Heartburn

A burning feeling in your chest, right behind your breastbone, is called heartburn. This discomfort is frequently worse after meals, especially in the evening, or when you're lying down or bending over.

Experiencing heartburn now and then is normal and usually nothing to worry about. Most people can handle mild heartburn by making changes to their daily habits and using over-the-counter medications.

However, if you have heartburn often or it's disrupting your everyday life, it might be a sign of a more serious problem that needs a doctor's attention. This could include conditions like acid reflux, where stomach acid flows back up into your esophagus (the tube that carries food from your mouth to your stomach). Persistent heartburn can also be a symptom of other more serious health issues. If you're concerned, it's important to see a doctor.

Heartburn is a common problem that causes an uncomfortable burning sensation in the chest. This pain often happens after eating a meal or sometimes even at night. Lying down or bending over can make the burning feeling worse. Another sign of heartburn is a sour or acidic taste in your mouth.

Aches or tightness in your chest could be a sign of a heart problem. If you experience severe chest pain or pressure, especially if it spreads to your arm or jaw, or if you're having trouble breathing, get medical help immediately. This is a serious situation that needs urgent attention.

It's also a good idea to see your doctor if:

• You have heartburn more than twice a week. This is important because frequent heartburn could be a sign of something more serious.
• Your symptoms don't go away even after trying over-the-counter medicines. If your discomfort continues, it's important to have it checked out by a professional.
• You have trouble swallowing food or liquids. This could be a sign of a problem in your esophagus or other digestive organs.
• You're constantly feeling sick to your stomach (nausea) or throwing up (vomiting). Persistent nausea and vomiting can be a symptom of various health issues.
• You've lost weight unexpectedly due to a lack of appetite or difficulty eating. Unexplained weight loss can indicate underlying medical conditions, so it's important to get it checked.

Heartburn happens when stomach acid comes up into your food pipe (esophagus).

Normally, when you swallow, a special muscle ring at the bottom of your esophagus (called the lower esophageal sphincter) opens to let food and drinks go into your stomach. Then, it closes again.

If this muscle ring doesn't close properly, stomach acid can travel back up the esophagus (this is called acid reflux). This can cause heartburn. Being bent over or lying down can make the acid backup worse because gravity isn't helping keep the acid in your stomach.

Heartburn happens when stomach acid flows back up into your esophagus, causing a burning feeling in your chest. Many things can make heartburn more likely.

Some foods and drinks are common culprits. Spicy foods, like chili peppers, can irritate the esophagus and trigger heartburn in some people. Onions, citrus fruits (like oranges and lemons), and tomato-based products like ketchup can also be problematic for some. Fatty or fried foods can also contribute to heartburn. Even seemingly harmless things like peppermint, chocolate, and alcohol can upset some stomachs. Carbonated drinks, coffee, and other caffeinated beverages can also play a role. Eating large meals, especially those high in fat, increases the chance of heartburn.

Beyond diet, being overweight or pregnant can also increase your risk of heartburn. Extra weight puts more pressure on the stomach, making it easier for acid to back up. During pregnancy, hormonal changes can also relax the valve between the stomach and esophagus, allowing stomach acid to rise more easily.

Frequent heartburn that disrupts your daily life is called gastroesophageal reflux disease (GERD). GERD treatment often involves prescription medicines. In some cases, surgery or other procedures might be needed. If left untreated, GERD can severely damage the tube connecting your mouth to your stomach (the esophagus), potentially leading to precancerous changes in the esophagus, known as Barrett's esophagus.

To figure out if your heartburn is GERD (Gastroesophageal Reflux Disease), your doctor might suggest some tests. These tests help them understand what's going on inside your digestive system.

One common test is an upper endoscopy. This involves a thin, flexible tube with a light and camera (an endoscope) being carefully guided down your throat and into your esophagus. The camera lets the doctor see the inside of your esophagus, stomach, and the beginning of your small intestine (called the duodenum). This allows them to look for any problems or unusual areas.

Other tests include:

• X-rays: These pictures can show the shape and health of your esophagus and stomach. They can reveal if there's any narrowing or other issues.

• Endoscopy (with possible biopsy): This is similar to the upper endoscopy described above. The doctor uses a camera to look closely at your esophagus. Sometimes, a small tissue sample (biopsy) is taken. The biopsy allows the doctor to examine the tissue under a microscope to check for any cell changes that might indicate a problem.

• Ambulatory acid probe tests: These tests measure how often and for how long stomach acid flows back up into your esophagus. A small device (an acid monitor) is placed in your esophagus. This monitor connects to a small, portable computer that you wear on your body (around your waist or on a strap). The computer records the data and shows when and how long the acid reflux occurs.

• Esophageal motility tests: These tests check how well your esophagus moves and how much pressure it builds up. This helps determine if there's any problem with the muscles in your esophagus that prevent proper movement of food. The test measures the movement and pressure in your esophagus as it pushes food down.

These tests help your doctor diagnose the cause of your heartburn and develop the best treatment plan for you.

Many over-the-counter (OTC) medicines can help with heartburn. Here are some common options:

• Antacids: These work by counteracting the acid in your stomach. They often provide fast relief, but they don't fix any damage that the acid might be causing to your esophagus (the tube connecting your throat to your stomach). Think of them as a temporary fix for the burning feeling.

• H2 blockers: These medicines reduce the amount of stomach acid produced. They're not as fast-acting as antacids, but they can offer longer-lasting relief. Some examples include cimetidine (often sold as Tagamet HB) and famotidine (often sold as Pepcid AC).

• Proton pump inhibitors (PPIs): These also help decrease the amount of acid your stomach makes. They're typically more powerful than H2 blockers and often provide the most extended relief. Common examples include esomeprazole (sometimes sold as Nexium 24HR), lansoprazole (often sold as Prevacid 24HR), and omeprazole (sometimes sold as Prilosec OTC).

If over-the-counter treatments aren't helping your heartburn or if you find yourself needing them frequently, it's important to see your doctor. You might need stronger medication or further tests to find the cause of your heartburn.

Making simple changes to your daily habits can often help reduce heartburn.

• Keep a healthy weight. Carrying extra weight puts pressure on your stomach, which can force stomach acid up into your food pipe (esophagus). Losing even a small amount of weight can make a big difference.

• Wear comfortable clothing. Tight clothes, especially around your stomach, put pressure on the valve between your stomach and esophagus (lower esophageal sphincter), making heartburn more likely. Loose-fitting clothing allows for better comfort and less pressure.

• Identify and avoid foods that trigger your heartburn. Some foods, like spicy foods, caffeine, chocolate, and fatty foods, can irritate your esophagus and cause heartburn. Keep a food diary to track which foods cause problems for you.

• Give your body time to digest. Don't lie down right after eating. Wait at least two to three hours after a meal before resting or lying down. This allows your food to settle and reduces the chance of acid reflux.

• Eat regular meals, but not large ones. Instead of a few big meals, try eating smaller portions more frequently throughout the day. This can also help with digestion and reduce the amount of acid your stomach produces.

• Elevate your sleeping position. If you frequently experience heartburn at night, raising the head of your bed can help. A few inches is often enough. If you can't raise your bed, a wedge placed between your mattress and box spring can also help elevate your upper body. Simply adding extra pillows usually isn't as effective.

• Quit smoking and limit alcohol. Smoking and drinking alcohol weaken the valve between your stomach and esophagus, making it easier for acid to flow back up. Cutting back on these habits can significantly improve your heartburn.

These lifestyle changes can often significantly reduce heartburn symptoms. If your heartburn is severe or persistent, consult a doctor to rule out any underlying medical conditions.