Chronic Heartburn

Whether it strikes after eating a large meal, a certain type of food, or during pregnancy, heartburn affects most adults at some point, and its symptoms can be very uncomfortable.

That burning pain in your chest and back of the throat can be nearly intolerable at times. Luckily, just as there are numerous causes of chronic heartburn, there are multiple remedies stretching from lifestyle changes to over-the-counter treatments.

Symptoms of heartburn can include:

  • A feeling of burning, warmth, or pain in your chest that occurs after eating.
  • Pain that worsens when you lie down or bend over.
  • A sour taste in your mouth.
  • Coughing after eating.

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What Causes Chronic Heartburn?

Heartburn is caused by acid reflux, which is the backward flow of stomach acid into the esophagus. It can also be a symptom of gastroesophageal reflux disease (GERD), a digestive disorder of the lower esophageal sphincter (LES), the ring of muscles that form a valve between the lower part of the esophagus and the stomach.

In some cases, chronic heartburn is caused by diet. Foods high in fat, salt, or spice can trigger heartburn. Certain foods relax the LES. Trigger food and beverages include:

  • Deep-fried food.
  • Fast food.
  • Alcohol.
  • Pizza.
  • Potato chips and other processed snacks.
  • Chili powder and pepper (white, black, cayenne).
  • Fatty meats such as bacon and sausage.
  • Cheese.
  • Tomato sauces.
  • Citrus fruits.
  • Chocolate.
  • Peppermint.
  • Carbonated beverages.
  • Coffee, tea, and other caffeinated beverages.

Some medications, such as NSAIDs, including aspirin, ibuprofen, and naproxen, may make acid reflux or heartburn worse, so you should avoid taking them when you have symptoms.

How To Treat Chronic Heartburn

While uncomfortable, chronic heartburn can be managed by minor lifestyle changes. Limiting instances of heartburn can be as simple as finding a common root cause in your day-to-day behaviors. Some common lifestyle changes that limit chronic heartburn include:

  • Avoid trigger foods and beverages (listed above).
  • Lose some weight.
  • Give up smoking or tobacco.
  • Wait at least 2 to 3 hours after eating before lying down to sleep.
  • Sleep with your head raised about 6 inches.
  • Avoid exercise right after eating.
  • Avoid tight-fitting clothing or belts around the waist.
  • Reduce stress.

Over-the-counter (OTC) remedies coupled with lifestyle changes can be effective as well. For all medications, remember to pay close attention to the directions and warnings on the box. Antacids (like calcium carbonate) can neutralize stomach acid. OTC H2 blockers (like famotidine) and proton pump inhibitors (usually a medication with Pantoprazole) can be used for more frequent or recurring heartburn. These medications reduce, in varying degrees, the amount of stomach acid your body produces to manage your symptoms and help you feel more comfortable.

When To Consult a Doctor

If you are having frequent (more than two times per week) or severe heartburn symptoms, you may need to consult your PCP. Depending on symptoms, it could be something more urgent that needs quick attention. Any stomach or chest discomfort that is worse with activity or exertion should be evaluated by a doctor right away to make sure this isn’t a heart attack or the prelude to a heart attack.

Seek emergency treatment if you feel common heart attack symptoms, such as chest pain or discomfort, even if it feels like heartburn; pain or discomfort in your jaw, neck, stomach, or one or both arms; shortness of breath; cold sweat; nausea; lightheadedness. Other symptoms that should trigger urgent treatment are black or maroon stool and vomit that appears bloody or looks like coffee grounds.

There are also nonemergency symptoms that warrant a visit with your PCP, such as:

  • Trouble swallowing.
  • Unwanted weight loss.
  • Cough or wheezing that does not go away.
  • Antacids and other OTC medications cause symptoms to worsen.

Seeing a Specialist

For some, your PCP may recommend that you see a gastroenterologist. Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts, and liver.

Gastroenterologists can help people who suffer from diseases of the gastrointestinal (GI) tract, which includes the esophagus, stomach, small and large intestine, and anus. They can help diagnose and treat causes of chronic heartburn, such as GERD, and other esophageal issues.

If your PCP thinks you need to see a specialist due to chronic heartburn or another digestive disorder, contact the UPMC Digestive Disorders Center at 1-866-442-7876 (4GASTRO) to request an appointment with one of our gastroenterologists.

Sources

Acid Reflux - American College of Gastroenterology (gi.org)

Heartburn: MedlinePlus Medical Encyclopedia

Treatments for Acid Reflux | UPMC HealthBeat

Keep an Eye on Recurring Heartburn | UPMC HealthBeat

5 Heartburn Warning Signs | UPMC HealthBeat

What Does Heartburn Feel Like? | UPMC HealthBeat

What Is GERD? Symptoms and Treatment | UPMC HealthBeat

Comparing 3 Common Digestive Disorders | UPMC HealthBeat

What is a Gastroenterologist? - American College of Gastroenterology

Digestive Health & Endoscopy Center | Gastroenterology Assoc.- UPMC

Contact the Digestive Disorders Center | UPMC │PA

About Digestive Disorders

The UPMC Digestive Disorders Center cares for a wide range of gastrointestinal (GI) conditions and diseases, from diagnosis to treatment. Whether your digestive condition is common or complicated, our experts can help. Upon referral from your physician, we coordinate your testing and treatment. If you have a complicated condition, we can refer you to one of UPMC’s digestive health centers of excellence. Find a GI doctor near you.