A burning pain that occurs in the chest (behind the breastbone) is called heartburn. Commonly, the pain worsens after a meal, in the evening, when lying down or bending over. In some cases, this condition may appear without any obvious reason or symptoms. People usually manage heartburn discomfort on their own with over-the-counter (OTC) medicines and lifestyle changes.
If the heartburn happens frequently or it interacts with your daily activities, it may indicate a more serious health problem that needs medical care.
Symptoms
These include:
- Pain that may worsen, especially with you lie down or bend over
- Acidic taste in the mouth
- Burning pain in the chest
In some cases, chest pain may be a myocardial infarction symptom. Therefore, you should go to the nearest emergency room right away or call 911 if experience severe chest pain or pressure, especially combined with breathing problems. In any case, it is advised to visit a doctor if any of the following cases occur. Examples include:
- Persistent nausea or vomiting
- Weight loss due to poor appetite or eating problems
- Difficulty swallowing
- Symptoms continue to persist nonetheless use of OTC medications
- Heartburn happens frequently (more than twice a week)
Causes
This unpleasant condition often happens when the stomach acid returns to the tube that carries the food from the mouth to the stomach (also known as the esophagus).
Generally, when the food is swallowed, a band of the lower esophageal sphincter (muscle around the bottom of the esophagus) allows the food and liquid to flow down into the stomach. However, if the lower esophageal sphincter does not work properly, the stomach acid may go backward into the esophagus (acid reflux) and cause heartburn. Moreover, acid reflux usually worsens when you bend over or lie down.
Risk Factors
There are some risk factors that may trigger or worsen heartburn. Examples include:
- Spicy foods
- Onions
- Citrus products
- Tomato products (including ketchup)
- Peppermint
- Chocolate
- Alcohol, carbonated drinks, coffee, and others
- Large or fatty meals
The risk of heartburn significantly increases in people who are overweight and pregnant.
What Are The Possible Complications of Heartburn?
For those who experience heartburn frequently and interact with daily activities, it usually indicates gastroesophageal reflux disease (also known as GERD). However, this is a serious health condition that requires treatment (including prescription medicines, surgery, and other procedures). Without treatment, GERD may cause esophagus damage or lead to precancerous esophagus changes (also known as Barrett’s esophagus).
Diagnosis
Healthcare professionals usually perform the following tests to determine if heartburn is a GERD symptom. For example:
- X-ray – This test helps doctors get detailed images of the esophagus and stomach. However, it may be used to identify other health problems.
- Endoscopy – This test involves a small tube with a camera at the end that is inserted into the esophagus to check for abnormalities. Sometimes, doctors may get a sample of tissue for analysis (biopsy).
- Acid probe tests – These tests involve an acid monitor that is placed in the esophagus and connected to a small computer that people often wear around the waist or on a strap over the shoulder. It helps determine how long the stomach acid returns to the esophagus.
- Esophageal motility testing – This test helps measure esophagus pressure and movement.
Treatment
There are multiple OTC medications that help with heartburn. Check some of them below:
- H2 blockers – This group of medications is used to reduce stomach acid production. For example Famotidine, Cimetidine, and others.
- Antacids – These drugs help neutralize stomach acid and provide quick relief. However, antacids cannot heal an esophagus once damage occurs.
- Proton pump inhibitors – These medicines work similarly to H2 blockers. For example Lansoprazole, Esomeprazole, Omeprazole, and others.
If you do not notice any improvements after using OTC medicines or use them too frequently, you should visit a doctor for prescription medicines and further testing.
Lifestyle Changes
The following lifestyle changes may help get rid of heartburn even without medicines. Examples include:
- Get and maintain a healthy weight – Excess weight may put extra pressure on the abdomen causing acid reflux.
- It is advised to avoid tight clothes because they also put extra pressure on the abdominal region and the lower esophageal sphincter.
- Avoid lying down after a meal for at least 2-3 hours, late meals, and foods that potentially trigger heartburn.
- Quit smoking and avoid alcoholic drinks, especially if heartburn happens frequently.
- Better eat many small meals than one but large.
- Elevate your head if you experience heartburn frequently during nighttime or when trying to sleep. If you cannot raise the head on your own, you can insert a wedge between the mattress and box spring to elevate the body from the waist up. However, elevating the head with an additional pillow usually is not effective.
Frequently Asked Questions
What are the best OTC medicines for heartburn?
The most effective medicines that help relieve heartburn instantly include:
- Antacids
- H2 blockers
- Proton pump inhibitors
However, before using any of the previous medicines, consult with your healthcare professional.
What are the main heartburn symptoms?
- A burning feeling in the stomach region
- Bitter or acidic taste in the mouth
- Chest pain worsens when you lie down or bend over
- A feeling that food is stuck in the middle of the throat or chest
- Swallowing problems (also known as dysphagia)
- A feeling of a lump in the throat
Do not hesitate to see a doctor if any of the previous symptoms occur. Moreover, in some cases, chest pain may be a symptom of a heart attack.
What are the potential complications of heartburn?
The following complications may happen in people with heartburn, especially without treatment. Examples include:
- Esophagitis – This is a condition in which damage to the esophagus lining occurs causing bleeding, ulcers, and inflammation.
- Esophageal stricture – In such cases, scar tissue occurs in the esophagus.
- Barrett’s esophagus
- LPR (laryngopharyngeal reflux) – It happens when stomach acid goes into the throat causing hoarseness and swelling.
- Dental erosion
- Aspiration pneumonia
- Chronic cough
- Asthma
- Pulmonary fibrosis – This complication may occur if stomach acid causes damage to the lungs.
If you have additional questions, ask your healthcare provider.
