Symptom

Heartburn

Overview | Possible Causes | Care and Treatment | HOME REMEDies | When to Call the Doctor | References

Heartburn

Overview

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.

Possible Causes

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.

Care & Treatment

In most cases, heartburn can be treated at home with over-the-counter medications and changes to lifestyle habits that cause the feeling. Occasional heartburn is common and is typically not serious. However, if you have frequent and severe heartburn, reach out to your healthcare provider. This could be a sign of a chronic condition like GERD. GERD can lead to other serious conditions like esophagitis, Barrett’s esophagus and even cancer. Sometimes, your doctor may want to do an endoscopy to check for underlying medication conditions. An endoscopy is the examination of your digestive tract with a lighted flexible instrument.

Over-the-counter medications for heartburn typically include antacids and acid blockers.

Home Remedies

You can often prevent and manage heartburn by making changes to your diet and lifestyle. These changes include:

Not going to bed with a full stomach. Eat meals at least three to four hours before you lie down. This gives your stomach time to empty and reduces the chance of experiencing heartburn overnight.
Avoiding overeating. Cutting back on the size of your portions during meals can help lower your risk of heartburn. You can also try eating four or five small meals instead of three larger ones.
Slowing down. Eating slowly can often help prevent heartburn. Put your fork down between bites and avoid eating too quickly.
Wearing loose-fitting clothes. Belts and tight clothing can sometimes cause heartburn. By changing your wardrobe to avoid these items, you might be able to prevent having heartburn.
Avoiding certain foods. For many people, there are certain foods that trigger heartburn. Avoiding these foods can help. Try keeping a log of these foods so that you can watch out for them in the future. Your healthcare provider may also suggest that you avoid alcohol.
Maintaining a healthy weight. Losing weight can often help relieve heartburn.
Not smoking. Nicotine can weaken the lower esophageal sphincter (the valve that separates your stomach and esophagus). Not smoking is recommended for your general health, as well as the strength of this valve.
Sleeping on your left side. This may help digestion and the removal of acid from your stomach and esophagus more quickly.
Raising the head of your bed so that your head and chest are higher than your feet. Place 6-inch blocks or books under the bed posts at the head of the bed. Do not use piles of pillows. They may cause you to put more pressure on your stomach and make your heartburn worse.
Planning your exercise to avoid heartburn. Wait at least two hours after a meal before exercising. If you work out any sooner, you may trigger heartburn. You should also drink plenty of water before and during exercise. Water aids digestion and prevents dehydration.

When to Call the 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: