Nearly everyone will experience occasional heartburn at some point in their lifetimes, and this is typically no cause for concern. There are many over-the-counter heartburn treatments and diet and lifestyle changes that ease symptoms. However, if heartburn is more frequent or is severe, it may be indicative of a different gastrointestinal problem, such as acid reflux or gastroesophageal reflux disease (GERD).
Heartburn is typically a burning sensation or pain in the chest that may or may not move up through the neck and throat. It can last from several minutes to several hours. The burning sensation that you feel is stomach acid escaping from the stomach into the esophagus. The amount of acid may vary, depending on whether it is occasional heartburn or symptomatic of another disease, such as GERD.
At the bottom of the esophagus is a muscle called the lower esophageal sphincter (LES). After food or liquid moves through the esophagus, a properly functioning LES closes. However, sometimes the LES opens and closes or is completely open. The stomach contents escape into the esophagus. Heartburn occurs when the stomach acid temporarily inflames the esophagus.
Heartburn symptoms can look slightly different in every patient, depending on the severity of the heartburn and how far the stomach acid has traveled. Common heartburn symptoms include:
Regurgitation (food and liquid coming back up into the mouth) can also occur with heartburn, particularly when the underlying cause is acid reflux or GERD.
The cause of heartburn is stomach acid in the esophagus. However, many outside factors can cause this to occur. Other than acid reflux and GERD, these can contribute to heartburn:
Many cases of occasional heartburn are caused by poor eating habits or the foods you eat. If you struggle with occasional bouts of heartburn, you can try diet and lifestyle changes as heartburn treatment. Some foods and beverages you may want to avoid to prevent heartburn include:
You also may want to make changes in your eating and lifestyle habits. This would include changes such as eating smaller meals, quitting smoking if you’re a smoker, and losing weight (if overweight). You should also avoid eating right before you lie down, as this can trigger heartburn.
Chest pain can sometimes be mistaken for heartburn when the pain is attributed to a heart attack instead. If you have severe chest pressure or pain, seek emergency help immediately.
For heartburn and heartburn symptoms, you should consult a gastroenterologist if:
Your GI doctor will likely want to rule out acid reflux or GERD, so they may run some diagnostics in order to provide heartburn treatment. Your gastroenterologist will ask you about your symptoms and medical history as well. Some of these tests could include:
Heartburn treatment will depend upon the testing, however, there are common medications used to treat heartburn, acid reflux, and GERD, as defined by the Food and Drug Administration (FDA). These drugs can be both over-the-counter and prescription, and your gastroenterologist will direct you which one is right for you.
Antacids . These medications help change the heartburn-causing stomach acid. Common OTC antacids include Mylanta® (aluminum hydroxide, magnesium hydroxide, and simethicone), Rolaids® (calcium carbonate), and TUMS® (calcium carbonate).
). PPIs work by reducing the amount of acid in the stomach. These are often prescribed but are also available over the counter. These include:
Proton pump inhibitors (PPIs
. These medications also work toward reducing acid in the stomach. In cases of GERD, PPIs and H2 blockers are often prescribed together. These commonly include:
Histamine-2 blockers (H2 blockers)
It’s important to remember that if you’re taking antacids, PPIs, or H2 blockers over the counter and your symptoms are not lessening, it’s time to schedule a consultation with a gastroenterologist for heartburn treatment.
