Heartburn

Overview

Heartburn is a painful burning sensation or feeling of discomfort in the upper chest or throat, usually after eating. Symptoms occur when acid from your stomach backtracks into the esophagus.

Heartburn can be caused by alcohol, spicy or acidic foods, overeating, or an underlying medical condition such as GERD. GERD, or gastroesophageal disease, is a digestive disorder in which the muscle between the esophagus and stomach, called the lower esophageal sphincter, is compromised, leading contents from the stomach to flow back up into the esophagus.

Your primary care physician can diagnose and treat most cases of heartburn. For severe cases of heartburn, you may be referred to a gastroenterologist to receive additional testing and treatment.

Heartburn causes

Heartburn occurs when acid from your stomach backtracks into the esophagus.

Heartburn can result from:

• Drinking alcohol
• Consuming spicy food
• Overeating
• Wearing tight clothing

Heartburn risk factors

Risk factors for heartburn include:

• Smoking
• Pregnancy
• A high-fat diet
• High intake of alcohol or caffeine

Heartburn symptoms

Symptoms of heartburn usually occur after eating, and can include:

• A painful burning sensation or feeling of discomfort in the upper chest or throat
• An acidic taste in the back of the throat or mouth
• Bad breath
• Nausea or vomiting
• Breathing problems
• Chest pain

Heartburn prevention

To prevent heartburn:

• Avoid lying down after you eat for at least two hours
• Avoid tightfitting clothing
• Avoid foods containing fats, citrus, or chocolate, or any foods that trigger heartburn for you
• Maintain a healthy weight
• Avoid alcohol and smoking
• Eat smaller meals throughout the day
• Avoid late-night meals

Heartburn diagnosis

Your doctor may use the following methods to determine whether your heartburn is a symptom of GERD:

• X-ray to view the esophagus and stomach’s shape and overall condition
• Endoscopy to look for any abnormalities in the esophagus, or to collect a tissue sample
• Ambulatory acid probe tests to assess when, and for how long, stomach acid backtracks into the esophagus
• Esophageal motility testing to assess movement and pressure levels in the esophagus

Heartburn treatment

Several over-the-counter medications can treat heartburn, including:

• Antacids — Antacids may provide fast relief by neutralizing stomach acid. They do not, however, heal a damaged esophagus or treat any underlying causes of heartburn.
• H-2-receptor antagonists (H2RAs) — These medications also reduce stomach acid, but do not provide relief as quickly as antacids. They can, however, provide relief for a longer amount of time.
• Proton pump inhibitors such as Prevacid 24HR, Nexium 24HR, and Prilosec OTC can reduce stomach acid as well.

In rare cases, surgery may be considered when all other treatments have failed to reduce symptoms.

When to seek care

Call your doctor to set up an appointment if you:

• Have heartburn several times a week
• Experience reflux symptoms that get in the way of sleep
• Get a newly developed cough
• Experience nausea or vomiting
• Have difficulty swallowing
• Have symptoms that don’t improve with home remedies or over-the counter antacids
• Decreased appetite or difficulty eating is causing you to lose weight

Seek medical attention immediately if you are experiencing sweating, shortness of breath, or arm or jaw pain in addition to severe chest pain or pressure.

Next Steps

Your doctor may recommend further testing or prescription medications if your symptoms do not improve with over-the-counter antacids, or if you rely on antacids very often. Talk to your doctor about additional tips for managing heartburn and GERD.