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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.
CAUSES & RISK FACTORS
What causes heartburn?
When you eat, food passes from your mouth down a tube (about 25 cm (10 inches) long in most people) called the esophagus. 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. Sometimes this causes heartburn.
What factors add to heartburn?
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.
Things that can make heartburn worse:
- Cigarette smoking
- Coffee (both regular and decaffeinated) and other drinks that contain caffeine
- 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
- Aspirin or ibuprofen (one brand name: Motrin)
- Certain medicines (such as sedatives and some medicines for high blood pressure)
What can I do to feel better?
You might be able to avoid heartburn by making some changes in your lifestyle.
Tips on preventing heartburn:
- 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.
- If you smoke, quit.
- 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.
What if my symptoms get worse?
If lifestyle changes and antacids don’t help your symptoms, contact your healthcare provider. Your healthcare provider may want you to take prescription medicine or schedule you for some tests. Tests might include X-rays to check for ulcers, a pH test to check for acid in the esophagus, or an endoscopy to check for other conditions. During an endoscopy, your healthcare provider looks into your stomach through a long, thin tube which is inserted down your esophagus. 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. 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.) Follow the directions on the package. H2 blockers (some brand names: Pepcid, Tagamet, Zantac) 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. Metoclopramide (brand name: Maxeran) reduces acid reflux. 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 may be a symptom of acid reflux disease, gastroesophageal reflux disease (GERD), an inflamed stomach lining (gastritis), hiatal hernia or peptic ulcer.
Is heartburn associated with heart attacks?
No. But 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.
Contact your healthcare provider if:
- 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 heartburn often (two or more times a week).
QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER
- What are some over-the-counter medicines that treat heartburn? Which ones do you recommend?
- What is causing my heartburn and what can I do about it?
- Are there lifestyle changes I can make that will prevent heartburn?
- Is heartburn a sign of another condition?
- My favorite foods are causing heartburn. Besides avoiding these foods entirely, what can I do to prevent heartburn?