Symptoms and causes of heartburn
Heartburn happens when your esophagus — the tube that joins your throat to your stomach — becomes irritated due to stomach acid. The pain caused by heartburn can be treated quickly with over-the-counter medicines like antacids.
The main symptoms of heartburn include:
- a burning sensation in the chest
- pain in the chest when bending over
- a hot, acidic, or bitter taste in the throat
- difficulty swallowing
Heartburn symptoms can last anywhere from a couple of minutes to a few hours.
Heartburn is caused by stomach acid backing up into the esophagus. The acid leaks into the tube through a valve called the lower esophageal sphincter (LES), which connects the esophagus with the stomach. If the LES is weak or not tight enough, the acid flows into the esophagus, causing a burning sensation in your chest.
While heartburn is fairly common and can happen to anyone, certain risk factors make you more likely to have it:
- Being overweight
- Use of anti-inflammatory painkillers
- Being pregnant
- Stress and anxiety
- A hiatal hernia
Acidic foods or foods high in fat often trigger heartburn. The most common culprits are tomatoes, citrus fruits, cheese, onions, garlic, chocolate, coffee, and peppermint. Eating spicy or indulgent meals can also cause the condition.
Antacids for heartburn
Heartburn pain can be treated immediately with antacids, the effects of which last a few hours. These are medicines that neutralize the acid in your stomach and come in liquid form or chewable tablets that can be bought over-the-counter. Antacids don't address the root cause of heartburn and should be treated as a temporary, rather than a long-term, solution.
When buying antacids to treat heartburn pain, look for products with the following effective ingredients:
- magnesium trisilicate
- calcium carbonate
- sodium bicarbonate
- magnesium hydroxide
- aluminium hydroxide
- magnesium carbonate
Antacids are best taken after eating food, as this is when you're most likely to get heartburn. Don't take other medications with antacids, because they can affect the efficacy of other drugs. Always follow the instructions on the medication packet.
The most common side effects of antacids are stomach cramps, feeling sick, flatulence, constipation, and diarrhea. Some antacids contain ingredients that aren't safe for people with liver disease, kidney disease, or heart failure, high blood pressure, or cirrhosis. Check with your doctor first if you have these conditions. Some antacids aren't suitable for children under 12 years.
H2-blockers for heartburn
Unlike antacids, Histamine-2 blockers (H2 blockers) target the root cause of heartburn by reducing the amount of acid made by the stomach. H2-blockers may take two to three hours to work and effectively reduce stomach acid for a few hours.
Histamine is a chemical that triggers cells in the stomach, causing them to produce hydrochloric acid, more commonly known as stomach acid. H2-blockers block the histamine receptors, which in turn reduces acid production. Lower dose H2-blockers are available over-the-counter but more potent versions require a prescription. These include:
H2-blockers are recommended for cases where heartburn doesn't go away with lifestyle changes, like avoiding triggering foods or eating fewer rich meals. If heartburn is also accompanied by esophagus inflammation with bleeding, you'll need an even stronger treatment.
PPIs for heartburn
Proton pump inhibitors (PPIs) are not an immediate or short-term treatment for heartburn — they can take one to four days to kick in. PPIs are recommended for people who experience frequent heartburn at least twice a week.
PPIs work by stopping certain stomach cells from producing acid in the stomach. Over-the-counter PPIs are usually recommended as a 14-day course of treatment and can only be used three times a year. They include Zegerid (omeprazole and sodium bicarbonate) and Prilosec (omeprazole magnesium). Check with your doctor first if you take other prescription medications.
The stomach can sometimes produce more acid if you take a PPI for longer than a couple of weeks. Once you stop taking the PPI, your acid levels may be higher than before the course of treatment.
This is known as the rebound period and your heartburn symptoms can get worse during this time. For this reason, it's important to stick to a limited treatment period and step down from PPIs gradually rather than all at once.
Your doctor may suggest certain measures to help you during the rebound period:
- Reducing the dose for a few weeks before stopping
- Changing the way you take the PPI
- Taking alginate to reduce rebound symptoms
- Lifestyle changes
Health Solutions From Our Sponsors
About GERD: "H2 Blockers."
Cedars Sinai: "Heartburn and Acid Reflux: What You Need to Know."
U.S. Food & Drug Administration: "Over-The-Counter (OTC) Heartburn Treatment."
NHS: "Advice for Patients taking Proton Pump Inhibitors (PPIs)", "Antacids", "Heartburn and acid reflux."
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- regurgitation, and
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest.
Causes of heartburn include dietary habits, lifestyle habits, and medical causes.
Treatments for heartburn include lifestyle changes, OTC medication,prescription medication, and surgery.
Heartburn During PregnancyHeartburn during pregnancy is quite common. During pregnancy the lower esophageal sphincter muscle becomes weakened , which likely occurs due to the effect of the high levels of the hormones estrogen and progesterone during pregnancy. Fortunately, this resolves after pregnancy. Management of heartburn during pregnancy are generally involves lifestyle changes and avoiding foods that promote heartburn, for example, don't smoke, avoid tight clothing, eat small, frequent meals, chew gum, or sip liquids.
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Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name because it feels like a burning sensation around the heart. Another symptom that occurs with heartburn is a bitter or sour taste in the mouth, usually when you eat or lye down. Heartburn affects more than 60 million people in the US at least once a month. Acid reflux, or GERD, occurs when stomach acid backs up into the esophagus, which irritates it. Heartburn is just one symptom of acid reflux. Other symptoms of acid reflux include:
- Nausea after eating
- A feeling of fullness during or after eating
- Abdominal bloating
- Upset stomach
- Reflux laryngitis
- A tightness in the throat
- Problems swallowing
- In some people, vomiting
Causes of acid reflux and heartburn include:
- Being obese
- Slouching (poor posture)
- Medications like calcium channel blockers, theophylline, nitrates, and antihistamines
- Foods and drinks like caffeine, citrus fruits and vegetables, alcohol, and chocolate
- Increase in stomach acid
- Eating a heavy meal
- Eating before bed
The treatment for heartburn and acid reflux is to treat the underlying cause, for example, GERD, with over-the-counter (OTC) medicine, prescription medicine, natural remedies, and lifestyle changes like a eating a healthy, less fatty, spicy diet, not eating big meals, not eating before bed, and getting regular exercise to improve your posture.
Sometimes a heart attack can mimic heartburn and acid reflux because they feel very similar. If you have symptoms of chest pain, tightness in the chest, heartburn, acid reflux, jaw, tooth, or head pain; shortness of breath, nausea, vomiting, sweating, discomfort in the upper middle of the abdomen, arm or upper back pain, or the general feeling of being ill, go to the nearest Emergency Department immediately because these are the symptoms of a heart attack.
American College of Gastroenterology. "Acid Reflux." 2017.
familydoctor.org. "Heartburn." Updated: Mar 2014.
National Library of Medicine; PubMed Health. "Heartburn and GERD: Treatment options for GERD." Updated: Nov 18, 2015.
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What Is the Quickest Way to Get Rid of Heartburn?Taking antacids is considered the quickest way to get rid of heartburn. These over-the-counter medications help neutralize stomach acid. They are one of the first recommended treatments. They may provide quick relief. However, antacid overuse can cause problems such as diarrhea or chronic kidney disease, especially if they contain aluminum and magnesium.
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