What is heartburn?
Heartburn is an uncomfortable burning feeling in your chest and throat. It doesn't have anything to do with your heart. However, the sensation is so close to your heart that it can feel like your heart is in pain.
Heartburn is caused by stomach acid creeping up into your esophagus, which is the tube that connects your throat to your stomach. The acid is irritating and leads to discomfort.
Learn more about heartburn and how to get heartburn relief fast.
The main symptom of heartburn is a feeling of irritation and pain in your chest and throat. It usually happens shortly after eating. It can last a few minutes or go on for hours.
You may also notice a sour taste in the back of your throat or feel like food or liquid is stuck there. You might experience coughing or your voice might become hoarse while the heartburn is going on.
Heartburn symptoms can feel worse when you bend over or lie down.
Heartburn is caused by stomach acid creeping up into your esophagus. Typically, the acid gets trapped behind a muscle called your lower esophageal sphincter (LES). The LES acts as a valve that opens to let food into your stomach. If it loosens, acid can escape and cause discomfort.
There are several different reasons why the LES can open up and lead to heartburn:
- Overeating: Over-filling your stomach can put pressure on the LES and allow it to open
- Pressure on the stomach: Obesity and constipation can push on the stomach and lead to heartburn
- Hiatal hernia: This happens when a small portion of the stomach pushes up into the diaphragm
- Pregnancy: Heartburn is a frequent symptom in pregnancy. Pregnancy naturally loosens many muscles, including the LES
Certain foods are also triggers for heartburn. Some of the common ones include:
Diagnosis for heartburn
GERD can cause chronic loosening of the LES so that you have heartburn frequently. Your doctor will need to do testing to diagnose it properly.
Possible tests include:
Your doctor will have you drink a barium suspension that coats your esophagus, stomach, and upper small intestine. The coating lets doctors identify what is causing your heartburn.
Doctors can thread a small camera on a flexible tube down your throat to see your stomach and esophagus.
Your doctor will run a small probe down your throat into your esophagus to measure your pH levels for 24 to 48 hours. You can continue your day as normal while it’s in, just remember to keep a diary to record any symptoms and all the food you’ve eaten.
Your doctor inserts a tube from your nostril into your stomach. This tests the strength of your esophagus muscles at rest.
Treatments for heartburn
Heartburn can be easy to treat and prevent, though severe cases can require help from a doctor. Learn more about what you can do to get rid of heartburn.
If the non-prescription medicines don't help, your doctor can write you a prescription for stronger versions of these medicines.
You can reduce or prevent heartburn by changing your diet. High-protein, low-fat meals are a good option.
You might find you feel better if you don't lie down too soon after eating. It can help to place 4- to 6-inch blocks under the legs at the head of your bed so gravity can keep the acid down. A wedge-shaped pillow would be an easier option, if you’d prefer.
Quitting tobacco may also help prevent heartburn.
Some people say an herbal supplement called Iberogast helps with heartburn, but you should only try this in moderation.
Chewing gum can provide some relief. You produce more saliva when you chew and saliva neutralizes the acid in your esophagus. As long as you’re not chewing large amounts of artificially sweetened gum, which could lead to diarrhea, this should be harmless.
If you have severe GERD and medicine isn't enough to ease symptoms, your doctor might suggest surgery. If a hiatal hernia causes your heartburn, there is surgery to repair that.
Other procedures for GERD include:
- Fundoplication: This tries to tighten the LES muscles by almost completely wrapping the esophagus to stop acid from creeping up from your stomach
- LINX surgery: An emerging treatment where a surgeon implants a device to help manage your reflux
Possible risks and complications
The most common complication of heartburn is esophagitis, or the inflammation of the food pipe. This can cause constant burning pain, making it hard to swallow or eat. Without treatment, this can also lead to ulcers, bleeding, or both.
In less than 2% of esophagitis cases from people with GERD, a condition called Barrett’s esophagus can develop. This causes premalignant changes in the cells lining the esophagus.
2% to 5% of people with Barrett’s esophagus end up getting cancer. If you have severe esophagitis, take medications regularly to keep acid down.
If you’re using antacids to treat your acid reflux, overuse can lead to diarrhea or constipation. Try to pick antacids that have both magnesium hydroxide and aluminum hydroxide to avoid this. One causes diarrhea and the other causes constipation, so they work against each other.
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Cedars-Sinai: "Heartburn and Acid Reflux: What You Need to Know."
GI Society: "Natural and Over-the-Counter Heartburn Treatments."
Harvard Health Publishing: "GERD: Heartburn and more."
University of Rochester Medical Center: "Gastroesophageal Reflux Disease (GERD)/Heartburn."
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What Is Esophageal pH Monitoring?Esophageal pH monitoring is used to measure the reflux (regurgitation or backwash) of acid from the stomach into the esophagus and to diagnose gastroesophageal reflux disease (GERD). Side effects of the procedure are few but may include mild discomfort in the back of the throat while the catheter is placed, and swallowing.
GERD (Acid Reflux, Heartburn)GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are:
- 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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Acid Reflux (Heartburn, GERD): Symptoms & RemediesHeartburn is a symptom of acid reflux that causes chest pain when stomach acid backs up into the esophagus. Heartburn symptoms may mimic chest pain that occurs during a heart attack. Gastroesophageal reflux disease (GERD) may produce other symptoms.
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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