I looked for those scientific determinations. I couldn't find anything substantial. Mostly I saw a bunch of "ayurvedic treatments suggest X for Y, X contains A, B, and C, and C is seems to affect Q, which may be related to Y, so if there's an effect then that effect might be mediated through Q. But we need more studies to be sure."

As to your heartburn example, here's what Western medicine suggests.

1) While true for <1% of the population, the heartburn could be caused by ischemic heart disease.
An adjustment of diet or lifestyle won't make a big difference at this point.

Diet and lifestyle makes a much bigger difference in the decade leading up to the problem, but you chose an example of treating heartburn, not of general health.

2) If it's caused by an H. pylori infection, then proscribe an triple therapy of of amoxicillin, clarithromycin and a proton pump inhibitor. This not only treats the immediate disease but eradicates H. pylori from the body. Western medicine learned about this in the 1980s. A change of diet might help with the immediate disease, but patients must follow that diet in order to avoid a recurrence.

History shows that people don't like sticking to diets. If a patient can't follow the diet, and the heartburn comes back, is that a failure in the patient, for not following the treatment, or a failure in the treatment, for being hard for patients to follow through on? I place the blame more on the treatment than the patient. Especially when there's a two week treatment which will eradicate the bacteria.

3) If it's caused by GERD then patients might try lifestyle changes. But here's what Wikipedia says on the topic:

> Certain foods and lifestyle are considered to promote gastroesophageal reflux, however most dietary interventions have little supporting evidence.[23] Weight loss and elevating the head of the bed are generally useful.[24] Moderate exercise improves symptoms however in those with GERD vigorous exercise may worsen them.[23] Stopping smoking and not drinking alcohol do not appear to result in significant improvement in symptoms.[24] Avoidance of specific foods and eating before lying down should only be recommended to those in which they are associated with the symptoms.[19] Foods that have been implicated include: coffee, alcohol, chocolate, fatty foods, acidic foods, and spicy foods.[19]

(Note: [23] from 2009 says "it is possible to hypothesize that GERD may be a curable condition through the control of body weight and, in particular, by reducing abdominal obesity." while [24] from 2006 says "Therefore, although weight loss seems to have a promising effect on pH measures and symptoms, further randomized controlled studies are warranted to determine its exact effect on GERD outcomes". I suggest that the Wikipedia summary, that weight loss being generally useful, is not backed up by the citation.)

So, three different causes of heartburn, but lifestyle and diet changes have at best little effect.

What is the ayurvedic treatment for heartburn? Does it distinguish between these different reasons for getting heartburn, each of which has a different set of treatments in Western medicine? Or is the answer for all cases to change diet and lifestyle, even where Western medicine has show that those changes aren't effective?