What is heartburn?
Heartburn symptoms can be similar to angina (heart attack), including pain in your chest or upper torso, irregular heartbeat, cold sweats, weakness, dizziness, lightheadedness, shortness of breath, indigestion, nausea, and vomiting.
Whoever coined the phrase “hurts so good” may have just finished a spicy meal. If you’ve ever felt a burning sensation in your throat or chest after eating, you understand the pain of heartburn.
Heartburn occurs when stomach acid ends up in your esophagus, the digestive tube that carries food to your stomach. Occasional heartburn is common. Recurring episodes of heartburn require treatment to prevent stomach acid from damaging the esophagus. The condition may also indicate bigger health problems.
Causes of heartburn
Stomach acid creates a burning sensation when it leaks into your esophagus through a lower esophageal sphincter (LES) valve. This valve connects the two digestive organs. Sometimes, the LES is weak and doesn’t close properly, making you more susceptible to heartburn.
Certain foods and medications can cause heartburn, including:
- High-fat foods
- Acidic foods, like citrus fruit, onions, tomatoes, chocolate, coffee, or cheese
- Spicy foods or seasonings
- Aspirin or ibuprofen
Pregnant women or people who are overweight may also experience heartburn. This is due to added pressure on the abdomen, specifically the stomach.
Symptoms of heartburn
Heartburn typically begins just after you finish eating. The burning sensation can disappear in a few minutes or last for hours. Common symptoms include:
- Burning in the chest
- A sour taste in your mouth
- Feeling that something is stuck in your throat.
Symptoms may get worse if you lie down or bend over to pick something up. These movements allow stomach acid to move into your esophagus.
If you don’t experience heartburn often or have all the classic symptoms just after eating, you may not need diagnostic testing. Over-the-counter (OTC) treatments will usually solve the problem.
However, severe symptoms, like internal bleeding or difficulty swallowing, may need medical attention. Possible tests include:
Upper GI endoscopy
This is the most common initial test for gastrointestinal concerns. Your doctor will insert a thin, flexible tube called an endoscope down your throat. The tube holds a light and a camera to allow your doctor to examine your stomach lining, esophagus, and first section of your small intestine for ulcers or irritation.
You’ll drink a liquid barium mixture, then undergo a series of X-rays for your chest and upper abdomen. The barium provides a clear image of the esophagus and may identify problems like ulcers or a hiatal hernia.
This test monitors your reflux episodes over a 24-hour period using a thin, acid-sensing probe. It’s inserted through your nose and placed just above your LES. pH monitoring helps document acid reflux for people who have unexplained coughing, wheezing, or chest pain.
This test is often conducted in tandem with pH monitoring, and measures how well food and gas pass through your esophagus. It’s another way to evaluate both acid and non-acid reflux.
Warning signs for other health conditions
The burning sensation in your chest may be from that huge bowl of chili you just ate. Or, it could be something much more serious. Heartburn symptoms are often similar to angina or a heart attack.
Common heart attack symptoms include:
- Pressure, tightness, squeezing, a dull ache or stabbing pain in the center of your chest
- Irregular heartbeat
- Pain that spreads into the neck, shoulders, and arms
- A cold sweat or clammy skin
- Feeling weak, dizzy, or lightheaded.
- Shortness of breath
- Indigestion, nausea, and vomiting
If you’ve had heartburn before and this feels different, or if you’re uncertain, head to the emergency room for an evaluation.
Constant heartburn can also result from a chronic digestive condition called gastroesophageal reflux disease (GERD). GERD symptoms include:
- Burning pain in the chest near or behind the breastbone
- Pain that moves up to the throat and doesn’t spread elsewhere
- A choking sensation, or a feeling that food is coming back up
- Bitter, sour, or acidic taste in your throat
- Pain that increases when lying down or bending over
- Sudden symptoms after eating a spicy meal or consuming too much food
Heartburn that lasts for a long time could also indicate a bigger problem, like esophageal cancer. Risk factors include:
Treatments for heartburn
There are three types of OTC medications you can take to treat your heartburn:
These change the stomach acid and treat mild heartburn. Brands include Tums, Rolaids, and Mylanta.
Proton pump inhibitors (PPIs)
PPIs, including lansoprazole (Prevacid), esomeprazole (Nexium), and omeprazole magnesium (Prilosec), reduce the amount of acid in the stomach. They are only intended for short-term use. Prescription PPIs are used to treat GERD, stomach ulcers, and esophageal inflammation.
Medications like cimetidine (Tagamet), famotidine (Pepcid Complete or Pepcid AC), ranitidine (Zantac) are also classified as H-2 Blockers and reduce acid in your stomach.
Medically Reviewed on 12/15/2020
Harvard Medical School: “Do you need diagnostic tests for heartburn?”
Harvard Medical School: “Heartburn vs. Heart Attack.”
Johns Hopkins Medicine: “Warning Signs of Esophageal Cancer.”
U.S. Food and Drug Administration (FDA): “Over-the-Counter (OTC) Heartburn Treatment.”
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