Heartburn Relief Tips

If you’ve ever felt like your chest was on fire after eating a big or greasy meal, then you’re probably familiar with heartburn. Whether it happens to you occasionally or more often, you can take simple steps to soothe the burn. Learn more about why heartburn happens, who’s at risk, and how to stop -- and prevent -- the pain.

Video Transcript

Mayo Clinic: "Heartburn Treatments and Drugs."<br>Cleveland Clinic: "Heartburn Symptoms."; AudioJungle; bhofack2; Dimitri Vervitsiotis; iStock.

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Heartburn Basics

What is heartburn?

Heartburn, sometimes called acid indigestion, is a painful, burning feeling in the middle of your chest or the upper part of your stomach. The pain, which can also spread to your neck, jaw, or arms, can last just a few minutes or stick with you for hours.

What causes heartburn?

There’s a muscle at the entrance of your stomach, called the lower esophageal sphincter (LES), that acts like a gate: It opens to let food move from your esophagus to your stomach, and it shuts to stop food and acid from coming back out.

When the LES opens too often or isn’t tight enough, stomach acid can rise up into the esophagus and cause the burning feeling.

What triggers heartburn?

Triggers vary from person to person, but you may be more likely to get heartburn when you:

  • Overeat
  • Eat spicy, fatty, or greasy foods
  • Lie down after you eat
  • Are under stress

Who gets heartburn?

Some people have a higher risk of heartburn, including those who are:

How should I change my diet to avoid heartburn?

You might have noticed that your heartburn gets worse when you eat or drink certain things. Here are a few that can trigger heartburn:

  • Alcohol
  • Chocolate
  • Coffee
  • Fatty or fried foods
  • Greasy foods
  • Onions
  • Oranges, lemons, and other citrus fruits and juices
  • Peppermint
  • Sodas and other bubbly drinks
  • Spicy foods
  • Tomatoes and tomato sauce

Big meals can also set off heartburn. Instead of eating three big meals a day, try to eat several small meals throughout the day.

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What else can I do to prevent heartburn?

Here are a few steps to try:

  • Lose weight if you’re overweight. Extra pounds put pressure on your stomach, forcing more acid up into your esophagus.
  • Wear loose clothing. Tight clothes that press on your stomach can trigger heartburn.
  • If you smoke, quit. Cigarette smoke relaxes the muscle that prevents acid from backing up into the esophagus. It also may increase how much acid your stomach makes.
  • Check your medicines. Regular use of anti-inflammatory and pain medicines (other than acetaminophen) contributes to heartburn.
  • Avoid high-impact exercise.

If heartburn bothers you at night:

  • Eat a light dinner and avoid foods that trigger your heartburn.
  • Don’t lie down for at least 2 to 3 hours after you eat.
  • Use blocks or books to raise the head of your bed by 4-6 inches. Or put a foam wedge under your mattress at the head of the bed. Sleeping at an angle will help stop acid from backing up into your esophagus.

Can exercise cause heartburn?

Exercise has more than a few health perks. Among them is weight loss, which can help you avoid getting heartburn in the first place if you are overweight. But some types of exercise can trigger the burning sensation. You’ll be less likely to reach for your heartburn medicine if you avoid crunches and inverted poses in yoga. You may need to find alternatives to high-impact workouts. For example, bicycle or swim instead of going for a run.

What is GERD?

Everyone has heartburn from time to time. But when you have it frequently (at least twice a week for a few weeks), or when it begins to interfere with your daily life or damage your esophagus, your doctor may tell you that you have a long-term condition called gastroesophageal reflux disease, or GERD. It’s also known as acid reflux disease. Heartburn is the most common symptom of GERD.

What are other symptoms of GERD?

Besides the frequent burning in your chest, you might also have symptoms like:

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Is it GERD or something else?

Frequent heartburn is a symptom of GERD, but it may also signal a more serious condition, like an ulcer or irritation of the stomach lining. It’s important to get help if you have heartburn frequently so you can avoid complications from GERD and uncover any other problems. Call your doctor or make an appointment with a gastroenterologist, who specializes in digestive illnesses.

Many of the symptoms of heartburn sound like a heart attack. If you’re not sure, call 911.

What are the complications of frequent heartburn and GERD?

Over time, heartburn that isn’t treated or controlled well by lifestyle changes or medicine may cause serious problems, including:

  • Breathing problems like asthma, nighttime choking, and repeated pneumonia
  • Changes in the cells that line the esophagus, called Barrett’s esophagus. This can lead to cancer of the esophagus.
  • Painful inflammation of the esophagus called esophagitis
  • Narrowing of the esophagus, called esophageal stricture. This can cause problems swallowing.

What medicines can I take to treat heartburn?

Several types of over-the-counter (OTC) and prescription medicines can help with heartburn. Your doctor or pharmacist can help you find the one that’s right for you.

Over-the-Counter Heartburn Relief

 

Type of medicine

How they work

How fast they start working

How long the effects last

Side effects

Antacids

 

They neutralize stomach acid.

Within seconds

Up to 3 hours

Some cause constipation and diarrhea.

H2 Blockers

 

They lower the amount of acid your stomach makes.

In about 30 minutes

Up to 12 hours

They may cause constipation, diarrhea, headache, nausea, or vomiting.

 

Proton-Pump Inhibitors (PPIs)

 

They lower the amount of acid your stomach makes.

Up to 4 days

Up to 24 hours

They may cause diarrhea, headache, stomach pain, nausea, or vomiting.

 

 

 

 

 

 

 

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Antacids

What type of antacid should I choose?

