Heartburn: Hints on Dealing With the Discomfort What is heartburn? Despite its name, heartburn doesn't affect the heart. Heartburn is a burning feeling in the lower chest, along with a sour or bitter taste in the throat and mouth. Heartburn is also called acid reflux disease or gastroesophageal reflux disease (GERD). It usually occurs after eating a big meal or while lying down. The feeling can last for a few minutes or a few hours. What causes heartburn? When you eat, food passes from your mouth down a tube (about 10 inches long in most people), called the esophagus. To enter the stomach, the food must pass through an opening between the esophagus and stomach. This opening acts like a gate to allow food to pass into the stomach. The opening to the stomach closes as soon as food passes through. If the opening doesn't close, acid in the stomach goes through the opening and up the esophagus. This is called reflux. The stomach acid can irritate the esophagus. It's the cause of heartburn. What is hiatal hernia? Hiatal hernia is a condition in which part of the stomach is pushed up through the diaphragm (the muscle wall between the stomach and chest) and into the chest. Sometimes this causes heartburn. What factors add to heartburn? Many things can make heartburn worse. Heartburn is most common after overeating, when bending over or when lying down. Other things can also worsen heartburn (see the box below) including pregnancy, clothing that's so tight it puts pressure on your stomach, stress and certain foods. Things that can make heartburn worse Cigarette smoking Coffee (both regular and decaffeinated) and other drinks that contain caffeine Alcohol Citrus fruits Tomato products Chocolate, mints or peppermints Fatty foods or spicy foods (pizza, chili, curry) Onions Being overweight Aspirin or ibuprofen (one brand name: Motrin) Some other medicines (check with your doctor) Can heartburn be serious? If you have heartburn only now and then, it's probably not serious. However, if heartburn goes on long enough, it can lead to esophagitis (an inflamed lining of the esophagus). If the esophagitis becomes severe, your esophagus might narrow and you might have bleeding or trouble swallowing. Heartburn can also be a sign of ulcers. What can I do to feel better? You might be able to avoid heartburn by making some changes in your lifestyle. The box below lists some tips on how to prevent heartburn. Tips on preventing heartburn Raise the head of your bed by placing 4- to 6-inch blocks under the legs at the head of the bed. Try to eat at least 2 to 3 hours before lying down. If you take naps, try sleeping in a chair. Lose weight if you're overweight. Don't overeat. Eat high-protein, low-fat meals. Avoid tight clothes and tight belts. Avoid foods and other things that give you heartburn. Will antacids take care of heartburn? Most people get fast, short-term relief with antacids. Antacids neutralize the acid that your stomach makes. However, antacids can cause diarrhea or constipation. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide. (One causes constipation while the other causes diarrhea, thereby counteracting each other.) Some brands of antacids include Maalox, Mylanta and Riopan. Follow the directions on the package. What if my symptoms get worse? If lifestyle changes and antacids don't help your symptoms, talk with your doctor. Your doctor may want you to take medicine or schedule you for some tests. Tests might include x-rays to check for ulcers, pH tests to check for acid in the esophagus, or an endoscopy to check for other conditions. For an endoscopy, a long, thin tube is inserted down your esophagus so your doctor can look at it. Your doctor may also check for H. pylori, a bacteria that can cause ulcers. What about medicines for heartburn? Several kinds of medicine can be used to treat heartburn. H2 blockers (some brand names: Pepcid, Tagamet, Zantac) reduce how much acid your stomach makes. Several are available without a prescription. Other medicines, such as omeprazole (brand name: Prilosec) and lansoprazole (brand name: Prevacid), also reduce how much acid the stomach makes. Metoclopramide (brand name: Reglan) reduces acid reflux. To find out what medicine is right for you, talk to your doctor. Is heartburn associated with heart attacks? No. But sometimes pain in the chest may be mistaken for heartburn when it's really a sign of heart disease. If you have any of the symptoms in the box below, call your doctor. Call your doctor if: You have trouble swallowing or pain when swallowing. You're vomiting blood. Your stools are bloody or black. You're having shortness of breath. You're dizzy or lightheaded. You have pain going into your neck and shoulder. You break out in a sweat when you have pain in your chest. You have heartburn often (more than 3 times a week) for over 2 weeks.