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Heartburn Worry: Serious or Not?

What you need to know about heartburn -- when to worry, when not, what to do.
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WebMD Feature

Heartburn is that awful burning sensation in your chest or throat, usually when acid rises up from your stomach. Heartburn is always an annoyance. But if you’re like many people with heartburn, you also probably find yourself worrying from time to time. Could it be something more serious? Is there something wrong with your digestive system? Or maybe you think it’s your heart.

Even when you’re pretty sure it’s heartburn, it can be hard to know what to do. Should you take an antacid, schedule an appointment to see your doctor, or call 911?

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Here’s information you can use to know what to do the next time heartburn gives you that burning feeling.

What Is Heartburn?

Heartburn,  also called acid indigestion, is a symptom of gastroesophageal reflux (GERD). It can occur when acid or other contents from your stomach "back up" into the esophagus. That’s the tube food passes through going from your mouth to your stomach.

The problem stems from a muscle that may be weak or may relax at inappropriate times. It’s called the lower esophageal sphincter or LES, and it’s located between your stomach and your esophagus. If it doesn't close quickly enough, it can’t prevent the acid backwash. That results in heartburn.

When acid reflux is frequent, you may have a condition called GERD, or gastroesophageal reflux disease.

How Do You Know If It’s Heartburn or Your Heart?

If you're trying to figure out if it's just heartburn from GERD -- which by itself is rarely life-threatening -- pay attention to any other symptoms. That’s the advice of Peter Galier, MD, an internal medicine specialist at Santa Monica UCLA Medical Center and Orthopaedic Hospital in Santa Monica, Calif. He is also an assistant professor of medicine at the University of California Los Angeles.

Galier typically asks patients who complain of heartburn these three questions:

  • Are you sweaty?
  • Do you have palpitations?
  • Are you short of breath?

If any of those symptoms occur with the heartburn, Galier says, you should see a physician and make sure it is not heart-related.

Note the Time Your Heartburn Symptoms Occur

Think, too, about when the heartburn occurs. Galier says if it happens after a big meal, and it's just the burning in the chest, with no other symptoms, it’s more than likely heartburn or indigestion. But if you have any doubt, it's wise to ask your doctor for an evaluation.

"If you have chest pain after a meal, it's more likely to be reflux," agrees Glenn Eisen, MD, MPH, professor of medicine and director of endoscopy at the Oregon Health & Science University in Portland. But that's not a perfect test, he says. "It could be cardiac."

Phil Katz, MD, says that knowing what "classic" heartburn is like may help. Katz is president-elect of the American College of Gastroenterology and clinical professor of medicine at Jefferson Medical College in Philadelphia.

“The classic heartburn symptom,” he tells WebMD, “is burning that starts at the upper stomach or lower breastbone and progresses upward and occurs after a meal or when bending over." He adds, "It's rapidly relieved by an antacid within a few minutes.”

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