Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2003;68(10):2033-2034

What is heartburn?

Despite its name, heartburn does not affect the heart. Heartburn is a burning feeling in the lower chest, along with a sour or bitter taste in the throat and mouth. Heartburn also is called acid reflux disease, or gastroesophageal reflux disease (GERD). You might get heartburn after eating a big meal or while you are lying down. The feeling can last for a few minutes or a few hours.

What causes heartburn?

When you eat, food goes from your mouth down a tube in your throat called the esophagus (say: eh-sof-ah-gus). To enter the stomach, the food must go through an opening between the esophagus and the stomach. This opening acts like a gate to let food go into the stomach.

The opening to the stomach closes as soon as food goes through. If the opening does not close, stomach acid comes back through the opening and up into the esophagus. This is called reflux. The stomach acid irritates the esophagus and is the cause of heartburn pain.

Another cause of heartburn is hiatal hernia (say: hi-a-tal her-nee-uh). Hiatal hernia is a condition in which part of the stomach gets pushed up through the diaphragm (the muscle wall between the stomach and chest) and into the chest.

Can heartburn be serious?

If you only have heartburn once in a while, it probably is not a serious problem. If heartburn goes on long enough, it can lead to esophagitis (an inflamed lining of the esophagus). If the esophagitis becomes very bad, your esophagus might get narrow, and you might have bleeding or trouble swallowing. Heartburn also can be a sign of ulcers.

What can I do to feel better?

You might be able to stop heartburn by making some changes in your life. Here are some tips on how to stop heartburn:

  • Raise the head of your bed by placing fourto six-inch blocks under the legs at the head of the bed.

  • Try to eat at least two to three hours before you lie down. If you take naps, try sleeping in a chair.

  • Lose weight if you are overweight.

  • Do not overeat.

  • Do not wear tight clothes or tight belts.

  • Do not eat acidic or spicy foods, caffeine, chocolate, mints, or alcohol.

  • Quit smoking if you smoke.

Will antacids get rid of heartburn?

Most people get fast, short-term relief with antacids. Antacids neutralize the acid in your stomach. However, some antacids can cause diarrhea or constipation. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide. (One causes constipation and the other causes diarrhea; the two ingredients work against each other.) Some brands of antacids include Maalox, Mylanta, and Riopan. Follow the directions on the package.

What if my symptoms get worse?

If lifestyle changes and antacids do not help your symptoms, talk with your doctor. He or she may want to give you medicine or schedule you for some tests.

Tests might include x-rays to check for ulcers, tests to check for acid in the esophagus, or an endoscopy to check for other conditions. For an endoscopy, a thin tube with a tiny camera inside it is put down your throat and into your esophagus so the doctor can look at it. Your doctor also may check for the bacteria that causes ulcers.

What about other medicines for heartburn?

Several kinds of medicine can be used to treat heartburn. H2 blockers (some brand names: Pepcid, Tagamet, Zantac) reduce the acid your stomach makes. Several are available without a prescription.

Other medicines, such as omeprazole (brand name: Prilosec) and lansoprazole (brand name: Prevacid), also reduce the acid your stomach makes. Metoclopramide (brand name: Reglan) reduces acid reflux. Your doctor will tell you which medicine is right for you.

Is heartburn associated with heart attacks?

No. But sometimes pain in the chest may be mistaken for heartburn when it is really a sign of heart disease. If you have any of the following symptoms, call your doctor right away:

  • Trouble swallowing or pain when swallowing

  • Vomiting blood

  • Stools that are bloody or black

  • Shortness of breath

  • Dizziness or lightheadedness

  • Pain going into your neck and shoulder

  • Breaking out in a sweat when you have pain in your chest

  • Heartburn that occurs often (more than three times a week) for more than two weeks

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