Many people experience heartburn every once in a while. While not uncommon and usually harmless, heartburn can be a sign of a more serious underlying condition. It’s important to understand the symptoms of heartburn and how to recognize whether it is cause for alarm or a sign of something more dangerous.
Heartburn is a condition marked by a painful burning sensation in the chest. The pain is usually centered just below or behind the breastbone, but it often rises to spread to the neck or throat. Most cases of heartburn are not serious and can be treated at home with over-the-counter products and lifestyle changes. However, frequent or severe heartburn may be an indicator of a more serious problem.
The key symptom of heartburn is burning chest pain that is usually centered near the breastbone. This pain can spread up towards the neck and throat. Also, heartburn pain usually gets worse if a person lies down or bends over. Heartburn typically occurs after eating and may feel worse at night.
Causes And Risk Factors
Heartburn is caused by the failure of the esophageal sphincter to function properly. This band of muscle is located at the bottom of the esophagus. Normally, the esophageal sphincter relaxes while you eat so that food and drink can get to your stomach. Then, it is supposed to close again to prevent those items from coming back up. Heartburn occurs when the esophageal sphincter relaxes abnormally or weakens, allowing the stomach acid to come back up through the esophagus.
There are several things which may increase your risk of heartburn, including:
- Being pregnant
- Taking certain medications, such as tricyclic antidepressants, beta-blockers, progestin, anticholinergics, sedatives, theophylline, calcium channel blockers or dopamine-like drugs
- Eating certain trigger foods, which may include soft drinks, tomato sauce, alcohol, chocolate, coffee, fatty foods, fried foods, ketchup, mustard, onions, black peppers, orange juice, vinegar or peppermint
Anxiety and stress may trigger heartburn or make it worse. Some individuals have found alternative treatments like massage, aromatherapy or hypnosis to be helpful in preventing and dealing with heartburn.
In addition, you can make some basic lifestyle changes which can help to prevent heartburn, such as:
- Lose weight: If you are overweight or obese, the extra weight you are carrying adds pressure to your abdomen. This pushes on the stomach and increases the risk of stomach acid travelling back up to the esophagus.
- Don’t wear tight clothes: Wearing clothes that cling to your waist or push on your body also adds pressure to the abdomen and increases the chances of heartburn occurring. Wear looser clothing, particularly if you are planning to eat
- Eat smaller meals. Overeating may increase your risk of heartburn.
- Stay upright after eating: Lying down after a meal can trigger heartburn or make it worse. Try to wait at least three hours after eating before lying down or going to bed.
- Avoid trigger foods and drinks: Things like alcohol, caffeine, tomato sauce and chocolate may trigger heartburn. Try to figure out what causes your heartburn and avoid those foods.
- Quit smoking: The more you smoke, the less likely your esophageal sphincter will function properly.
- Elevate your head while sleeping: This can help prevent heartburn or keep it from getting worse. There are two main ways to do this. The first is to purchase a wedge from a medical supply store and place it between your mattress and box spring on the head end of the bed. The other is to place something under the feet of the bed by the head end so that it is raised by about six inches or so.
The majority of heartburn cases can be treated with over-the-counter medications, including:
- Antacids: These medications neutralize stomach acids but may cause side effects like diarrhea or constipation. Mylanta, Maalox and Tums are common brand names in this category.
- H-2 Receptors: These medications reduce acid production, and though they don’t act as quickly as antacids, they provide more long-lasting relief. Pepcid AC and Zantac are common brand names in this category. Prescription varieties of H-2 receptors are also available.
- Proton Pump Inhibitors: These medications block acid production and also help the esophagus heal. Prevacid and Prilosec are common brand names in this category. There are some side effects for long-term use of these medications, such as increased risk of fractures to the hip, wrist or spine.
Some cases of heartburn may be chronic or more severe and require treatment from a doctor. If you have heartburn more than twice a week, difficulty swallowing or your symptoms are persisting even though you are utilizing over-the-counter medications, make an appointment with your doctor to explore medical treatment options or to find out if an underlying condition is causing your heartburn. It’s important to have frequent heartburn treated since it could lead to a condition called gastroesophageal reflux disease (GERD), which may require surgery or other procedures to treat.
Finally, make sure you don’t confuse your heartburn with general chest pain, as this could be a sign of a heart attack. Seek emergency medical attention if you feel severe chest pain along with difficulty breathing, arm pain or jaw pain.