Hints on Dealing With the Discomfort
What is heartburn?
Despite its name, heartburn doesn't affect the heart. Heartburn is a
burning feeling in the lower chest, along with a sour or bitter taste in
the throat and mouth. It usually occurs after eating a big meal or
while lying down. The feeling can last for a few minutes or a few hours.
What causes heartburn?
When you eat, food passes from your mouth down a tube
(about 10 inches long in most people) called the esophagus.
To enter the stomach, the food must pass through an opening
between the esophagus and stomach. This opening acts like a
gate to allow food to pass into the stomach.
Usually, this opening closes as soon as food passes through.
But if it doesn't close, acid from your stomach can get through
the opening and into your esophagus. This is called reflux.
Stomach acid can irritate the esophagus and cause heartburn.
What is hiatal hernia?
Hiatal hernia is a condition in which part of the stomach is pushed
up through the diaphragm (the muscle wall between the stomach
and chest) and into the chest. Sometimes this causes heartburn.
What factors add to heartburn?
Many things can make heartburn worse. Heartburn is most common
after overeating, when bending over or when lying down. Pregnancy,
clothing that's so tight it puts pressure on your stomach, stress and
certain foods can also make heartburn worse. The box below lists
other things that can aggravate heartburn symptoms.
Things that can make heartburn worse
Coffee (both regular and decaffeinated) and other
drinks that contain caffeine
Chocolate, mints or peppermints
Fatty foods or spicy foods (pizza, chili, curry)
Aspirin or ibuprofen (one brand name: Motrin)
Some other medicines (check with your doctor)
Can heartburn be serious?
If you only have heartburn now and then, it's probably not serious.
However, if you have heartburn frequently, it can lead to esophagitis
(an inflamed lining of the esophagus). If esophagitis becomes severe,
your esophagus might narrow and you might have bleeding or trouble
If you get more than occasional heartburn, it may be a symptom of
acid reflux disease, gastroesophageal reflux disease (GERD),
an inflamed stomach lining (gastritis), hiatal hernia or peptic ulcer.
What can I do to feel better?
You might be able to avoid heartburn by making some changes in
your lifestyle. The box below lists some tips on how to prevent
Tips on preventing heartburn
Place 4- to 6-inch blocks under the legs at the head
of your bed to raise it.
Try to eat at least 2 to 3 hours before lying down.
If you take naps, try sleeping in a chair.
Lose weight if you're overweight.
Eat high-protein, low-fat meals.
Avoid tight clothes and tight belts.
Avoid foods and other things that give you heartburn.
Will antacids take care of heartburn?
Antacids neutralize the acid that your stomach makes. For most people,
antacids that you can get without a prescription (over-the-counter)
give fast, short-term relief.
However, antacids can cause diarrhea or constipation. Look for
antacids that contain both magnesium hydroxide and aluminum
hydroxide. (One causes constipation while the other causes
diarrhea so they counteract each other.) Some brands of antacids
include Maalox, Mylanta and Riopan. Follow the directions on the
What if my symptoms get worse?
If lifestyle changes and antacids don't help your symptoms,
talk with your doctor. Your doctor may want you to take
medicine or schedule you for some tests.
Tests might include x-rays to check for ulcers, a pH test to check
for acid in the esophagus, or an endoscopy to check for other conditions.
During an endoscopy, your doctor looks into your stomach through
a long, thin tube which is inserted down your esophagus.
Your doctor may also check for H. pylori, a bacteria that can
What about medicines for heartburn?
Several kinds of medicine can be used to treat heartburn. H2
blockers (some brand names: Pepcid, Tagamet, Zantac) reduce
the amount of 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 how much acid
the stomach makes. Metoclopramide (brand name: Reglan) reduces
acid reflux. To find out what medicine is right for you, talk with your doctor.
Call your doctor if:
You have trouble swallowing or pain when swallowing.
You're vomiting blood.
Your stools are bloody or black.
You're short of breath.
You're dizzy or lightheaded.
You have pain going into your neck and shoulder.
You break out in a sweat when you have pain in your
You have heartburn often (more than 3 times a week)
for more than 2 weeks.
Is heartburn associated with heart attacks?
No. But sometimes pain in the chest may be mistaken for heartburn
when it's really a sign of heart disease. If you have any of the
symptoms in the box below, call your doctor.