Heartburn

Heartburn is a burning pain in the chest at the lower end of the breastbone. There may be a sour or bitter taste in the mouth or throat. This pain usually happens after a big meal or when lying down after eating. It can last from a few minutes to several hours. Heartburn is very common. Despite the name, heartburn has nothing to do with the heart.

Heartburn is caused by acid in the stomach backing up into the esophagus. The esophagus is the tube that takes food from the mouth to the stomach. The area where the esophagus connects to the stomach has a ring-like muscle that acts like a gate. When food is swallowed, the muscle closes to keep the stomach acid in the stomach. When it does not close acid can get into the esophagus. The stomach has a special lining to protect it from the acid. The esophagus does not have this lining. So when acid gets into the esophagus, it becomes irritated and starts burning. Sometimes the acid may come up into the mouth. It may have a bitter or salty taste. This is called regurgitation.

Heartburn is fairly common for pregnant women. This may happen because of the baby pushing on the stomach. Other conditions associated with heartburn are obesity, hiatal hernia, peptic ulcer disease, and diabetes. It is also common after eating a big meal, when lying down or bending over shortly after eating, with certain foods, or experiencing stress.

Heartburn may occur when eating:

• foods high in fat or sugar
• chocolate
• onions
• citrus foods
• tomato-based foods
• spicy foods and
• when taking some medicines

Anyone can have an attack of heartburn from overeating or eating foods that are high in acid. Most of the time heartburn is mild and lasts for a short time. There is usually not a problem when heartburn occurs just once in a while. Antacids may be used to help relieve the symptoms. If these do not work, a type of medicine called H2-receptor blockers can be tried. These medicines reduce the acid in the stomach and there are several available over-the-counter.

If heartburn occurs several times a week, comes back when the antacid wears off, or awakens you at night, make an appointment with a healthcare provider. Heartburn that happens more than occasionally is called GERD or gastroesophageal reflux disease. People with GERD often need prescription medicines.

Further medical evaluation will be necessary if symptoms continue in spite of medication, or if having difficulty swallowing, spitting up blood, tarry stool, or weight loss.

There are several ways to prevent heartburn with lifestyle changes. They include:

• lose weight if overweight
• eat smaller more frequent meals
• eat high-protein, low-fat meals
• avoid foods that cause heartburn
• do not eat 2 to 3 hours before going to bed
• raise the head of the bed 4 to 6 inches and
• stop smoking

Seek emergency care if heartburn symptoms happen along with shortness of breath, sweating, weakness, or chest, arm, or back pain. Heartburn that is not relieved by over-the-counter medicines needs to be evaluated.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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