Heartburn is a painful burning feeling just below or behind the breastbone. Most of the time it comes from the esophagus. The pain often rises in your chest from your stomach and may spread to your neck or throat.
Almost everyone has heartburn sometimes. If you have heartburn very often, you may have gastroesophageal reflux disease (GERD).
Normally when food or liquid enters your stomach, a band of muscle at the end of your esophagus closes off the esophagus. This band is called the lower esophageal sphincter (LES). If this band does not close tightly enough, food or stomach acid can back up (reflux) into the esophagus. The stomach contents can irritate the esophagus and cause heartburn and other symptoms.
Heartburn is more likely if you have a hiatal hernia. A hiatal hernia is a conditions which occurs when the top part of the stomach pokes into the chest cavity. This weakens the LES so that it is easier for acid to back up from the stomach into the esophagus.
Pregnancy and many medications can bring on heartburn or make it worse.
Medicines that can cause heartburn include:
Talk to your doctor if you think one of your medicines may be causing heartburn. Never change or stop taking medicine without talking to your doctor first.
You should treat heartburn because reflux can damage the lining of your esophagus. This can cause serious problems over time. Changing your habits can be helpful in preventing heartburn and other symptoms of GERD.
The following tips will help you avoid heartburn and other GERD symptoms. Talk to your doctor if you're still bothered by heartburn after trying these steps.
First, avoid foods and drinks that can trigger reflux, such as:
Next, try changing your eating habits:
Make other lifestyle changes as needed:
If you still do not have full relief, try over-the-counter medications:
Get urgent medical care if:
Call your doctor if:
Heartburn is usually easy to diagnose from the symptoms you describe to your doctor. Sometimes, heartburn can be confused with another stomach problem called dyspepsia. If the diagnosis is unclear, you may be sent to a doctor called a gastroenterologist for more testing.
First, your doctor will do a physical examination and ask questions about your heartburn, such as:
You may need the following tests:
If your symptoms do not get better with home care, your doctor may prescribe medicine to reduce acid. These are stronger than over-the-counter medicines. Any sign of bleeding will need more testing and treatment.
Pyrosis; Non-cardiac chest pain
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Kahrilas PJ, Shaheen NJ, Vaezi MF, Hiltz SW, Black E, Modlin IM. American Gastrointestinal Association Medical Position Statement on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135:1383-1391.
Wilson JF. In the clinic: gastroesophageal reflux disease. Ann Intern Med. 2008;149:ITC2-1-ITC2-15.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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