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Alternative Names Return to topPyrosis; Non-cardiac chest pain
Definition Return to top
Heartburn is a painful burning sensation in the esophagus, just below or behind the breastbone. The pain often rises in your chest and may radiate to your neck or throat.
Causes Return to top
Almost everyone has occasional heartburn. If you have frequent, ongoing heartburn, you may have gastroesophageal reflux disease (GERD).
Normally, when food or liquid enters your stomach, a band of muscle at the end of your esophagus (called the lower esophageal sphincter or LES) closes off the esophagus. If this muscle fails to close tightly enough, stomach contents can back up (reflux) into the esophagus. This partially digested material is usually acidic and can irritate the esophagus, causing heartburn and other symptoms.
Heartburn is more likely to occur if you have a hiatal hernia, which is when the top part of the stomach protrudes upward into the chest cavity. This weakens the LES and makes it easier for acid to reflux from the stomach into the esophagus.
Heartburn can be brought on or worsened by pregnancy and by many different medications.
Such drugs include:
If you suspect that one of your medications may be causing heartburn, talk to your doctor. NEVER change or stop medication you take regularly without talking to your doctor.
Home Care Return to top
Pay attention to heartburn and treat it, especially if you feel symptoms often. Over time, ongoing reflux can damage the lining of your esophagus and cause serious problems. The good news is that making changes to certain habits can go a long way to preventing heartburn and other symptoms of GERD.
The following tips will help you avoid heartburn and other GERD symptoms. If these measures are not working, talk to your doctor.
First, avoid foods and beverages that can trigger reflux, such as:
Next, try changing your eating habits:
Make other lifestyle changes as needed:
If you still do not have full relief, try over-the-counter medications:
When to Contact a Medical Professional Return to top
Call 911 if:
Call your doctor if:
What to Expect at Your Office Visit Return to top
Heartburn is usually easy to diagnose from the symptoms you describe to your doctor. Sometimes, heartburn can be confused with another stomach problem called dyspepsia. If the diagnosis is unclear, then you may be sent to a gastroenterologist for further testing.
First, your doctor will perform a physical examination and ask questions about your heartburn, such as:
The following tests may be performed:
If self care has not been successful, your doctor may consider prescribing you medications to reduce acid secretion. These are stronger than the medications available over the counter. Any sign of bleeding will require a more complicated treatment plan.
References Return to top
DeVault KR, Castell DO. Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2005;100:190-200.
Smith L. Updated ACG Guidelines for Diagnosis and Treatment of GERD. Am Fam Physician. 2005; 71(12): 2376-2382.
Fass R. Predictors of heartburn during sleep in a large prospective cohort study. Chest. 2005; 127(5): 1658-1666.
McCarthy D. Living with chronic heartburn: insights into its debilitating effects. Gastroenterol Clin North Am. 2003; 32(3 Suppl): S1-S9.Update Date: 5/3/2007 Updated by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.