Heartburn

Heartburn, also called acid indigestion or acid reflux, is a burning sensation in your chest behind your breastbone that can move up your neck and throat. It occurs when stomach acid backs up into your esophagus, the tube that connects your mouth to your stomach and moves food and drink when you swallow.

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Causes and triggers for heartburn

When swallowing goes wrong

Normally when you swallow, your lower esophageal sphincter – a band of muscle around the bottom of your esophagus – relaxes to allow food and liquid to enter your stomach, then tightens again.

When this sphincter weakens or relaxes abnormally, stomach contents and acid can flow back up into your esophagus, causing acid reflux or heartburn.

Over time, acid reflux can damage the esophagus. That’s why it’s important that you see your primary care provider if you get frequent heartburn.

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Common causes and triggers

Pregnancy, being overweight and some medications can cause heartburn.

For many people, certain foods and drinks are common triggers too:

  • Alcohol, carbonated beverages, coffee or other caffeinated beverages
  • Citrus products
  • Chocolate
  • Fatty or fried foods
  • Onions
  • Peppermint
  • Spicy foods
  • Tomato products, like pizza sauce

When to see your primary care provider

You should see your provider if you have:

  • Common symptoms that persist despite taking OTC medications.
  • Difficulty swallowing.
  • Heartburn more than twice a week.
  • Persistent nausea or vomiting.
  • Weight loss because of poor appetite or difficulty eating.

Heartburn that occurs frequently can be a symptom of GERD, which may require prescription medications and surgery or other procedures. GERD can seriously damage your esophagus or lead to precancerous changes in the esophagus called Barrett’s esophagus.

You should get medical help immediately if you have heartburn plus severe chest pain or pressure, or pain in the arm or jaw or difficulty breathing, as you may be having a heart attack.

Treating and preventing heartburn

Many of our patients find that OTC antacids (Tums, Rolaids or generic equivalents) help alleviate occasional heartburn.

If OTC antacids don’t work for you, or you are taking them often, your primary care provider may prescribe medicines, especially if you are diagnosed with GERD:

  • H2-receptor antagonists (H2RAs), or H2 blockers. These medicines reduce stomach acid and provide long-term relief. Some H2 blockers are available without a prescription.
  • Proton pump inhibitors. These medicines reduce stomach acid, and includes lansoprazole (Prevacid 24HR) and omeprazole (Prilosec OTC).

Your treatment plan will also include proven lifestyle changes that can help prevent and relieve your heartburn:

  • Avoid “trigger foods” and alcohol, large meals, eating two to three hours before going to sleep and lying down after a meal.
  • Elevate the head of your bed, which helps prevent heartburn at night.
  • Do not wear tight clothes, as they put pressure on your abdomen and the lower esophageal sphincter.
  • Maintain a healthy weight, as excess weight puts pressure on your abdomen and the lower esophageal sphincter.
  • Quit smoking.
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References

MedlinePlus: National Library of Medicine. Heartburn, Also called: Acid indigestion, Pyrosis (https://medlineplus.gov/heartburn.html)

American Academy of Family Physicians. Heartburn (https://familydoctor.org/condition/heartburn/)