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
of heartburn .
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
Causes of heartburn
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
- Incomplete closing of the valve (the
lower esophageal sphincter, or LES) between the
esophagus and the stomach.
- Foods and
drinks, such as chocolate, peppermint, fried foods, fatty foods, sugars, coffee, carbonated drinks, and alcohol. After heartburn occurs, the backflow of
stomach juices can cause the esophagus to become sensitive to other foods, such
as citrus fruits, tomatoes, spicy foods, garlic, and onions. Eating these foods
may cause more heartburn.
- Pressure on the stomach caused by
obesity, frequent bending over and lifting, tight clothes, straining with bowel
movements, vigorous exercise, and pregnancy.
- Smoking and use of
other tobacco products.
- Prescription and nonprescription
medicines, such as aspirin, ibuprofen, prednisone,
iron, potassium, antihistamines, and sleeping pills.
hiatal hernia , which occurs when a small portion of the stomach pushes upward
through the diaphragm, which is the muscle that separates the lungs from the
- Stress, which can increase the amount
of acid your stomach makes and cause your stomach to empty more slowly.
Severity of heartburn
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.
- Abdominal pain, especially pain located
directly below the breastbone, may be a sign of more serious problems, such as
peptic ulcer disease,
gallbladder disease, a tear in the esophagus, or
inflammation of the stomach (gastritis). For more information, see
Abdominal Pain, Age 11 and Younger or
Abdominal Pain, Age 12 and Older.
of blood may mean bleeding in the digestive tract, often from the esophagus
or stomach. If you have bleeding in the esophagus, stomach, or part of the
small intestine attached to the stomach (duodenum), stools may be dark red or
black and tarry. Large amounts of bleeding can lead to
shock, a life-threatening condition. For more
information, see the topic
Nausea and Vomiting, Age 12 and Older.
Heartburn in children
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.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
H. Michael O'Connor, MD - Emergency Medicine
July 11, 2011
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