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What is heartburn and what does heartburn feel like? Heartburn or acid indigestion is a burning pain behind the breastbone. The pain from heartburn can radiate to the throat, neck, and jaw. Some people may experience additional heartburn symptoms such as a bitter taste, nausea, or vomiting.¹

Heartburn affects approximately 42% of the United States population.² Though this figure may vary between cultures due to differences in diet and lifestyle, most modern cultures with diets high in processed foods will probably be close to this figure.

What Causes Heartburn?

The esophagus is the tube running from the mouth to the stomach. It doesn’t have the same protective lining of the stomach. When acids come in contact with the esophagus, they can irritate causing the pain we know as heartburn.

How do stomach acids get into the esophagus?… There is a band of muscle at the base of the esophagus called the lower esophageal sphincter (LES). When food is swallowed, the LES relaxes allowing the contents to enter the stomach. If the LES doesn’t close tightly enough, stomach acid can reflux back into the esophagus. This backflow of acid is called acid reflux.

Is Heartburn Serious?

Occasional heartburn usually isn’t serious and is quite common. Occasional heartburn can be managed through use of over-the-counter heartburn medication or natural heartburn remedies. If you have frequent heartburn, you should see a doctor. Frequent heartburn can develop into more serious conditions.

How Long Does Heartburn Last?

Heartburn lasts anywhere from a few minutes to hours. It depends on the underlining cause of heartburn.

When should I see a doctor?

You should see a doctor about your heartburn symptoms if:

• You have heartburn more than three times a week for more than two weeks.
• Symptoms are not remedied by use of antacids.
• You have trouble swallowing, get choked when swallowing, or experience pain when swallowing.

Ulcers can be confused with heartburn. Symptoms of ulcers include:

• Weight loss
• Loss of appetite due to pain
• Nausea or vomiting
• Bloating
• Burping
• Acid reflux and heartburn
• Vomiting blood
• Bloody or black stools

Some people confuse heartburn and a heart attack. Symptoms of a heart attack include:

• Chest, neck, back, or arm pain
• Chest pressure
• Fatigue
• Lightheadedness
• Abnormal heartbeat
• Shortness of breath
• Nausea or vomiting
• Anxiety

If you experience symptoms of a heart attack, you should see a doctor immediately.

Don’t try to cope with chronic heartburn. See a doctor about treatment and prevention options. Chronic heartburn, otherwise known as gastroesophageal reflux disease (GERD), can diminish quality of life, cause an esophageal stricture, and can even lead to other health issues including cancer.

How to Prevent Heartburn

Lifestyle change is usually required to prevent heartburn. Eating healthy and in proper proportions, limiting alcohol consumption, and exercising are some of the lifestyle changes that will prevent heartburn.

Common causes of heartburn include heartburn trigger foods, pressure on the LES, tobacco use, bacterial or yeast infections, and certain medications. Heartburn trigger foods, small intestine bacterial overgrowth (SIBO), and Helicobacter pylori (H. pylori) bacteria have been covered in previous articles in greater detail.

Pressure on the LES can cause stomach contents to reflux and lead to heartburn. Pressure can be in the form of:

• Overeating
• Carbonated drinks
• Bending over after eating
• Reclining or laying down after eating
• Certain exercises or timing of exercises. Please refer to the articles on “Exercise Without Heartburn” and “Heartburn Friendly Exercises“.
• Pregnancy
• Being overweight
• Wearing tight clothing

How to Treat Heartburn

There is no one best treatment for heartburn. People differ in chemistry and the cause of heartburn can differ as well. A doctor can help formulate the best plan for your situation. Gastroenterologists are doctors that specialize in digestive disorders and are the best to see for heartburn treatment.

Your doctor may recommend one or more of the following tests:

• A pH test to check acid level in the esophagus.
• An x-ray to analyze the condition of your esophagus, stomach, and possibly intestines.
• An endoscopy where a scope is put done the throat to view the condition of the esophagus and stomach. During an endoscopy biopsies of tissue can be taken to check for certain conditions including cancer.
• Hydrogen and methane breath test to check for SIBO.
• Breath test, blood test, stool test, or biopsy to check for helicobacter pylori.

Heartburn Medicine

Heartburn medications can be found in three over the counter (OTC) levels for treating heartburn, acid reflux, and GERD. Their order of aggression is antacids, histamine receptor blockers (H2 blockers), and proton pump inhibitors (PPIs).

Antacids are used for occasional heartburn. For many, they are the closest thing to instant heartburn relief giving fast but temporary relief.

H2 blockers decrease stomach acid production.

PPIs reduce stomach acid and are used when antacids and H2 blockers don’t provide the desired level of relief.

Heartburn While Pregnant

Fewer remedies exist for those needing relief from pregnancy heartburn. What should you take for heartburn when pregnant? Please see:

• Preventing Heartburn During Pregnancy
• Heartburn Remedies During Pregnancy
• Unsafe Heartburn Remedies During Pregnancy

References

1) “Heartburn.” FamilyDoctor.org – American Academy of Family Physicians, November 8, 2017.

2) Pamela R. Kushner. “Role of the primary care provider in the diagnosis and management of heartburn.” Current Medical Research and Opinion (journal), January 22, 2010.