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
DeVault KR. Symptoms of esophageal disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 12.
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.
MedlinePlus Topics
Images
Patient Instructions
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2012, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions.