Occasional heartburn is common and no cause for alarm. Most people can manage the discomfort of heartburn on their own with lifestyle changes and over-the-counter medications.
More frequent heartburn that interferes with your daily routine may be a symptom of something more serious that requires help from a doctor.
Symptoms
Symptoms of heartburn include:
A burning pain in the chest that usually occurs after eating and may occur at night
Pain that worsens when lying down or bending over
When to see a doctor
Seek immediate help if you experience severe chest pain, especially when combined with other signs and symptoms such as difficulty breathing or jaw or arm pain. Chest pain may be a symptom of a heart attack.
Make an appointment with your doctor if:
Heartburn occurs more than twice a week
Symptoms persist despite use of over-the-counter medications
You have difficulty swallowing
Causes
Heartburn occurs when stomach acid backs up into your esophagus.
Normally when you swallow, your lower esophageal sphincter — a circular band of muscle around the bottom part of your esophagus — relaxes to allow food and liquid to flow down into your stomach. Then it closes again.
However, if the lower esophageal sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing heartburn. The acid backup may be worse when you’re bent over or lying down.
Complication
Heartburn that occurs frequently and interferes with your routine is considered gastroesophageal reflux disease (GERD). GERD treatment may require prescription medications and, occasionally, surgery or other procedures. GERD can damage the esophagus and cause serious complications.
Many over-the-counter medications are available to relieve the pain of heartburn. Options include:
Antacids that neutralize stomach acid. Antacids, such as Maalox, Mylanta, Gelusil, Rolaids and Tums, may provide quick relief. But antacids alone won’t heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects such as diarrhea or constipation.
Medications to reduce acid production. Called H-2-receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac 25, Zantac 75, Zantac 150). H-2-receptor blockers don’t act as quickly as antacids, but they provide longer relief. Stronger versions of these medications are available in prescription form.
Medications that block acid production and heal the esophagus. Proton pump inhibitors block acid production and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC).
According to the Food and Drug Administration, long-term use of proton pump inhibitors, especially in people age 50 and older, has been associated with an increased risk of fractures of the hip, wrist and spine.
Read and follow the instructions on over-the-counter medications. If you find over-the-counter treatments don’t work or you rely on them often, make an appointment with your doctor.
Lifestyle and prevention
Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.
Avoid tight-fitting clothing.
Avoid foods and drinks that trigger heartburn. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse. Avoid foods you know will trigger your heartburn.
Eat smaller meals. Avoid overeating by eating smaller meals.
Don’t lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
Elevate the head of your bed. If you regularly experience heartburn at night or while trying to sleep, put gravity to work for you.
Don’t smoke.
The best way to prevent heartburn is to lower acid in the stomach.
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