Generally heartburn is the result of acid gastric juice refluxing on an oesophageal mucosa which has been sensitized by frequent reflux. Heartburn may also be caused by irritant material that is neutral or alkaline, e.g. reflux from the duodenum. If there is a period of time of frequent gastro-oesophageal reflux in an otherwise eupeptic individual, then this will cause heartburn.
Oesophageal spasm also has a role in the generation of the sensation of heartburn. However, if anticholinergic drugs are used to abolish the pressure changes evident in spasm then heartburn still occurs.
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