If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

OVERVIEW

What is heartburn?

Despite its name, heartburn doesn’t affect the heart. Heartburn is a burning feeling in the lower chest, along with a sour or bitter taste in the throat and mouth. It usually occurs after eating a big meal or while lying down. The feeling can last for a few minutes or a few hours.

SYMPTOMS

Heartburn symptoms vary. They may be slight or extreme. The severity of heartburn may depend on what—and how much—you have eaten. The main symptom of heartburn is a burning feeling in your throat and chest. This happens when the acidic liquid from your food or drink comes back up into your esophagus. You may have difficulty swallowing or choke on this acid. It may even make you hoarse or cough.

CAUSES & RISK FACTORS

What causes heartburn?

When you eat, food passes from your mouth down a tube called the esophagus. The esophagus is about 25 cm (10 inches) long in most people. To enter the stomach, the food must pass through an opening between the esophagus and stomach. This opening acts like a gate to allow food to pass into the stomach. Usually, this opening closes as soon as food passes through. But if it doesn’t close all the way, acid from your stomach can get through the opening and into your esophagus. This is called reflux. Stomach acid can irritate the esophagus and cause heartburn.

Hiatal hernia can also cause heartburn. Hiatal hernia is a condition in which part of the stomach is pushed up through the diaphragm (the muscle wall between the stomach and chest) and into the chest.

DIAGNOSIS

Heartburn symptoms are easy to recognize. If you think you may have this condition, contact your healthcare provider. They will likely be able to diagnose you based on your symptoms.

PREVENTION

Can heartburn be prevented or avoided?

You might be able to avoid heartburn by making some changes in your lifestyle.

• Place 15 to 23 cm (6- to 9-inch) blocks under the legs at the head of your bed to raise it.
• Try to eat at least 2 to 3 hours before lying down. If you take naps, try sleeping in a chair.
• Quit smoking if you smoke.
• Try to lose weight if you’re overweight.
• Don’t overeat.
• Eat high-protein, low-fat meals.
• Avoid tight clothes and tight belts.
• Avoid foods and other things that give you heartburn.

Things that can make heartburn worse

Many things can make heartburn worse. Heartburn is most common after overeating, when bending over or when lying down. Pregnancy, stress, and certain foods can also make heartburn worse.

• Cigarette smoking
• Coffee (both regular and decaffeinated) and other drinks that contain caffeine, alcohol, and carbonated drinks.
• Citrus fruits
• Tomato products
• Chocolate, mints, or peppermints
• Fatty foods or spicy foods (such as pizza, chili, and curry)
• Lying down too soon after eating
• Being overweight or obese
• Certain medicines (such as sedatives and some medicines for high blood pressure)

TREATMENT

If taking over-the-counter antacid medicines and lifestyle changes don’t help your symptoms, contact your healthcare provider. They may want you to take prescription medicine. Or they may schedule you for some tests. Tests might include:

• pH test to check for acid in the esophagus,
• Endoscopy to check for other conditions. During it, your healthcare provider looks into your stomach through a long, thin tube which is inserted down your esophagus. You are sedated for this procedure, so you don’t feel it. Your healthcare provider may also check for H. pylori, bacteria that can cause ulcers.

What about medicines for heartburn?

Several kinds of medicine can be used to treat heartburn. Antacids neutralize the acid that your stomach makes. For most people, antacids that you can get without a prescription (over-the-counter) give fast, short-term relief. You may need to try different medicines to find one that works best for you. However, if you use antacids too much, they can cause diarrhea or constipation. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide. One causes constipation while the other causes diarrhea, so they counteract each other.

One brand name of antacid includes Gaviscon. Follow the directions on the package. H2 blockers (brand name: Pepcid, ) reduce the amount of acid your stomach makes. Several are available without a prescription. Other medicines, such as omeprazole (brand name: Losec) and lansoprazole (brand name: Prevacid), also reduce how much acid the stomach makes. To find out what medicine is right for you, contact your healthcare provider.

Can heartburn be serious?

If you only have heartburn now and then, it’s probably not serious. However, if you have heartburn frequently, it can lead to esophagitis (an inflamed lining of the esophagus). If esophagitis becomes severe, your esophagus might narrow and you might have bleeding or trouble swallowing. If you get more than occasional heartburn, it could mean you have:

• gastroesophageal reflux disease (GERD),
• an inflamed stomach lining (gastritis),
• hiatal hernia or
• peptic ulcer.

Living with heartburn

Sometimes pain in the chest may be mistaken for heartburn when it’s really a sign of heart disease. If you have any of the symptoms below, contact your healthcare provider.

• You have trouble swallowing or pain when swallowing.
• You’re vomiting blood.
• Your stools are bloody or black.
• You’re short of breath.
• You’re dizzy or lightheaded.
• You have pain going into your neck and shoulder.
• You break out in a sweat when you have pain in your chest.
• You have pain when you exercise
• You have heartburn often (more than 3 times a week) for more than 2 weeks