Heartburn

Many describe heartburn as a feeling of burning discomfort, localized behind the breastbone, which moves up toward the neck and throat. Some even experience the bitter or sour taste of the acid in the back of the throat. The burning and pressure symptoms of heartburn can last for several hours and often worsen after eating food. All of us may have occasional heartburn. If you have heartburn more than twice a week, you may have gastroesophageal reflux disease (GERD). But you can have GERD without having heartburn. If you have other symptoms such as crushing chest pain, it could be a heart attack. Get help immediately.

Prevention

YOU MIGHT BE ABLE TO AVOID HEARTBURN BY MAKING SOME OF THE FOLLOWING CHANGES IN YOUR LIFESTYLE.

• Lose weight if you’re overweight.
• Don’t overeat.
• ​Eat high-protein, low-fat meals.
• If you smoke, quit.
• Avoid tight clothes and tight belts.
• Place 6- to 9-inch blocks under the legs at the head of your bed to raise it.
• Try to eat at least 2 to 3 hours before lying down. If you take naps, try sleeping in a chair.

Risk Factors

Many things can make heartburn worse. Heartburn is most common after overeating, when bending over or when lying down. Pregnancy, certain medications, stress and certain foods can also make heartburn worse.

Causes

When you eat, food passes from your mouth down a tube called the esophagus. To enter the stomach, the food must pass through an opening between the esophagus and stomach.
Usually, this opening closes as soon as food passes through, but if it doesn’t close all the way, acid from your stomach can get through the opening and into your esophagus. This is called reflux. Stomach acid can irritate the esophagus and cause heartburn.

Hiatal hernia can also cause heartburn. Hiatal hernia is a condition in which part of the stomach is pushed up through the diaphragm (the muscle wall between the stomach and chest) and into the chest. Sometimes this causes heartburn.

Symptoms

Both heartburn and a developing heart attack can cause symptoms that subside after a while. The pain doesn’t have to last a long time to be a warning sign. Heartburn is discomfort or actual pain caused by digestive acid moving into the tube that carries swallowed food to your stomach (esophagus).

Typical features of heartburn include:

• A BURNING SENSATION STARTING IN THE UPPER ABDOMEN AND MOVING UP INTO THE CHEST

• USUALLY OCCURS AFTER EATING OR WHILE LYING DOWN OR BENDING OVER

• MAY AWAKEN YOU FROM SLEEP, ESPECIALLY IF YOU HAVE EATEN WITHIN TWO HOURS OF GOING TO BED

• USUALLY RELIEVED BY ANTACIDS

• MAY BE ACCOMPANIED BY A SOUR TASTE IN YOUR MOUTH — ESPECIALLY WHEN YOU’RE LYING DOWN

• MAY BE ACCOMPANIED BY A SMALL AMOUNT OF STOMACH CONTENTS RISING UP INTO THE BACK OF YOUR THROAT (REGURGITATION)

Treatment

Several kinds of medicine can be used to treat heartburn. Antacids neutralize the acid that your stomach makes. For most people, over-the-counter antacids give you fast, short-term relief. However, if you use antacids too much, they can cause diarrhea or constipation. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide. (One causes constipation while the other causes diarrhea so they counteract each other.) Some brands of antacids include Maalox, Mylanta and Riopan. Follow the directions on the package.

H2 blockers (some brand names: Pepcid, Tagamet, Zantac) reduce the amount of acid your stomach makes. Several are available without a prescription.

Other medicines, such as omeprazole (brand name: Prilosec) and lansoprazole (brand name: Prevacid), also reduce how much acid the stomach makes. Metoclopramide (brand name: Reglan) reduces acid reflux. To find out what medicine is right for you, talk with your doctor.