Heartburn Download
Clara Zellinger
Heartburn has nothing to do with a heart attack, except they both cause discomfort in your chest that can sometimes be severe. The biggest difference is a heart attack usually feels like tightening and pressure in your chest, while heartburn feels more like burning.
For some people, heartburn might last only a few minutes, but for others it can last for several hours. Your symptoms should stop once the last thing you ate finishes digesting. When your stomach is empty, there are no acids to come back up your esophagus.
It should stay closed to keep food and stomach acids in your stomach. When you're eating, your LES opens so food can go into your stomach. Then it closes again. If it doesn't close, even just a little, or if it opens when it shouldn't, stomach acids can go back into your esophagus, causing heartburn pain.
We don't know what causes the LES valve to weaken, but it could be caused by eating big meals too often, if you're overweight, or you have a hiatal hernia (a hernia in your upper stomach that pushes through your diaphragm).
If your heartburn doesn't improve, it could be a more serious condition known as gastroesophageal reflux disease (GERD). Your doctor may be able to diagnose GERD just from your symptoms, but they also might want to do some tests, like:
You get heartburn when acids in your stomach back up into your esophagus, the tube that goes between your mouth and stomach. The acid causes a painful, burning sensation in your chest. You usually get heartburn after you eat or when you're lying down, and the symptoms last for several hours. It's not life-threatening and is usually treated with lifestyle changes or over-the-counter medicines.
Low-fat yogurt is similar to milk in how it can soothe heartburn. Plus yogurt has probiotics (good bacteria) that also help with digestion. So eating a serving of low-fat yogurt may help relieve symptoms of heartburn.
Heartburn is often a symptom of gastroesophageal reflux disease, or GERD. Many studies have shown a link between genes and GERD, including several twins studies and a family study. All showed that genetics played a role, but we still need more research to know for sure how genes are involved.
Typically, when food is swallowed, a band of muscle around the bottom of the esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow down into the stomach. Then the muscle tightens again.
If the lower esophageal sphincter isn't working as it should, stomach acid can flow back up into the esophagus (acid reflux) and cause heartburn. The acid backup may be worse when you're bent over or lying down.
Heartburn that occurs frequently and interferes with your routine is considered gastroesophageal reflux disease (GERD). gastroesophageal reflux disease (GERD) treatment may require prescription medications and, occasionally, surgery or other procedures. GERD can seriously damage your esophagus or lead to precancerous changes in the esophagus called Barrett's esophagus.
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In 2020, the Food and Drug Administration (FDA) 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.
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.
Daniel Jennings is a board certified physician assistant who specializes in cardiology. He practices at a busy cardiology practice in Indianapolis, Indiana. He sees patients with heart failure, high blood pressure, high cholesterol, coronary artery disease, heart rhythm problems, among other cardiac pathologies.
How long you experience symptoms depends on the underlying cause. It also depends on what you do at the first sign of symptoms. For example, sometimes heartburn symptoms last until your body digests the triggering food. Other times, it goes away if you stand up instead of lying down after eating.
Your esophagus connects to your stomach at a juncture known as the lower esophageal sphincter. If the lower esophageal sphincter is functioning properly, it closes when food leaves the esophagus and enters the stomach.
Heartburn is common, and many people experience it from time to time. However, you should contact your doctor if you experience heartburn more than twice per week or if you have heartburn that does not improve with treatment.
Heartburn is a painful burning feeling just below or behind the breastbone. Most of the time, it comes from the esophagus. The pain often rises in your chest from your stomach. It may also spread to your neck or throat.
Normally when food or liquid enters your stomach, a band of muscle at the lower end of your esophagus closes off the esophagus. This band is called the lower esophageal sphincter (LES). If this band does not close tightly enough, food or stomach acid can back up (reflux) into the esophagus. The stomach contents can irritate the esophagus and cause heartburn and other symptoms.
Heartburn is more likely if you have a hiatal hernia. A hiatal hernia is a condition which occurs when the top part of the stomach pokes into the chest cavity. This weakens the LES so that it is easier for acid to back up from the stomach into the esophagus.
You should treat frequent heartburn (heartburn that occurs 2 or more days per week) because reflux can damage the lining of your esophagus. This can cause serious problems over time. Changing your habits can be helpful in preventing heartburn and other symptoms of GERD.
Heartburn is easy to diagnose from your symptoms in most cases. Sometimes, heartburn can be confused with another stomach problem called dyspepsia. If the diagnosis is unclear, you may be sent to a doctor called a gastroenterologist for more testing.
If your symptoms do not get better with home care, you may need to take medicine to reduce acid that is stronger than over-the-counter medicines. Any sign of bleeding will need more testing and treatment.
DeVault KR. Symptoms of esophageal disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 13.
Mayer EA. Functional gastrointestinal disorders: irritable bowel syndrome, dyspepsia, chest pain of presumed esophageal origin, and heartburn. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 128.
Updated by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Several kinds of medicine can be used to treat heartburn. Antacids neutralize the acid that your stomach makes. For most people, antacids that you can get over the counter (without a prescription) give fast, short-term relief. You may need to try different medicines to find one that works best for you. However, if you use antacids too much, they can cause diarrhea or constipation. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide. One causes constipation while the other causes diarrhea. So they counteract each other.
Some brands of antacids include Maalox and Mylanta. Follow the directions on the package. H2 blockers (some brand names: Pepcid, Tagamet) reduce the amount of acid your stomach makes. Several are available without a prescription. Other medicines, such as omeprazole (brand name: Prilosec) and lansoprazole (brand name: Prevacid), also reduce how much acid the stomach makes. Metoclopramide (brand name: Reglan) reduces acid reflux. To find out what medicine is right for you, talk with your doctor.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Heartburn, also known as pyrosis, cardialgia or acid indigestion,[2] is a burning sensation in the central chest or upper central abdomen.[3][4][5] Heartburn is usually due to regurgitation of gastric acid (gastric reflux) into the esophagus. It is the major symptom of gastroesophageal reflux disease (GERD).[6]
Other common descriptors for heartburn (besides burning) are belching, nausea, squeezing, stabbing, or a sensation of pressure on the chest. The pain often rises in the chest (directly behind the breastbone) and may radiate to the neck, throat, or angle of the arm. Because the chest houses other important organs besides the esophagus (including the heart and lungs), not all symptoms related to heartburn are esophageal in nature.[7]
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