counter antacids. However, if the problem persists, you may consult a doctor to identify the exact cause and treat it.

Causes Of Heartburn In Teenagers

Heartburn can be caused due to GERD,  a condition in which acid from the stomach flows up to the esophagus due to weakness or other problems of the lower esophageal sphincter.

Heartburn may also often be caused due to the following factors besides GERD (2):

• Obesity
• Overeating or eating very fast
• Lying down immediately post meals
• Stress
• Lack of sleep
• Dyspepsia, or indigestion
• Medications for asthma, pain, and allergies (antihistaminesⁱMedications that help relieve allergic symptoms. )
• Cigarette smoking
• Alcohol consumption
• Eating habits, such as eating late at night or consuming large meals
• Any neurological diseases at a young age
• Previous surgery of the esophagus
• Bacterial infection with helicobacter pylori

Heartburn can also be caused or worsened by certain foods such as (3):

• Spicy foods
• Fried or oily foods
• Vinegar
• Tomato sauce and foods containing preservatives
• Chocolates
• Coffee or tea
• Soft drinks

If your teen has heartburn that is frequent, excessively painful, not related to dietary factors and despite exercising and adequate rest seek a doctor’s advice.

Risks And Complications Of Heartburn In Teens

Heartburn can be diagnosed based on the symptoms and medical history of your teen. If dietary and lifestyle changes and medications do not improve it, your doctor may order tests to confirm the cause of heartburn. It can be (4):

• Esophagitis (inflammation of the esophagus)
• Ulcerations in the esophagus
• Narrowing of the esophagus followed by damage (esophageal stricture)
• Hiatus hernia (the upper part of the stomach protrudes into the chest cavity through the diaphragm, and can be exacerbated by eating late at night)
• Dry cough and other respiratory complications
• Change in voice

Heartburn may interrupt sleep and often worsen asthma problems. It may also be associated with inflammation of the larynx (laryngitis). Long-standing acid reflux may cause changes in the esophagus, known as Barrett’s esophagus. It is a precancerous change and requires medical care.

Diagnosis Of Heartburn In Teenagers

Heartburn can be diagnosed based on the symptoms and medical history of your teen. If dietary changes and medications do not improve it, your doctor may order tests to confirm the cause of heartburn. It can be (5):

• Radiography (X-ray): This is a visualization of the esophagus under an x-ray with the help of contrast liquidⁱA chemical that highlights anomalies when it is ingested during radiological procedures. . Your teen should swallow contrast liquid, such as barium, during this procedure. This method helps to identify structural defects in the esophagus. Contrast may cause nausea and light-colored stool, but it is not something to worry about.

• Esophageal impedance and pH monitoring: This test helps to identify the acid reflux using specific tubes.

• Upper gastrointestinal endoscopy and biopsyⁱA diagnostic test involving microscopic examination of tissues. : This test could give clear information about esophageal tissue damages from acid and sphincter function. Your doctor may also collect samples for biopsy during endoscopy. Usually, endoscopy is done in severe and moderate cases of heartburn.
  

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Doctors may order blood tests, breath tests, and stool tests to exclude helicobacter pylori infection that could cause heartburn. The infection  is often caused due to the consumption of  contaminated food or water. 

Treatment For Heartburn In Teenagers

Your doctor may suggest dietary modifications and lifestyle changes to reduce acid reflux. Chewing sugarless gums after eating and sleeping on the side or with an elevated head position may be useful in some teens. If conservative management fails to resolve heartburn, your teen will have to undergo pharmacological treatments.

Heartburn can be treated with medications depending on the causes. The following medications are used (6):

Almost all of the following drugs, except prokinetics, are available OTC (over the counter), one or two doses may be taken for acute relief. But a doctor’s advice should be sought if they are needed more than that not only because they have potential adverse effects but also because their abuse may mask the underlying condition which could be dangerous.

• Antacids: This medication neutralizes stomach acid, and it is available as Maalox, Alka-Seltzer, Riopan, Mylanta, etc. Seek a doctor’s advice for dosing since it may cause side effects such as constipation and diarrhea. Also prolonged consumption of antacids for symptom relief is not advisable and treatment of cause is needed to avoid long-term complications of acid reflux.

• H2 blockers: These drugs decrease the production of stomach acid. Cimetidine (Tagamet AB), ranitidine (Zantac 75), or famotidine (Pepcid) are H2 blockers.

• Proton pump inhibitors (PPIs): These drugs also reduce stomach acid production. omeprazole (Zegerid), esomeprazole (Nexium), and pantoprazole (Protonix) are a few examples of PPIs.

• Prokinetics: These medications induce faster emptying of stomach contents. Bethanechol (Urecholine) and metoclopramide (Reglan) are prokinetics available on prescription. These drugs may cause nausea, diarrhea, and tiredness. Prokinetics should not be taken with other anti-reflux medications.

Note:

Consult your teen’s doctor for appropriate doses. Over-the-counter medications are not viable a solution for persistent heartburn.

The following treatments are often given to resolve the underlying conditions that cause heartburn:

• Triple therapy: If your teen has heartburn due to gastritis caused by helicobacter pylori infection, your doctor will recommend antibiotic therapy. This treatment regime includes amoxicillin, clarithromycin, and a PPI in recommended doses (7).

• Surgery: Nissen fundoplication under laparoscope is a surgical procedure to correct weak sphincters. Fundoplication is effective in controlling acid reflux for the long-term. The upper part of the stomach is wrapped around the lower part of the esophagus during this surgery. Endoscopic sewing may be done in some cases. Post surgery, strict dietary and lifestyle modifications are required to prevent recurrence.

Remedies For Heartburn In Teenagers

The following remedies are suggested by doctors to reduce or prevent acid reflux from the stomach. Your teen may require medical treatments if dietary and lifestyle modifications do not resolve it. The remedies to prevent heartburn include (8):

• Cutting down weight if your teen is overweight or obese
• Eating smaller portions of food, slowly and not overeating
• Eating two to three hours before bedtime
• Getting enough exercise and adequate sleep
• Destressing
• Quitting smoking
• Avoiding foods that cause reflux

You may encourage your teen to consume healthy food and do some exercises to avoid weight gain and to improve overall health. However, there is no approved diet to prevent heartburn, and the triggering foods may vary among individuals.

Foods To Avoid In Heartburn

Dietary changes can have a major impact on your teen’s heartburn problems. They should not consume foods and drinks that often worsen acid reflux. You may ask them to avoid (9):

• Fried and fatty foods
• Coffee and tea
• Spicy foods
• Tomato sauce
• Chocolates
• Carbonated drinks
• Foods with added preservatives
• Canned food

These are foods that usually trigger or increase heartburn. If your teen experiences heartburn after eating certain foods, ask them to avoid those.

When To See A Doctor?

You may seek medical care if the heartburn in your teen does not resolve with dietary and lifestyle changes. The following may require immediate attention in teens with heartburn:

• Severe vomiting
• Hematemesis (vomiting of blood); Often looks like ground coffee
• Trouble breathing
• Repeated respiratory infections
• Throat pain while swallowing
• Reduced food intake
• Weight loss
• Dehydration
• Tarry stools
• Severe abdominal pain

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Gain expert insights about GERD in children, ways to manage its symptoms and promote your child’s digestive health, by a medical professional