What is heartburn?
Heartburn is common among most individuals and can be described as a burning sensation in your upper chest, directly below your breastbone. Heartburn is often caused by stomach acid entering and irritating the lower portion of the esophagus, where the throat connects to the stomach. This circular muscle is known as the lower esophageal sphincter (LES).
Pain often intensifies after meals, at nighttime, and when lying down or bending over. Symptoms of heartburn can be treated with over-the-counter medication, diet, and lifestyle changes. However, heartburn can be an underlying symptom of other potentially serious conditions that require medical attention.
What causes heartburn?
Occasional heartburn is often triggered by a variety of food and lifestyle factors. Below are the most common causes of heartburn.
- Fatty and fried foods, and
- Coffee and carbonated beverages
Individuals who are overweight or pregnant are more susceptible to heartburn. This is caused by increased pressure within the abdominal cavity, causing the lower esophageal sphincter (LES) to relax and allowing acid to reflux into the esophagus. Hormonal changes in pregnancy also cause the LES to relax, further contributing to reflux.
Smoking and consuming high-fat content foods also affect the LES, leading to heartburn.
A hiatal hernia, which is when a portion of the stomach lies within the chest rather than the abdomen. This causes the LES to relax and heartburn to occur.
Scleroderma, a connective tissue disease, can affect the esophagus, causing patients with this condition to present with heartburn as a primary symptom.
How can I treat heartburn?
If you’re experiencing heartburn after consuming the foods and beverages listed above, you can manage heartburn with dietary modification. If dietary changes are not successful, over-the-counter (OTC) antacids approved by the FDA, which include:
Antacids – These work by decreasing the stomach acid that causes heartburn. Common OTC antacids include:
Histamine-2 (H2) blockers – H2 blockers relieve and prevent heartburn and work by reducing the amount of acid produced by the stomach. Common H2 blockers include:
- Tagamet HB (cimetidine)
- Pepcid Complete or Pepcid AC (famotidine)
- Axid AR (nizatidine)
Lifestyle and diet changes can help reduce the occurrence of heartburn. Below is a list of changes you can make to alleviate the pain:
- Eat smaller, more frequent meals
- Avoid eating before bedtime or laying down for a long duration of time
- Avoid alcohol, aspirin, ibuprofen, carbonated beverages, and caffeine
- Stop smoking
- Elevate your head while sleeping to allow gravity to keep the acid in the stomach
Long-term heartburn that is poorly responsive to treatment is often a sign of a more serious condition known as gastroesophageal reflux disease (GERD). GERD impacts the ring of muscle between the esophagus known as the lower esophageal sphincter (LES), which causes heartburn and acid indigestion. Over-the-counter proton pump inhibitors (PPIs) can treat GERD, stomach and small intestine ulcers, and inflammation of the esophagus. However, they are only intended to be used in a 14-day treatment, up to three times a year, unless prescribed by a physician.
Common PPIs include:
- Prevacid 24HR (lansoprazole)
- Nexium 24HR (esomeprazole)
- Prilosec OTC (omeprazole magnesium)
- Zegerid OTC (omeprazole and sodium bicarbonate)
How is heartburn diagnosed?
In most cases, heartburn can be diagnosed by your gastroenterologist quickly and accurately using your history, physical exam, and a few selected tests.
When is it time to speak to a doctor about heartburn?
If you are experiencing any of the following symptoms, please schedule a time to speak with a gastroenterologist. Note: If you are experiencing extreme chest pain or pressure, seek medical help immediately as it can be a symptom of a heart attack or other serious medical conditions.
- Heartburn occurs more than twice a week
- Heartburn symptoms continue despite the use of over-the-counter medications and diet changes
- Difficulty swallowing
- Nausea and/or vomiting
- Weight loss caused by loss of appetite or difficulty eating
Surgery is an option for patients who are unable to relieve heartburn from intensive medical treatments. You will need to consult with a gastroenterologist about these options after you try the other recommended treatments.
Disclaimer: The information presented on this website is not intended to take the place of your personal physician’s advice and is not intended to diagnose, treat, cure or prevent any disease. Discuss this information with your healthcare provider to determine what is right for you. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for a specific medical condition.
This website is owned and managed by Brian Cooley, MD. Any information, offers, or instruction as written, inferred, or implied is the sole responsibility of Brian Cooley, MD, and does not warrant claim or representation, inherent, or implied of DHAT, its subsidiaries, or employees.