What is heartburn?

Heartburn refers to the symptoms you feel when the acidic contents of your stomach flow backward into the esophagus. The esophagus is the tube that carries food from the back of the mouth to the stomach.

Heartburn, also called gastroesophageal reflux, is a common problem. It is not related to the heart at all.

How does it occur?

At the bottom of the esophagus is a ringlike muscle called the lower esophageal sphincter. When you swallow food, this muscular ring opens to let the food pass into the stomach. It then closes to prevent the stomach contents from backing up into the esophagus. When this sphincter muscle is not able to do its job, the acidic stomach contents flow backward into the esophagus. Because the esophagus does not have the protective lining that the stomach has, the acid stomach contents cause the symptoms of heartburn.

What are the symptoms?

The main symptom of heartburn is a burning pain in the lower chest, usually close to the bottom of the breastbone. Often the pain is accompanied by an acid or sour taste in the mouth. You may have belching and the sensation of bloating or fullness of the stomach. These symptoms tend to occur after very large meals and especially with activity such as bending or lifting after meals. The symptoms may be made worse by lying down or by wearing tight clothing.

Heartburn is very common during the last few months of pregnancy. The weight of the baby pushes on the stomach and tends to cause the sphincter to allow back flow.

How is it diagnosed?

Usually heartburn can be diagnosed from your medical history. If there is any question about the diagnosis, your health care provider may order a barium swallow, a complete upper GI (gastrointestinal) x-ray, or an upper endoscopy. In an upper endoscopy, a lighted tube is placed in your mouth and down into your stomach. These tests allow your doctor to look at your esophagus and check for ulcers or other problems that might cause your symptoms.

How is it treated?

The simplest treatment of heartburn is to avoid increasing the intra-abdominal pressure soon after eating. Losing any excess weight will help eliminate pressure on the sphincter muscle. Nonprescription antacids (tablets or liquid) taken after meals and at bedtime may prevent symptoms. Avoiding substances likely to make the symptoms worse will also help. Alcohol, nicotine, caffeine, aspirin, acidic food and drink (orange juice), and spicy foods are examples of such substances. Raising the head of your bed or using more than one pillow, so your head is higher than your stomach, may allow gravity to help alleviate the symptoms.

If the simple measures described above do not relieve the symptoms, your health care provider may prescribe medication. The prescription medicines help reduce stomach acid. They also help stomach emptying.

How long will the effects last?

Heartburn symptoms are usually relieved by treatment in just a few days. However, the symptoms may recur from time to time, especially if you get heavier or increase your use of nicotine, alcohol, caffeine, or spicy foods.

What can be done to help prevent heartburn?

The best prevention is to maintain a normal body weight, eat a healthy diet, and avoid substances that have caused symptoms of heartburn in the past.