Soothe occasional, mild heartburn with an antacid that contains calcium carbonate or magnesium. They help neutralize stomach acid. Some prevent acid reflux. Those that contain magnesium may also help heal stomach ulcers. They come in liquids and pills and are fast-acting.

What are the side effects of antacids?

Antacids can cause constipation and diarrhea. Look for brands that contain calcium carbonate, magnesium hydroxide, and aluminum hydroxide to reduce these side effects. Don’t take antacids with magnesium if you have chronic kidney disease. Some antacids have a lot of salt, so you should take them only for occasional heartburn.

H2 Blockers

H2 blockers help relieve and prevent occasional heartburn by lowering the amount of acid your stomach makes. Though they don’t work as fast as antacids, their effects last longer. Your doctor may tell you to take an antacid and an H2 blocker together. H2 blockers are for short-term use -- less than 2 weeks. You can take them before your meals to prevent heartburn, or at bedtime. They come in liquids and pills.

All H2 blockers work about the same. So if one doesn’t help with your heartburn, switching to a different one isn’t likely to help. Switching to a higher-dose prescription version of the drug might help, though. Talk to your doctor if over-the-counter H2 blockers aren't working for you.

Some H2 blockers can interfere with other drugs, including:

Talk to your doctor if you take any of these medicines and you need to take an H2 blocker.

What are the side effects of H2 blockers?

The most common side effects are mild and include:

  • Constipation
  • Diarrhea
  • Headache
  • Nausea or vomiting

Proton-Pump Inhibitors (PPIs)

What are PPIs?

PPIs are used to prevent frequent heartburn that happens more than twice a week. They work by lowering the amount of acid your stomach makes. Often, they work better than H2 blockers. You also can take these drugs for a longer period of time than H2 blockers.

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PPIs are available over the counter and by prescription. But if you have GERD, you may need prescription-strength medication.

How do you take PPIs?

You need to take PPIs once a day on an empty stomach so they’ll work best. Usually you’ll take the medicine every morning, about 30 to 60 minutes before you eat breakfast, to control stomach acid.

Talk to your doctor before taking the PPI called omeprazole if you take clopidogrel (a drug used to prevent heart attacks and strokes). Taking the two drugs will make clopidogrel less effective.

What are the side effects of PPIs?

The most common side effects are mild and include:

  • Diarrhea
  • Headache
  • Nausea and vomiting
  • Stomach pain

PPIs may also raise your chances of getting an infection of the intestines or lungs, but this is rare. These medicines have also been linked to fractures of the hip, wrist, and spine. The risk is highest in people who take PPIs for a year or more.

Prokinetics

Prokinetics help your stomach empty faster, so you have less acid left behind. Usually you take this medicine before meals and at bedtime.

Prokinetics are sold only by prescription.

What are the side effects of prokinetics?

Prokinetics can have more serious side effects than PPIs or H2 blockers. These include:

If Medicines Don’t Help

Should you call your doctor?

Yes. If your heartburn isn’t getting better, your medicines cause side effects you can’t tolerate, or you have other complications, you may need surgery. It is rare to need surgery for heartburn.

What will my doctor do?

Your doctor will ask about your symptoms and do an exam. It can be helpful to keep a journal to note what you eat and drink and when you have heartburn. This will help you and your doctor pinpoint your triggers.

If medicine and lifestyle changes don’t control your heartburn, you can take one of these tests to find out what's causing the problem:

  • pH test. This measures the acidity of your esophagus. The doctor will either attach a small sensor to your esophagus or place a thin tube down your esophagus.
  • Endoscopy. A long, thin tube with a light on the end is put down your esophagus so your doctor can look inside your esophagus and stomach. Endoscopy can look for problems such as an ulcer or narrowing inside your esophagus.
  • X-ray. You’ll drink a liquid that coats the inside of your digestive tract. Then X-rays are taken, which will allow your doctor to see the outline of your digestive system.

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When is heartburn an emergency?

Heartburn is usually a minor problem that goes away over time. But if you also have other symptoms, it could be a sign that something more serious is wrong. Call your doctor or go to the emergency room if:

  • It hurts to swallow.
  • You feel like you’re choking.
  • You have black, tarry-looking bowel movements.
  • Your mouth or throat hurt when you eat.
  • Your voice is hoarse.
  • Your vomit contains blood or what looks like coffee grounds.
  • You have trouble breathing.

Is it heartburn or a heart attack?

Heartburn doesn’t affect your heart, but it can feel a lot like the chest pain that happens during a heart attack. Call 911 if you have any of these symptoms along with chest pain, even if you’re not sure that you’re having a heart attack:

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on February 03, 2017

Sources

SOURCES:

AHRQ: “Treatment Options for GERD or Acid Reflux Disease: A Review of the Research for Adults.”

American Academy of Family Physicians: “Heartburn.”

American College of Gastroenterology: “Acid Reflux.”

American Gastroenterological Association: “Understanding Heartburn and Reflux Disease.”

American Society for Gastrointestinal Endoscopy: “Understanding Gastroesophageal Reflux Disease.”

American Society of Health-System Pharmacists: “Cimetidine.”

Brahm, N. The Consultant Pharmacist, April 2011.

Cleveland Clinic: “GERD and Asthma.”

FDA: “Possible Increased Risk of Bone Fractures with Certain Antacid Drugs.”

Hye-kyung J. Journal of Neurogastroenterol Motility, January 2010.

International Foundation for Functional Gastrointestinal Disorders: “Exercise & GI Symptoms.”

Katz, P. American Journal of Gastroenterology, 2013.

NHLBI: “What are the symptoms of a heart attack?”

NIDDK: “Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) in Adults.”

Thompson, W. International Foundation for Functional Gastrointestinal Disorders.

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