Ever had a large or spicy meal, only to be hit with a burning pain in your chest soon afterwards? You might feel like having a lie down and waiting it out, but that makes your discomfort even worse.
What you’ve probably experienced is the common condition known as heartburn. And despite its name and the fact that you feel the pain in your chest, you’ll be relieved to know that it actually has nothing to do with the heart.
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 is a painful burning feeling in your chest or throat. It happens when stomach acid backs up into your esophagus, the tube that carries food from your mouth to your stomach.
If you have heartburn more than twice a week, you may have GERD. But you can have GERD without having heartburn.
Pregnancy, certain foods, alcohol, and some medications can bring on heartburn. Treating heartburn is important because over time reflux can damage the esophagus.
We’ve looked at why we get heartburn, its common symptoms and triggers, and what you can do to keep heartburn at bay.
What Is Heartburn?
Heartburn is a common problem. One fifth of adults in the United States have occasional heartburn, and 10% suffer daily attacks. With aging, changes occur in the ability of the esophagus, the swallowing tube that leads from the mouth to the stomach, to work smoothly. There is an associated increase in the occurrence of heartburn as one grows older.
The symptom of heartburn is usually a warm or burning feeling in the middle of the front of the chest. Bending, straining, or stooping often causes heartburn, and it is frequently worse when one lies down. Food or drink can relieve the burning sensation, as does the use of an antacid preparation. Such relief is temporary, because the problem is recurrent. Often particular foods cause heartburn. Icing on rolls or cake, orange juice, hot (spicy) foods, and hot dogs are common causes.
Any individual may have a particular food that brings on the problem, although it may not be the same food that bothers other sufferers. A few patients with severe heartburn experience the regurgitation of food and acid into the mouth and throat. Sometimes they are aware of this only as a bitter taste in the mouth on awakening in the morning. On other occasions it is very apparent, producing irritation with coughing and choking.
Nighttime regurgitation while asleep can occur and occasionally permits acid or food to get into the windpipe. This can cause hoarseness and cough that on occasion is the only complaint related to the reflux. In some individuals this provokes wheezing and shortness of breath resembling asthmatic attacks. Acid coming up into the mouth at night may be the cause of erosion of the teeth. These complications may occur without the occurrence of heartburn.
What Can Heartburn Be A Sign or Symptom
Symptoms of acid reflux that may accompany heartburn include
- difficulty swallowing,
- chronic cough,
- stomach pain or burning in the upper abdomen,
- persistent sore throat,
- regurgitation of foods or liquids with a taste of acid in the throat, and
- persistent hoarseness or laryngitis.
How can you tell if you are having a heart attack or heartburn?
- If you think that you are having a heart attack, call 911 immediately to save your life.
- A heart attack and heartburn can have the same symptoms, for example, be the same, for example, heartburn is a symptom of another disease or condition, for example, chest pain, shortness of breath, and nausea and vomiting.
- Heart attack signs and symptoms that are not the same as in heartburn include, for example, dizziness, toothache, and headache while heartburn symptoms include problems swallowing, persistant sore throat, hoarseness, laryngitis or reflux laryngitis.
What Causes Heartburn?
Heartburn typically occurs when contents from the stomach back up into the esophagus. The esophagus is a tube that carries food and fluids from the mouth into the stomach.
Your esophagus connects to your stomach at a juncture known as the cardiac or lower esophageal sphincter. If the cardiac sphincter is functioning properly, it closes when food leaves the esophagus and enters the stomach.
In some people, the cardiac sphincter doesn’t function properly or it becomes weakened. This leads to contents from the stomach leaking back into the esophagus. Stomach acids can irritate the esophagus and cause symptoms of heartburn. This condition is known as reflux.
Heartburn can also be the result of a hiatal hernia. This happens when part of the stomach pushes through the diaphragm and into the chest.
Heartburn is also a common condition during pregnancy. When a woman is pregnant, the progesterone hormone can cause the lower esophageal sphincter to relax. This allows stomach contents to travel into the esophagus, causing irritation.
