Overview
Heartburn is a burning pain in the chest, just behind the breastbone. It's sometimes accompanied by a bitter or acidic taste in the mouth. The pain is often worse after eating, in the evening, or when lying down or bending over.
Occasional heartburn is common and no cause for alarm. Most people can manage the discomfort of heartburn on their own with lifestyle changes and nonprescription medicines.
Heartburn that is more frequent or interferes with your daily routine may be a symptom of a more serious condition that requires medical care.
Symptoms
Symptoms of heartburn include:
- A burning pain in the chest that usually occurs after eating and may occur at night.
- Pain that worsens when lying down or bending over.
- A bitter or acidic taste in the mouth.
When to see a doctor
Chest pain may be a symptom of a heart attack. Seek help right away if you have severe chest pain or pressure, especially when combined with pain in the arm or jaw or difficulty breathing.
Make an appointment with a healthcare professional if:
- Heartburn occurs more than twice a week.
- Symptoms persist despite use of nonprescription medicines.
- You have difficulty swallowing.
- You have persistent nausea or vomiting.
- You have weight loss because of poor appetite or difficulty eating.
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Causes
Heartburn happens when stomach acid backs up into the tube that carries food from the mouth to the stomach, called the esophagus.
Typically, when food is swallowed, a band of muscle around the bottom of the esophagus, called the lower esophageal sphincter, relaxes to allow food and liquid to flow down into the stomach. Then the muscle tightens again.
If the lower esophageal sphincter isn't working as it should, stomach acid can flow back up into the esophagus and cause heartburn. The acid reflux may be worse when you're bent over or lying down.
How heartburn and GERD occur
Acid reflux happens when the sphincter muscle at the lower end of your esophagus isn't working as it should, allowing stomach acid to back up into your esophagus. This can cause heartburn and other signs and symptoms. Frequent or constant reflux can lead to gastroesophageal reflux disease (GERD).
Risk factors
Certain foods and drinks can trigger heartburn in some people, including:
- Spicy foods.
- Onions.
- Citrus products.
- Tomato products, such as ketchup.
- Fatty or fried foods.
- Peppermint.
- Chocolate.
- Alcohol, carbonated beverages, coffee or other caffeinated beverages.
- Large or fatty meals.
Being overweight or pregnant also can increase your risk of experiencing heartburn.
Complications
Heartburn that happens often and interferes with your routine is considered gastroesophageal reflux disease (GERD). GERD treatment may require prescription medicines and, occasionally, surgery or other procedures. GERD can seriously damage your esophagus or lead to precancerous changes in the esophagus called Barrett's esophagus.
