Heartburn

Heartburn is a burning feeling in your chest. It can get worse if you bend over or lie down. It is usually not a concern unless it occurs often – a couple times a week or more.

You can get heartburn when stomach acid backs up into your esophagus. This happens when the sphincter muscle in your lower esophagus doesn't work right. This muscle is supposed to relax to let food and drink pass into your stomach, and then close. If it doesn't close when it should, stomach acid can go up into your esophagus.

You Are at Risk for Heartburn if You Eat and/or Drink:

  • Alcohol
  • Coffee
  • Carbonated drinks
  • Orange juice
  • Chocolate
  • Fatty food
  • Fried foods
  • Ketchup
  • Mustard
  • Onions
  • Tomato sauce
  • Pepper
  • Vinegar
  • Peppermint

Symptoms

Heartburn symptoms include:

  • Burning in the chest after eating
  • Pain that gets worse at night
  • Pain that gets worse when you bend over or lie down

Tell your doctor if you have heartburn more than a couple of times a week and can't get relief from over-the-counter medication.

If you have chest pain, get immediate medical help. Chest pain can be a sign of a severe medical condition.

Diagnosis

If you have frequent heartburn, your doctor may want to make sure you do not have gastroesphoageal reflux disease (GERD). GERD is more serious than occasional heartburn.

Tests to check for GERD include:

  • X-ray – You drink a chalky liquid that coats the lining of your digestive tract and then have X-rays of your upper GI system. The chalky substance helps your insides show up better on X-rays.
  • Endoscopy – Your doctor inserts an endoscope (flexible tube equipped with a light and tiny camera) down your throat to see inside your esophagus and stomach. If needed, your doctor can get tissue samples (biopsy) during endoscopy. These samples are examined in a lab to check for problems.
  • Ph monitoring – This test checks for stomach acid in your esophagus. In some types of Ph monitoring, a thin tube is threaded through your nose and into your esophagus to take the measurement. This tube remains in place, and you wear a small computer around your waist to check for acid in your esophagus over time. Other times, a tiny monitoring device is placed in your esophagus during endoscopy (tube down your throat). You wear a small computer around your waist for a couple of days, and the monitoring device sends signals to the computer about acid in your esophagus. The monitoring device comes off of your esophagus and passes through your bowels.
  • Motility testing – This procedure measures if the esophagus is working properly. Your doctor puts a thin, flexible tube (catheter) through your nose, down your esophagus and into your stomach. The tube has sensors on it to take measurements.

Treatment

Over-the counter medications include:

  • Antacids – These neutralize acid. They may make your symptoms better for the short term, but they can't fix damage that has occurred to your esophagus. Using antacids too much can cause problems like diarrhea and constipation.
  • H-2 receptor blockers – These reduce the amount of acid your body makes. They do not act as quickly as antacids but help relieve your symptoms longer.
  • Proton pump inhibitors – These block the acid your body makes, which can let your esophagus heal.

How to Prevent Heartburn

You may be able to prevent heartburn in these ways:

  • Maintain your healthy weight – Extra weight pushes your abdomen upward and causes acid to back up into your esophagus.
  • Eat smaller meals.
  • Avoid food and drink that cause heartburn – These can include fatty foods, fried foods, alcohol, chocolate, garlic, onions, tomato sauce and caffeine.
  • Don't smoke.
  • Remain upright after meals for at least three hours.
  • Raise the head of your bed 6 to 9 inches. You can buy wedges at medical supply stores to raise your mattress, or put blocks under your bed to raise the frame.
  • Don't wear clothes that are tight around your waist.

Find an Aurora Health Care GI Specialist