Know the Signs of Heartburn


Chris Iliades, MD

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Heartburn happens when normal stomach acid backs up into your esophagus. The esophagus is the long tube that connects your mouth to your stomach. Your stomach is built to withstand the acids in the digestive juices needed to break down food. Your esophagus isn't. So, when those juices back up into your esophagus, you feel the burning sting.

What Heartburn Feels Like

Heartburn usually occurs after you eat or when you lie down. In fact, lying down shortly after eating is most likely to bring it on.

Heartburn feels like a burning pain in your mid-chest, just behind your breastbone. You might first feel it lower in your chest. The sensation can also move up into your throat.  A bout of heartburn can last anywhere from a few minutes to a few hours.

Other heartburn symptoms may include:

  • Sour taste in your throat

  • Feeling a lump in your throat

  • Trouble swallowing

  • Sore throat

  • Cough

  • Hoarse voice

  • Waking up at night choking

Self-Care Tips for Heartburn Prevention

Lifestyle changes can help you avoid heartburn:

  • Lose some weight if you are overweight.

  • Don’t smoke.

  • Drink alcohol only in moderation.

  • Reduce your caffeine intake including coffee, tea and chocolate.

  • Avoid fatty, fried and spicy foods. Also steer clear of acidic foods like citrus.

  • Eat smaller, more frequent meals.

  • Don't eat for 3 hours before lying down to nap or sleep.

  • Avoid tight-fitting clothes.

  • Raise the head of your bed by 6 to 8 inches by placing cinder blocks or bricks under the bed.

  • For a few hours after eating, don't do strenuous exercise that involves straining or bending.

Some medicines also cause heartburn. These include aspirin, ibuprofen, sedatives and certain high blood pressure drugs. Ask your doctor if any of your regular medicines could be causing your heartburn. If so, a change might resolve your heartburn.

Treatment Tips for Heartburn

If lifestyle changes don’t stop your heartburn, medication may help:

  • The first choice is usually an over-the-counter (OTC) antacid. It immediately changes your stomach acid so it's less acidic.

  • If antacids don’t help, you could try an H2 blocker. These OTC drugs quickly block acid production in your stomach.

  • If H2 blockers don’t work, consider an OTC proton pump inhibitor (PPI). PPIs block acid production better than H2 blockers. But they may take 24 hours or longer to begin providing relief.

  • If OTC medicines are not helping and you have heartburn two or more times a week, talk to your doctor. You may need a prescription-strength drug. Also, frequent heartburn could be a symptom of a more serious type of reflux.

Key Takeaways

  • Heartburn feels like burning pain behind your breastbone. It can last from a few minutes to a few hours.

  • Lifestyle changes can often help prevent heartburn.

  • Medications for heartburn commonly include antacids, H2 blockers, and PPIs.

  • Heartburn that occurs more than twice a week for several weeks could be a more serious type of reflux, so let your doctor know.


Sleep Tips for Heartburn

Most people have their worst heartburn at night. That's because heartburn has a lot to do with gravity.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: May 28, 2016

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Medical References

  1. Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) in Adults. National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases.
  2. Heartburn. American Academy of Family Physicians.
  3. Gastroesophageal Reflux Disease in Adults. NYU Langone Medical Center.

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