Heartburn, also known as pyrosis, cardialgia, or acid indigestion, is a burning sensation in the chest, just behind the breastbone or in the epigastrium, the upper central abdomen. The pain often rises in the chest and may radiate to the neck, throat, or angle of the jaw.

Heartburn is usually associated with regurgitation of gastric acid (gastric reflux) which is the major symptom of gastroesophageal reflux disease (GERD). It may also be a symptom of ischemic heart disease, though this is true for only 0.6% of those experiencing heartburn.

What is Heartburn?

Heartburn is a symptom that rarely has anything to do with your heart. It occurs when you feel a burning sensation in your chest that is often accompanied by a bitter taste in your throat or mouth. Symptoms of heartburn may get worse after you eat a large meal or when you are lying down. In general, the symptoms of heartburn can be treated successfully at home. However, if frequent heartburn makes it difficult to eat or swallow, your symptoms may be a sign of a more serious medical condition.

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 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 does not 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 caused by a hiatal hernia. This happens when part of the stomach pushes through the diaphragm and into the chest.

Who Is at Risk for Heartburn?

Symptoms of heartburn can be made worse by other health conditions or lifestyle choices including:

  • smoking
  • being overweight or obese
  • consuming caffeine or alcohol
  • eating spicy foods
  • lying down immediately after eating
  • taking aspirin or ibuprofen
  • taking certain medications

How is Heartburn Diagnosed?

Many people occasionally experience heartburn. However, if you experience frequent heartburn (more than twice a week) or heartburn that does not improve with treatment, you should contact your doctor, as this could be a sign of a more serious condition (NLM).

Heartburn is often associated with other gastrointestinal conditions, such as ulcers (sores in the lining of the esophagus and stomach) or gastroesophageal reflux disease (GERD). Contact your doctor if you have heartburn and develop any of the following symptoms:

  • difficulty swallowing
  • pain when swallowing
  • bloody stools
  • shortness of breath
  • pain that radiates from your back to your shoulder
  • feeling dizzy or light-headed
  • sweating while having chest pain

Heartburn is not associated with a heart attack. However, many people that have heartburn believe that they are having a heart attack. You may be having a heart attack if you have the following symptoms:

  • severe or crushing chest pain
  • difficulty breathing
  • jaw or arm pain

How Can the Symptoms of Heartburn Be Treated?

If you experience occasional heartburn, there are several home remedies and lifestyle changes that can help alleviate your symptoms. Lifestyle changes or modifications can help reduce your symptoms and include:

  • maintaining a healthy weight
  • avoiding foods that cause heartburn
  • avoiding lying down after meals
  • avoiding tobacco products
  • avoiding consuming alcohol or caffeinated drinks

If these treatments do not 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 is causing your heartburn. Tests may include:

  • X-ray of the stomach or abdomen
  • Endoscopy to check for an ulcer (passing a small tube equipped with a camera down the throat and into the stomach)
  • 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
  • H-2 receptor antagonists to reduce stomach acid production (such as Zantac or Prevacid)
  • Proton pump inhibitors that block acid production (Prilosec)

Although these medications can be helpful, they do have side effects. Antacids can cause constipation or diarrhea. Long-term use of proton pump inhibitors can increase the risk of bone fractures in people over the age of 50 (Mayo Clinic).

What Are the Complications of Heartburn?

Occasional heartburn is typically not a cause for concern. However, if you get this symptom frequently, you may have a serious health problem that requires treatment. If you do not get treatment for your heartburn you may develop additional health problems such as an inflammation of the esophagus (esophagitis) or Barrett’s esophagus. Barrett’s esophagus causes changes in the lining of the esophagus that can cause esophageal cancer.

How Can You Prevent Heartburn?

If you have occasional heartburn, you can prevent it by avoiding foods or activities that may cause your symptoms. You can also take some over-the-counter medications before you eat to prevent heartburn before symptoms start. Leading a healthy lifestyle and avoiding alcohol and tobacco can also help to prevent symptoms of heartburn.