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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.
Dyspepsia 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 serious.
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 include:
Mild heartburn occurs about once a month. Moderate heartburn occurs about once a week.
Severe 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.
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.
Children who 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, such as 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 symptoms.
Check your symptoms to decide if and when you should see a doctor.
Health Tools help you make wise health decisions or take action to improve your health.
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
Based on your answers, you need emergency care.
Call911or other emergency services now.
After you call 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.
Pain in adults and older children
Based on your answers, the problem may not improve without medical care.
Symptoms of a heart attack may include:
The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness, tingling, or a strange feeling in your chest or other areas.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
Many prescription and nonprescription medicines can cause heartburn. A few examples are:
Caffeine and alcohol also can cause heartburn.
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Home treatment, such as lifestyle changes and nonprescription medicines, may be all that is needed to treat mild to moderate heartburn. But if your symptoms do not get better with home treatment, or if your symptoms occur frequently, see your doctor to find out whether other medical conditions may be causing your symptoms.
Keep a record of your heartburn symptoms before and after making lifestyle changes or using nonprescription medicines so you can discuss any improvement with your doctor. See an example of a heartburn symptom record(What is a PDF document?).
If you are pregnant and have heartburn symptoms, be sure to talk to your doctor before you take any heartburn medicines. Some medicines may not be safe to take while you are pregnant. For more information, see the topic Pregnancy-Related Problems.
Many people take nonprescription antacids for mild or occasional heartburn. If you use antacids more than just once in a while, talk with your doctor.
Antacids work faster than acid reducers (H2 blockers), but their effect does not last more than 1 to 2 hours. H2 blockers can provide relief for up to 12 hours.
Antacids do have side effects. They may cause diarrhea or constipation. Also, antacids can interfere with how your body absorbs other medicines.
If you have any health risks, talk with your doctor before you start taking an antacid. If you have kidney disease, it is especially important to discuss antacid use with your doctor. Regular use of antacids that contain magnesium or aluminum can cause a dangerous buildup of magnesium or aluminum in people who have kidney disease.
Acid reducers, also called histamine receptor (or H2) blockers, decrease the amount of acid that the stomach makes, which may reduce irritation to the stomach lining and decrease heartburn. Some examples of nonprescription acid reducers are Pepcid AC, Tagamet HB, Zantac 75, and Axid AR. Talk with your doctor if you take an H2 blocker for more than 2 weeks.
Proton pump inhibitors (PPIs), such as omeprazole (for example, Prilosec), reduce stomach acid and effectively treat severe heartburn symptoms. These acid-reducing medicines are used when your heartburn has not gotten better with other home treatment measures, antacids, or H2 blockers. You may need to use a PPI for up to 5 days before you have relief of your heartburn, but they are safe to use for long-term management. They also are safe to use if you have kidney or liver problems. PPIs are available without a prescription.
Acid reducers can sometimes change the way other medicines work. If you are taking prescription medicines, be sure to talk with your doctor before you take a nonprescription acid reducer.
Call your doctor if any of the following occur during home treatment:
You can make changes to your habits and lifestyle to prevent your symptoms of heartburn. Here are some things to try:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
It will be easier to make lifestyle changes if your family understands the reasons for the changes. Take a friend or family member to the appointment with you, and discuss diet and sleeping habits with your doctor.
Remember to take your heartburn symptom record(What is a PDF document?) to your doctor visit. Be sure to note any lifestyle changes you have made or nonprescription medicines you use.
Current as of: June 4, 2014
Author: Healthwise Staff
Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & H. Michael O'Connor, MD - Emergency Medicine
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