Feeling the burn? Understanding heartburn, its triggers, symptoms and management


by Rassa Shahidzadeh, MD

Sep 13, 2023

Heartburn is a common digestive condition that many individuals experience at some point in their lifetime. Despite its name, heartburn does not actually involve the heart; it gets its name from the burning sensation felt in your chest.

If you suffer from heartburn, you can manage it through lifestyle changes and medication.

What is heartburn?

Heartburn occurs when stomach acid backs up into the tube that carries food from your mouth to your stomach, known as the esophagus. This can happen when the lower esophageal sphincter (LES), a muscular ring that separates the stomach from the esophagus, relaxes or doesn't close properly. As a result, stomach acid flows up into the esophagus, causing irritation and a burning sensation.

What triggers heartburn?

  • Certain foods: Spicy, acidic and fatty foods can trigger heartburn. These might include citrus fruits, tomatoes, onions, garlic, chocolate and fried foods.
  • Large meals: Eating large meals or lying down right after eating can increase the likelihood of heartburn.
  • Certain beverages: Drinks such as coffee, tea, soda and alcohol can contribute to heartburn.
  • Obesity: Excess weight can put pressure on the stomach, leading to acid reflux and heartburn.
  • Pregnancy: Many women report suffering from heartburn while they are pregnant. This is because of hormonal changes and pressure on the stomach during pregnancy.
  • Smoking: Smoking can increase the risk of heartburn.
  •  Certain medications: Some medications, such as aspirin, ibuprofen or blood pressure medications can contribute to heartburn.

Heartburn vs. acid reflux

Heartburn and acid reflux have similar symptoms, and both can cause discomfort. However, there are several differences between the two.

Heartburn is characterized by a burning sensation or discomfort in the chest, usually behind the breastbone. Acid reflux is a broader condition that involves the backflow of stomach acid into the esophagus, which can cause heartburn but also may have symptoms such as:

  • Regurgitation of sour or bitter-tasting fluid into the mouth
  • A persistent cough
  • Hoarseness
  • Difficulty swallowing (dysphagia) Acid reflux can even cause chest pain that can mimic heart attack symptoms.

When acid reflux becomes chronic, it causes persistent symptoms or can lead to complications like esophageal inflammation or damage. Chronic acid reflux is often referred to as gastroesophageal reflux disease (GERD).

What are the treatments for heartburn?

Lifestyle changes can make a difference for individuals who suffer from heartburn.

  • Adjust your diet to eat less spicy food and avoid common acid triggers such as chocolate, caffeine, mints, peppers and tomato sauce.
  • Elevate your head with pillows or a wedge while sleeping or laying down.
  • Shed a few pounds if you’re overweight.
  • Avoid anti-inflammatory medications that trigger acid such as ibuprofen, naproxen, and aspirin unless recommended by your physician.

When is heartburn serious?

Most cases of heartburn are not serious, but complications such as aspiration (breathing in acid, especially at night) can occur. Chronic acid reflux has been associated with esophageal cancer and a precancerous condition called Barrett’s esophagus

Because of these issues, it is important to discuss your risk factors with your physician to see if any further medical treatment such as endoscopy is needed. An endoscopy is a sedated procedure that inspects the esophagus and stomach for the common causes and complications of acid reflux.

If you’re feeling the burn caused by digestive issues, don’t dismiss it. Take our assessment to learn your risk for heartburn and other digestive conditions, then discuss the results with your doctor. You can also schedule an appointment with a digestive specialist near you.

About the Author

Rassa Shahidzadeh, MD, is a gastroenterologist on the medical staff at Baylor Scott & White Medical Center – Plano. He is clinically interested in colorectal cancer prevention, gastroesophageal reflux disease, disorders of the pancreas and biliary system, disorders of the intestinal tract, disorders of the liver, gastroparesis and nutrition. In 2006, Dr. Shahidzadeh received the American College of Gastroenterology Fellow Recognition Award and was featured in D Magazine’s Best Doctors list.

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