Heartburn and Acid Reflux: What You Need to Know
Feb 17, 2018 Cedars-Sinai Staff
If you're one of the millions who suffer from heartburn, you know how unpleasant it can be. Heartburn, or acid reflux, is characterized by a feeling of burning in your chest or throat and actually has nothing to do with your heart.
Causes of heartburn
Heartburn happens because stomach acid becomes backed up in the esophagus, which moves food from your mouth to your stomach.
The burning sensation is usually the result of stomach acid leaking up into the esophagus through a flaw in a valve known as the lower esophageal sphincter (LES), which connects the esophagus and the stomach. When the LES doesn't tighten properly or becomes weakened, stomach acid can flow back into the esophagus, causing a burning feeling.
Spicy foods or large meals can be the root of distress.
Many things can trigger heartburn. The most common cause is food that's acidic or high in fat—like citrus fruits, tomatoes, onions, chocolate, coffee, cheese, and peppermint. Spicy foods or large meals can also be the root of distress.
Other sources of heartburn include aspirin or ibuprofen, as well as some sedatives and blood pressure medications. Tobacco in cigarettes is known to affect LES function too; cigarette smoking relaxes the muscle, which can result in heartburn.
Being overweight or pregnant can also trigger heartburn due to added pressure on the abdomen and stomach.
Symptoms of heartburn
Symptoms usually begin shortly after eating and may persist for hours or fade in minutes. In addition to burning in the chest, you may have a sour taste in your mouth, coughing, or hoarseness. You may also feel like you have food "stuck" in your throat.
Many people experience worsening heartburn when they lie down or bend over, because these actions allow stomach acid to move more easily into the esophagus.
Treatment of heartburn
What should you do to prevent or relieve heartburn? Your doctor might start by suggesting simple lifestyle changes, says Dr. Nipaporn Pichetshote, gastroenterologist and assistant medical director of the Cedars-Sinai GI Motility program.
Avoid foods that trigger the problem; eat smaller, more frequent meals; and wait 2-3 hours after you eat before lying down.
"If your symptoms don't get better with over-the-counter medication, if you take it more than twice a week, or if your symptoms come on with exertion or exercise, you should see your healthcare provider."
Over-the-counter antacids can help and may be taken after meals or as needed. Your doctor could also suggest an H2 blocker or proton pump inhibitor, both of which are available over the counter or with a prescription.
If your symptoms are not alleviated or you rely on drugstore medication often, you may have GERD (gastroesophageal reflux disease), a more serious form of acid reflux. Your doctor may order an X-ray, endoscopy, or other tests to determine if your symptoms are related to GERD.
"If you're taking medications like proton pump inhibitors or H2 blockers and don't see any improvement, you may need tests for the motility of your esophagus or pH testing," says Dr. Pichetshote.
She also notes that it's important to monitor your symptoms closely and discuss them with your doctor, because they could actually indicate a more serious condition, such as heart disease, hiatal hernia, or esophageal cancer, which require immediate attention.
"If your symptoms don't get better with over-the-counter medication, if you take it more than twice a week, or if your symptoms come on with exertion or exercise, you should see your healthcare provider," says Dr. Pichetshote.