Heartburn 101: What it is and how to manage it

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At some point in your life, you’ve probably experienced heartburn — a sudden, burning pain in the middle of your chest that’s estimated to affect 60 million Americans at least once a month and 15 million once a day. Though experiencing mild heartburn every so often is common, more frequent heartburn episodes — at least twice per week — could indicate a more serious health issue.

Anyone can experience heartburn and acid reflux, but it’s more likely to affect pregnant women, older adults and people who are overweight or obese. Here's what you need to know about heartburn, how to manage it and what to do if you suspect it’s something more serious.

What does heartburn feel like?

The term “heartburn” is misleading — it has nothing to do with the heart. Heartburn occurs in your esophagus (the tube that runs from your throat to your stomach) but causes mild to severe pain in the chest. For someone who doesn’t know what heartburn is or how it feels, it can sometimes be mistaken for heart attack pain.

Are heartburn and acid reflux the same thing?

Heartburn is actually a symptom of acid reflux and gastroesophageal reflux disease (GERD), which is the chronic, more serious form of acid reflux. GERD is diagnosed when acid reflux occurs more than twice a week or causes inflammation in the esophagus.

These conditions are caused by weakness in the muscle connecting your esophagus and stomach called the lower esophageal sphincter (LES). When the LES can’t tighten your esophagus after food passes through it to the stomach, acid from your stomach can move back into your esophagus, causing heartburn.

Why does heartburn occur?

Many people experience heartburn after eating large meals or drinking a lot of alcohol. There are several foods and beverages that can trigger acid reflux, including citrus fruits, spicy foods, onions, chocolate, fried food, caffeine, tomatoes, peppermint and carbonated drinks.

However, other conditions can cause heartburn, including a hiatal hernia (when part of the stomach pushes through the diaphragm and into the chest) and pregnancy, during which progesterone relaxes the LES.

How can I manage heartburn?

Heartburn can last anywhere from a few minutes to a few hours, and taking an antacid might provide some relief. However, treating heartburn after it starts can mask a larger problem — especially if it's experienced frequently. Instead, make these proactive lifestyle changes to stop heartburn in its tracks:

• Avoid late-night meals or snacks
• Don’t lay down within two hours of eating
• Sleep on a slight incline with a wedge pillow
• Wear loose-fitting clothing
• Limit alcohol consumption
• Quit smoking
• Maintain a healthy weight
• Limit use of certain over-the-counter medications, like aspirin or ibuprofen, which can damage the protective layer in your stomach with prolonged use

Is it heartburn or a heart attack?

Having heartburn is different from having a heart attack, though the chest pain can feel similar. Seek immediate care if you experience severe chest pain or pressure, have pain in your jaw, arm or back, are nauseous or vomiting, have trouble breathing, are short of breath, feel lightheaded and/or break out in a cold sweat. These symptoms are signs of a heart attack — not heartburn.

When should I call the doctor about heartburn?

While heartburn may seem like an uncomfortable inconvenience, it can become a more serious health issue if it goes untreated for too long. It’s important to check in with your primary care provider if you’ve been experiencing frequent heartburn despite making lifestyle changes or if you’ve been treating frequent heartburn with over-the-counter medications and they aren’t effective.

You should also make an appointment if you have trouble swallowing, unexplained weight loss or persistent nausea and vomiting, as these can be signs of a more serious gastrointestinal health issue. If needed, your PCP can provide a referral for a specialist. If you don’t already have a PCP, you can register for or log in to myWellmark^® to find a doctor in your network.

Heartburn is never fun. But knowing the differences between heartburn and acid reflux, what signs to watch out for and when it’s time to go to the doctor means you can make it through the next episode worry-free. Just don’t forget your antacids.