Heartburn is a burning pain in your chest, just behind your breastbone. The pain is often worse after eating, in the evening, or when lying down or bending over.
Occasional heartburn is common and no cause for alarm. Most people can manage the discomfort of heartburn on their own with lifestyle changes and over-the-counter medications.
Heartburn that is more frequent or interferes with your daily routine may be a symptom of a more serious condition that requires medical care.
Causes of Heartburn
Heartburn occurs when stomach acid backs up into the tube that carries food from your mouth to your stomach (esophagus).
Normally when you swallow, a band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow down into your stomach. Then the muscle tightens again.
If the lower esophageal sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus (acid reflux) and cause heartburn. The acid backup may be worse when you’re bent over or lying down.
It is common for people to experience occasional heartburn, and it is rarely a significant cause for concern.
However, a doctor may diagnose recurrent acid reflux as GERD. This condition can have a serious impact on health, and it can indicate other underlying health issues.
People of all ages may develop GERD. Some of the most common causes include obesity and smoking.
Symptoms of heartburn include:
- A burning pain in the chest that usually occurs after eating and may occur at night
- Pain that worsens when lying down or bending over
- Bitter or acidic taste in the mouth
When to see a doctor
Seek immediate help if you experience severe chest pain or pressure, especially when combined with other signs and symptoms such as pain in the arm or jaw or difficulty breathing. Chest pain may be a symptom of a heart attack.
Make an appointment with your doctor if:
- Heartburn occurs more than twice a week
- Symptoms persist despite use of over-the-counter medications
- You have difficulty swallowing
- You have persistent nausea or vomiting
- You have weight loss because of poor appetite or difficulty eating
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Using some lifestyle and behavioral tips can help prevent or reduce heartburn.
- reaching or maintaining a moderate weight
- quitting smoking, if applicable
- eating smaller meals more frequently
- elevating the head of the bed before lying down
- avoiding wearing tight-fitting clothes
- avoiding heavy lifting and straining
- avoiding food triggers, such as alcohol, caffeine, spicy food, acidic foods, or foods causing gas and bloating
- following a healthy diet, with a limited fat intake
- avoiding eating 2–3 hours before bedtime
Changes to lifestyle and behavior can prevent or improve heartburn symptoms.
A person may prevent heartburn by avoiding acidic foods and drinks that contain caffeine.
Getting more exercise, reaching or maintaining a moderate weight, eating smaller meals, and sitting upright after eating may also help avert heartburn.
Many people experience heartburn occasionally. Usually, it is no cause for concern.
However, if a person has heartburn regularly, they should contact a healthcare professional, who may recommend dietary changes and regular exercise and make suggestions with regard to posture, among other things.
If lifestyle and behavioral changes do not prove effective, a doctor may recommend OTC medications, such as antacids or H2 blockers.
If a person is unsure whether they are experiencing symptoms of heartburn or a heart attack, they should seek immediate medical attention.