Other health conditions or lifestyle choices can worsen your heartburn, including
- being overweight or obese
- consuming caffeine, chocolate, or alcohol
- eating spicy foods
- lying down immediately after eating
- taking certain medications, such as aspirin or ibuprofen
How to Get Rid of Heartburn with Home Remedies
In addition to avoiding foods listed above, there are several home remedies that can help people avoid and reduce the symptoms of heartburn. These include:
- eating small meals,
- avoiding bending over (especially soon after eating),
- waiting about three hours after a meal before lying down, elevate the head of your bed about eight inches, and avoid lying on the right side.
- If you are overweight, loose the extra weight.
- Reduce the amount of stress by using relaxation techniques.
- following a healthy diet, with a limited fat intake
- avoiding eating 2–3 hours before bedtime
- elevating the head of the bed before lying down
- avoiding wearing tight-fitting clothes
How Is Heartburn Diagnosed?
Often all that a health-care professional requires is a thorough history and physical to make the preliminary diagnosis of heartburn. To evaluate if there is any damage and how severe your heartburn is, the doctor my suggest some of the following tests:
- Endoscopy: A flexible scope is passed down the esophagus to examine the esophagus as well as the stomach. Biopsies can be taken if indicated. This lets the doctor see if there is any obvious damage, and also eliminate other reasons for the patient’s symptoms (foreign body, malignancy).
- Upper GI series (upper GI series): After drinking a liquid that coats the inside of the digestive tract, X-rays are taken. These X-rays will show the outline of the digestive system.
- Ambulatory pH testing: This test measures the acidity in the esophagus via a small tube that goes through the nose into the stomach.
A person may alleviate symptoms of heartburn by using drugs such as:
- antacids, which are over-the-counter (OTC) medications that help relieve mild heartburn
- proton pump inhibitors (PPIs), which reduce the amount of stomach acid
- H2 blockers, which are a type of medication that reduces the stomach acid levels and may help heal the esophageal lining
- It is important to note that PPIs heal the esophageal lining and treat GERD symptoms more effectively than H2 blockers.
Additionally, H2 blockers can produce various side effects, such as diarrhea, constipation, upset stomach, and headaches.
In 2020, the Food and Drug Administration (FDA)Trusted Source requested that manufacturers remove all forms of prescription and OTC ranitidine (Zantac), an H2 blocker, from the market because of its unacceptable levels of N-Nitrosodimethylamine, a probable carcinogen.
If you experience occasional heartburn, there are several home remedies and lifestyle changes that can help alleviate your symptoms. Lifestyle changes, such as maintaining a healthy weight, can help reduce your symptoms. You should also avoid:
- lying down after meals
- using tobacco products
- consuming chocolate
- consuming alcohol
- consuming caffeinated drinks
Certain foods can increase the likelihood of experiencing heartburn. These include:
- carbonated drinks
- citrus fruits
- fried foods
Avoiding these foods can help decrease how often you experience heartburn.
If these treatments don’t improve your symptoms, you may need to see your doctor. Your doctor will review your medical history and ask you about your symptoms. Your doctor may also order several tests to find out what’s causing your heartburn. Tests may include:
- an X-ray of the stomach or abdomen
- an endoscopy to check for an ulcer or irritation of the esophagus or lining of the stomach, which involves passing a small tube equipped with a camera down your throat and into your stomach
- at pH test to determine how much acid is in your esophagus
- Depending on your diagnosis, your doctor will be able to provide you with treatment options to help reduce or eliminate your symptoms.
Medications for the treatment of occasional heartburn include antacids, H2 receptor antagonists to reduce stomach acid production, such as Pepcid, and proton pump inhibitors that block acid production, such as:
Although these medications can be helpful, they do have side effects. Antacids can cause constipation or diarrhea. Talk to your doctor about any medications you’re already taking to see if you’re at risk for any drug interactions.
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.