When someone has a case of severe heartburn, it can be compared to the sensation of swallowing lava, or what one would approximate that feeling to be. It can cause extreme pain from the back of your throat, all the way down to your stomach. In some cases, the severe heartburn pain can even be mistaken for a more life threatening condition, such as a heart attack. It is also accompanied by nausea and other indigestion symptoms, which create an overall very unpleasant experience. Treating heartburn when it is severe can be a bit more challenging than the regular and occasional bouts, where it tends to quickly respond to a single dose of medication. When it comes to treating it properly and efficiently, it requires a bit more knowledge and understanding what tends to be the cause of it.
Common causes for severe cases of heartburn.
There are a number of potential causes for severe heartburn, many of which can thankfully be treated with ease. One of the biggest culprits for causing very acute cases of intense heartburn symptoms is dietary. Spicy and acidic foods can do a number of harm on the digestive system, especially the stomach. There are also a lot of hidden acids in the foods we eat and drink, which can lead to unknowingly riling up a nasty case of heartburn. Citric acid is a major cause for acidic upset and it is found in citrus foods, as well as, many pastas sauces. Garlic is also a major cause of indigestion, and even caffeine can contribute to developing or worsening a case of heartburn.
Having an over-production of acid in the stomach can also be the culprit when it comes to dealing with extreme heartburn. For some people, the amount of acid in the stomach is a bit too much to be contained, and it can lead to nasty spills, where the acid escapes the LES, the lower esophageal sphincter, and creeps up the throat. The lining of which, is not at all prepared for the heavy acids of the stomach. When the stomach’s digestive enzymes come into contact with the less prepared tissues, it can result in some intense pain and a lot of discomfort. A medical condition called GERD, gastro-esophageal reflux disease, wherein there is a marked occurrence of stomach acid and an issue with the LES that results in it entering the throat in frequent episodes. The resulting inflammation and irritation can lead to increasingly more intense and painful bouts of heartburn.
Symptoms that distinguish severe heartburn from regular heartburn.
For regular cases of heartburn, the symptoms are often mild to slightly annoying, but not debilitating. Minor pain between the stomach and throat, or a touch of an odd taste at the back of the throat after a burp, with perhaps some mild nausea may be worst for what is considered normal heartburn. When it comes to severe heartburn symptoms, the pain level for one is marked significantly higher. There is also a lot more nausea and a persisting acidic taste at the back of the throat. People who are having a severe case of heartburn tend be at an extreme amount of pain, which is felt to the point of being partially disabled by it. The pain can also radiate to other parts of the chest and torso, making it to be mistaken for a heart attack and landing many people in emergency care each year. The amount of discomfort that severe heartburn can cause can even lead to temporarily elevated blood pressure readings, which can make it even more tricky to deal with. Some patients describe a bout of severe heartburn as being similar to regular heartburn, but a thousand times worse.
Treatments for such extreme heartburn tend to be multifaceted.
As with any medical situation, the approach taken to treatment depends on all the mitigating factors. A doctor would examine the patient physically and go over the symptoms in detail. They would also be sure to rule out any other conditions that might be mimicking the signs of heartburn, orw be the alternate cause such as H. Pylori. Ulcers are another condition that can often contribute to an intense sensation of heartburn. Once the doctor feels they have a clear cause of list of potential causes, the next step involves trying the treatment that is likely to work best. They will also prescribe modifications to the patient’s diet to help deter heartburn from recurring. The best approach to treatment and prevention is to view the issue from multiple angles and attack the problem from multiple fronts. The cycle of building up excessive amounts of acid and having it reflux into a potentially damaged or already irritated throat can require treating both the throat and stomach.
Medications commonly used for severe heartburn relief. 
Many of the same types of medication used to treat regular heartburn can be employed in the management of more severe cases as well. Liquid medications, such as bismuth subsalicylate (Pepto Bismol) or combination antacids (Maalox) can provide a lot more immediate soothing sensations that pills alone can provide. Generally, patients trying to treat intense heartburn will be put on multiple medications. They will be given one to take on a regular basis to help control the acid production in their stomach, and they will be given something they can take in the meantime for sudden and severe attacks of heartburn. Some may even use a third or alternate secondary medication for preventative measures. As an example, there is a patient who suffers with GERD and as a result, has many bouts of heartburn that range in severity between mild and severe. The doctor may have the patient try a combination of over-the-counter treatments before escalating to prescription-only options. Medications such as Prilosec and Prevacid may be good starting daily medications to help control the acid production in the stomach, while Zantac or Pepcid would be good choices for preventative treatments, something they could take prior to meals that would not interfere with the other medications. An emergency medication for sudden and severe attacks would be either a quick acting liquid like Maalox, or easy dissolving tablets such as Tums.
Alternative treatments for intense heartburn can be fickle. 
For patients who dislike taking a lot of medications, the idea of using multiple pills to treat a condition can be discouraging. When examining alternative medication and therapies, it is important to remember that controlling the stomach’s production of acid can be very difficult. Some examples of alternative medicine include using combinations of herbs and fruits to treat a condition. For heartburn, soothing teas, bananas and apples are the most common components recommended for treating and preventing it without medication. The biggest problem with using foods and herbs is that they run a much higher risk of causing further irritation to your stomach. In recent studies, it has been shown that the herb peppermint, which was traditionally considered soothing to the stomach, can actually incite a lot more problems than it can be helpful. This and similar studies are coming to light each day to show that traditional and homeopathic medicine is not always the best route to take. The only solid treatment that is congruent, with both standard medicine and holistic, is the concept of watching what you eat and limiting the intake of foods that are known to cause problems. When diet is not the issue so much as physiological factors, as it is with people who have frequent and severe heartburn, medication tends to offer the only feasible solutions.
Can severe heartburn be a sign of something more significant?
The occasional bout of severe heartburn tends to not require alarm, even though you may feel panicked while its occurring. In truth, most cases of intense heartburn tend to be isolated or purely related to GERD. In a very small percentage of cases, where there was also an H. Pylori infection, increasingly intense bouts of heartburn was the only indication of the infection. This is why most doctors order for blood work during their diagnostic phase, to help rule out the bacteria. Great importance is stressed on the results because H. Pylori infection does have a chance of leading to cancer. The most common condition that tends to be found along with severe heartburn is ulcers. They are the result of acid coming into contact with the tender linings of the esophagus and in weakened areas of the stomach. Having an ulcer can sometimes result in being stuck in a viscous cycle of irritation and pain. The acid causes the ulcer which is painful, the ulcer causes pain which can lead to stress and increased acid, the increased acid can result in more reflux that irritates the ulcer. Stopping these cycles requires diligent detection and diagnostic skills on the part of the doctor, and openness on the patient’s part. When discussing symptoms and concerns about heartburn, it is imperative that patients be open and honest with their ailments.