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Heartburn is a feeling of burning, warmth, heat, or pain that often
starts in the upper abdomen just beneath the lower breastbone (sternum). This
discomfort may spread in waves upward into your throat, and you may have a sour
taste in your mouth. Heartburn is sometimes called indigestion, acid
regurgitation, sour stomach, or pyrosis. It is not caused by problems with your
heart, although sometimes heart problems can feel like heartburn. See a picture
Heartburn may cause problems
with swallowing, burping, nausea, or bloating. These symptoms can sometimes
last up to 2 hours or longer. In some people, heartburn symptoms may cause
sleep problems, a chronic cough,
asthma, wheezing, or choking episodes.
Heartburn usually is worse after eating or made worse by lying down or bending
over. It gets better if you sit or stand up.
Almost everyone will
have troubles with heartburn now and then.
Heartburn occurs more
frequently in adults than in children. Many women have heartburn every day when
they are pregnant. This is because the growing uterus puts increasing upward
pressure on the stomach.
Symptoms of heartburn and
symptoms of a heart attack may feel the same.
Sometimes your heartburn symptoms may mean a more
serious problem and need to be checked by your doctor.
is a medical term that is used to describe a vague feeling of fullness,
gnawing, or burning in the chest or upper belly, especially after eating. A
person may describe this feeling as "gas." Other symptoms may occur at the same
time, such as belching, rumbling noises in the abdomen, increased flatus, poor
appetite, and a change in bowel habits.
Causes of dyspepsia can vary from minor to
Heartburn occurs when food and
stomach juices back up (reflux) into the esophagus,
which is the tube that leads from the throat to the stomach. This process is
called gastroesophageal reflux. Common causes of reflux
Mild heartburn occurs about
once a month. Moderate heartburn occurs about once a week.
heartburn occurs every day and can cause problems such as trouble swallowing,
bleeding, or weight loss. Heartburn with other symptoms, such as hoarseness, a
feeling that food is stuck in your throat, tightness in your throat, a
hoarse voice, wheezing, asthma, dental problems, or
bad breath, may be caused by a more serious problem, such as
gastroesophageal reflux disease (GERD). A persistent
inflammation of the lining of the esophagus occurs in GERD and can lead to
other health problems. Heartburn may also be related to an infection with
Helicobacter pylori (H. pylori) bacteria.
Persistent heartburn symptoms can be a sign of a more serious medical
condition, such as severe inflammation of the esophagus or cancer of the
stomach or esophagus.
Heartburn is more serious when it occurs
with abdominal pain or bleeding.
Almost all babies spit up,
especially newborns. Spitting up decreases when the muscles of the esophagus,
which is the muscular tube that connects the throat to the stomach, become more
coordinated. This process can take as little as 6 months or as long as 1 year.
Spitting up is not the same thing as vomiting. Vomiting is forceful and
repeated. Spitting up may seem forceful but usually occurs shortly after
feeding, is effortless, and causes no discomfort.
vomit frequently after eating during the first 2 years of life have increased
chances of having heartburn and reflux problems, such as GERD, later in life.
Children with reflux problems also have increased chances of other problems,
sinusitis, laryngitis, asthma,
pneumonia, and dental problems. For more information,
see the topic
Nausea and Vomiting, Age 11 and Younger.
The treatment of heartburn depends on how
severe your heartburn is and what other symptoms you have. Home treatment
measures and medicines that you can buy without a prescription usually will
relieve mild to moderate heartburn. It is important to see your doctor if
heartburn occurs frequently and home treatment does not relieve your
Check your symptoms to decide if and when
you should see a doctor.
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Home treatment, such as lifestyle
changes and nonprescription medicines, may be all that is needed to treat mild
to moderate heartburn. But if your symptoms do not get better with home
treatment, or if your symptoms occur frequently,
see your doctor to find out whether other medical conditions may be causing
Keep a record of your heartburn symptoms before and
after making lifestyle changes or using nonprescription medicines so you can
discuss any improvement with your doctor. See an example of a
heartburn symptom record(What is a PDF document?).
If you are pregnant and have heartburn symptoms, be sure to
talk to your doctor before you take any heartburn medicines. Some medicines may
not be safe to take while you are pregnant. For more information, see the topic
Many people take nonprescription antacids for mild or occasional heartburn. If you use antacids more than just once
in a while, talk with your doctor.
Antacids work faster than acid reducers (H2 blockers), but their effect does not last more than 1 to 2 hours. H2
blockers can provide relief for up to 12 hours.
Antacids do have side effects. They may cause diarrhea or constipation. Also, antacids can interfere with how your
body absorbs other medicines.
If you have any health risks, talk with your doctor before you start taking an antacid. If you have kidney disease, it
is especially important to discuss antacid use with your doctor. Regular use of antacids that contain magnesium or
aluminum can cause a dangerous buildup of magnesium or aluminum in people who have kidney disease.
Acid reducers, also called histamine receptor (or H2) blockers, decrease the amount of acid that the stomach makes,
which may reduce irritation to the stomach lining and decrease heartburn. Some examples of nonprescription acid
reducers are Pepcid AC, Tagamet HB, Zantac 75, and Axid AR. Talk with your doctor if you take an H2 blocker for
more than 2 weeks.
Proton pump inhibitors (PPIs), such as omeprazole (for example, Prilosec), reduce stomach acid and effectively
treat severe heartburn symptoms. These acid-reducing medicines are used when your heartburn has not gotten
better with other home treatment measures, antacids, or H2 blockers. You may need to use a PPI for up to 5 days
before you have relief of your heartburn, but they are safe to use for long-term management. They also are safe to
use if you have kidney or liver problems. PPIs are available without a prescription.
Acid reducers can sometimes change the way other medicines work. If you are taking prescription medicines, be
sure to talk with your doctor before you take a nonprescription acid reducer.
Call your doctor if any of the following occur during home
You can make changes to your habits and lifestyle to
prevent your symptoms of heartburn. Here are some things to try:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
It will be easier to make lifestyle changes if your family
understands the reasons for the changes. Take a friend or family member to the
appointment with you, and discuss diet and sleeping habits with your
Remember to take your
heartburn symptom record(What is a PDF document?) to your doctor visit. Be sure to note any lifestyle changes
you have made or nonprescription medicines you use.
July 11, 2011
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & H. Michael O'Connor, MD - Emergency Medicine
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