Heartburn is a painful burning feeling just below or behind the breastbone. It usually comes from the esophagus. The pain often rises in your chest 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, contents from the stomach can back up (reflux) into the esophagus. This partly digested material can irritate the esophagus, causing heartburn and other symptoms.
Heartburn is more likely if you have a hiatal hernia. A hiatal hernia is when the top part of the stomach sticks up into the chest cavity. This weakens the LES and makes it easier for acid to back up from the stomach into the esophagus.
Pregnancy and many medications can bring on heartburn or make it worse.
Drugs that can cause heartburn include:
If you think one of your medicines may be causing heartburn, talk to your doctor. Never change or stop taking medicine without talking to your doctor.
Treat heartburn, especially if you often feel symptoms. Over time, reflux can damage the lining of your esophagus and cause serious problems. The good news is that changing your habits can help prevent heartburn and other symptoms of GERD.
The following tips will help you avoid heartburn and other GERD symptoms. If these measures do not work, talk to your doctor.
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:
The following tests may be done:
If you have not been able to improve your symptoms 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; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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