Heartburn

Things to know about heartburn

Heartburn can be relieved and cured for many people with lifestyle changes, such as the following.

Heartburn is a symptom that feels like a burning in your chest and is a symptom of acid reflux (GERD, gastroesophageal reflux disease).

Do most people get heartburn?

Heartburn is more common during pregnancy. Most people get heartburn after meals, but can also awaken people while they are sleeping. People also may experience heartburn after eating specific foods or drinking certain beverages.

What can heartburn be a sign or symptom of?

Symptoms of acid reflux that may accompany heartburn include

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 heartburn include, for example, dizziness, toothache, and headache while heartburn symptoms include problems swallowing, persistent sore throat, hoarseness, laryngitis, or reflux laryngitis.

How can you get rid of heartburn?

Heartburn can be relieved and cured for many people with lifestyle changes, for example,

• eat a healthy diet,
• consume foods that are low in calories and avoid caffeine, 
• stop smoking, and
• sleep with your head elevated with a pillow.

Over-the-counter, prescription, and surgery may be necessary to cure heartburn.

What natural home remedies relive and cure heartburn?

Heartburn can be treated with lifestyle changes and medications (over-the-counter and prescription). In rare cases, surgical procedures are available to help with severe and chronic heartburn (GERD).

What lifestyle changes relieve heartburn?

There are several ways to treat and avoid heartburn with lifestyle changes.

• Lose weight and maintain your ideal weight. Excess weight increases the pressure on the stomach, increasing the chance of acid reflux into the esophagus.
• Quit smoking. Smoking interferes with the proper functioning of the lower esophageal sphincter.
• Avoid foods that aggravate heartburn and replace them with healthy foods. Avoid foods that trigger heartburn (see previously). Consider keeping a food journal to alert you to foods that make your heartburn worse. Decrease the amount of food you eat.
• Elevate the head of the bed. If you are experiencing heartburn at night, elevating the head of the bed will decrease reflux.

What over-the-counter (OTC) and prescription medicine cures heartburn?

There are many over-the-counter and prescription medications available. These fall into three major categories:

1. Medications that neutralize stomach acid (antacids): Antacids (Mylanta, Maalox, Rolaids, Tums) provide quick relief because they decrease the acid. These medications don’t heal existing damage to your esophagus nor prevent future episodes of heartburn.
2. Medications that reduce the production of acid: These medications are named after the receptor they block (H-2 blockers) and are available as over-the-counter as well as prescription medications. Their symptom relief tends to last longer than antacids, but it also takes longer for them to start working. They are available as several brands and formulations (ranitidine [Zantac], nizatidine [Axid], cimetidine [Tagamet], famotidine [Pepcid]). Depending on the strength they are available over-the-counter and by prescription.
3. Medications that block acid production: Proton pump inhibitors (for example, omeprazole [Prilosec], lansoprazole [Prevacid]) block the production of acid. This then allows healing of the damaged esophagus.

Note: You should make your healthcare professional aware if you take these medications on a chronic basis as there can be interactions with other medications and frequent use will alert your doctor to the severity of symptoms.

What is heartburn?

Heartburn is a sensation of burning in the chest caused by stomach acid backing up into the esophagus (food pipe). The burning is usually in the central part of the chest, just behind the sternum (breast bone). The burning can worsen or can be brought on by lying flat or on the right side. Pregnancy tends to aggravate heartburn.

Many people experience heartburn and there are a large number of over-the-counter (OTC) medications and home remedies available to treat heartburn.

In most cases, you will not need to see a healthcare professional, except if the symptoms are frequent (several times a week), severe, or increasing in severity.

If heartburn is severe or the pain is accompanied by additional symptoms such as shortness of breath, or radiation into your arms or neck, you will need to see a doctor to distinguish these symptoms from more serious medical conditions such as a heart attack.

GERD (Gastroesophageal reflux disease) can be considered a chronic and more serious form of reflux with heartburn as the major symptom; however, there may be other symptoms or no symptoms at all.

If your heartburn symptoms occur more than twice a week you should see your healthcare professional make sure no serious problems are present.

What causes heartburn?

The esophagus (the tube that connects your mouth to the stomach) has a tight band of muscles at the lower end (lower esophageal sphincter [LES]) that closes after the food enters the stomach and prevents the stomach contents to reenter the esophagus. If this sphincter weakens or relaxes at the wrong time, stomach acid can back up into the esophagus, causing heartburn and its complications.

What foods and drinks cause heartburn (list)?

• Alcohol: Alcohol can relax the lower esophageal sphincter.
• Coffee and orange or other acidic juices: Some of these beverages can worsen or trigger heartburn.
• Fatty foods, fried foods, and some acidic foods (oranges, grapefruits, tomatoes) as well as spicy foods can cause heartburn.
• Additional foods that make heartburn worse.

Every person reacts somewhat differently to specific food groups. To track what foods worsen your symptoms, keep a food journal. In this journal, you should keep track of what you eat, the time you ate, any activity that worsened or made the heartburn better, and indicate which days you have heartburn symptoms. Over time, you will be able to correlate the offending foods with heartburn events.

Print this table below and take it with you to your next doctor’s appointment to discuss possible causes of heartburn you may be experiencing.

What signs and symptoms can tell if you have heartburn?

The usual symptom of heartburn is a burning sensation in the chest. It can be accompanied by:

• a sour taste at the back of the throat,
• regurgitation of food, or
• a feeling of food being stuck in the throat.

A person needs to be evaluated by a healthcare professional for heart disease as soon as possible if he or she has heartburn symptoms that are accompanied with:

• shortness of breath,
• radiation to the arms or neck,
• dizziness or cold sweat.

What does heartburn look like?

Acid reflux or GERD

Picture of GERD (gastroesophageal reflux disease, heartburn)

How can you relieve heartburn symptoms naturally during pregnancy?

Pregnancy tends to aggravate heartburn because the lower esophageal sphincter (LES) is weakened during pregnancy. This weakened (LES) resolves after delivery of the baby. Pregnancy also distorts the organs in the abdomen and the increased abdominal pressure from the growing fetus causes heartburn. These changes promote the reflux of acid and heartburn.

Approximately 17% to 45% of women who become pregnant will suffer from heartburn.

Unfortunately, there are no clear studies on the safety of heartburn medications on the growing fetus, and researchers are not going to test these drugs on pregnant women to evaluate how safe they are for the developing fetus, so the only option is to test these drugs on pregnant animals. There is no evidence that most of the acid-neutralizing or suppressing drugs are harmful to the fetus although nonabsorbable medications are preferred.

Management of heartburn during pregnancy consists of many of the same home remedies and lifestyle changes for a person with heartburn who is not pregnant (see the previous section on home remedies and lifestyle changes).

How is heartburn diagnosed?

Often all that a healthcare 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 may 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 eliminates 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.

What surgical procedures treat and cure heartburn?

Laparoscopic surgical procedures are available to treat heartburn. This option is usually only chosen if lifestyle changes and medications have not helped. There also are endoscopic treatments for treating heartburn that doesn’t require surgery, but endoscopic procedures are much less used than surgery.

How can you prevent heartburn?

The first step, as it is so often, is basic lifestyle changes. Stop smoking, lose weight, and watch what you eat (sounds familiar?).

If these interventions do not fully alleviate heartburn symptoms, then the addition of medications that decrease heartburn or prevent it together, under the guidance of your healthcare professional, should allow you to control heartburn.