Heartburn is one of the most common health complaints. It almost never has anything to do with your heart, but this traditional name for a burning sensation or pain in the middle of the chest is universally understood to refer to problems with the upper part of your digestive system. The symptoms of heartburn can vary considerably from person to person, and can be worse or milder depending on the amount and kind of meals a person eats, and whether you’re lying down or active.
Heartburn causes only mild irritation for most people, and presents itself infrequently, but others have recurring, serious bouts with heartburn, which can make it difficult to eat or swallow properly, and can interfere with normal sleep. Most types of heartburn are handled successfully in the home, but severe heartburn symptoms can also indicate more serious medical conditions that might need immediate medical care. 
What Causes Heartburn?
While there are different triggers for heartburn, the most common way for the condition to appear is when the contents of the stomach escape back into the esophagus. When you eat, drink, and swallow, the food is carried to your stomach through a tube called the esophagus. A muscular ring called a cardiac sphincter, controls the place where the esophagus joins the stomach. When it’s working properly, this opens to allow food into the stomach, and then closes to keep the stomach’s contents inside.
There are many reasons why this muscle can begin to function improperly. Like any muscle, it can become weakened as you grow older, or suffer an injury or other malady. If the cardiac sphincter doesn’t do its job, it can allow the acid in your stomach, and partially digested foods, to leak back into the esophagus. Your stomach lining is very tough, and designed to withstand the acid it holds, but your esophagus is more delicate and can become irritated easily. Irritation of the esophagus from stomach acid is called acid reflux.
While acid reflux is the most common way for heartburn to occur, there are other causes for heartburn. If part of your stomach is pushed through the muscles that line the wall of your chest, you can suffer from a condition called a hiatal hernia. A hiatal hernia can be very painful, and is often visible as a bulge on the outside of your chest. It often requires surgery to correct it, and if left untreated, it can even be fatal.
Other causes of heartburn include peptic ulcers. A peptic ulcer is a sore that affects the lining of the stomach. These ulcers have different names depending on where the ulcer is located. Gastric ulcers are very common, and are located inside the stomach itself. Esophageal ulcers develop in the esophagus, and duodenal ulcers form in the small intestine. Peptic ulcers can be traced to different causes. There’s a bacterium called helicobacter pylori that causes inflammation of the stomach wall. Heavy alcohol consumption is also a common trigger. Certain pain relief drugs like aspirin can harm the stomach wall, especially if they’re taken in large doses, or too often. There are other conditions that are similar to peptic ulcers. Gastritis is chronic inflammation of the entire protective lining of the stomach, often blamed on H. pylori. Esophagitis is the same condition in the esophagus.
There are other health problems that can mimic the symptoms of heartburn. Angina is a severe pain and crushing sensation in the chest, caused by a restriction of blood flow to the heart muscle. Since decreased blood flow to the heart can lead to a heart attack, angina calls for immediate emergency medical care. Heart attacks don’t necessarily need to be preceded by bouts of angina, and their symptoms are often mistaken for heartburn. If your heartburn symptoms are accompanied by shortness of breath, a bluish tinge to the skin or lips, and sweating, you should seek immediate medical attention.
In addition to heart conditions, conditions like gallstones can cause heartburn. Pregnancy can also trigger heartburn, and people prone to panic disorders often report symptoms of heartburn due to anxiety. It’s also possible for heartburn symptoms in either the stomach or esophagus to be caused by cancer.
What Causes Constant Heartburn?
If you’re often plagued with heartburn symptoms, but you’re not suffering from an underlying medical condition that explains them, you should look to lifestyle choices that can cause heartburn, or make it worse when it does appear. These include habits like smoking, being overweight or clinically obese, eating very spicy food, or food that you’re allergic to, taking too many aspirins or other painkillers, drinking too much alcohol, or eating too close to bedtime. Drinking too much coffee is also a common trigger for heartburn.
When Should You Contact a Doctor for Heartburn Symptoms?
Most people have heartburn at one time or another, and learn by trial and error what causes it. In most cases, the condition subsides in a few hours with little or no attention, or with simple over-the-counter remedies. If you’re suffering from heartburn more than twice a week, or if you don’t get relief after a day or so, you should contact a doctor to make sure you don’t have a serious underlying cause for your discomfort.
What causes heartburn symptoms to be considered a reason to visit your doctor immediately?
• Heartburn accompanied by a difficulty in swallowing
• Severe pain when swallowing
• Blood in your bowel movements
• Sweating while suffering from chest pains
• Dizziness or lightheadedness
• Chest pain along with shortness of breath
• Chest pain or burning with discoloration of the skin or lips
• Chest pain that radiates out to your back, shoulders, or down your arm
Can Heartburn Lead to Complications?
While the symptoms of heartburn can be mistaken for serious medical conditions like heart attacks, heartburn doesn’t cause these conditions. However, constant bouts of heartburn can damage your digestive system permanently. Chronic inflammation of the stomach lining or esophagus can lead to cancers, and stomach acid can harm the esophagus enough to cause a condition called Barrett’s esophagus, which can lead to painful swallowing permanently.
Treatments for Heartburn
Ultimately, treatments for heartburn are only treatments for the symptoms of heartburn. Home remedies can’t address underlying medical conditions that cause heartburn, but for most people, simple home remedies or lifestyle changes are all that’s necessary for relief. If you suffer from occasional heartburn, try the following techniques to get relief:
• Antacid tablets and liquids can soothe your stomach
• Doctors can prescribe drugs that inhibit production of stomach acid, like Prilosec. Some are now available over-the-counter, as well as, by prescription
• Quit smoking
• Time your meals to avoid reclining or sleeping right after eating
• Cut back or eliminate drinks containing alcohol or caffeine
• Keep track of foods that cause heartburn and avoid them
Eating Habits Often Implicated in Heartburn
While the kinds and amount of foods that can cause heartburn can vary from person to person, and change over time for the same person, there are some foods that are implicated in heartburn more often than others.
When wondering what causes heartburn, people often overlook the most obvious cause. The amount of food you eat is as likely to cause heartburn as the type. Restaurant portions are often designed to offer diners the feeling that they’re getting a lot for their money, and they’re often too large to eat in one sitting. We have all been taught since we were young not to waste food, so it can lead us to try to clean our plates no matter how big the portions. The number one key to avoiding heartburn is to stop eating before you feel entirely full.
Eating on-the-go is likely to cause heartburn, too. Eating in the car is stressful, and if you’re in a hurry already, you often gulp your food and don’t chew it completely. Avoid eating and driving, and eating too fast.
Fried foods are the most common culprit for heartburn, and not just because they’re heavily featured at fast food restaurants. They’re high in fat, which makes them linger in your stomach longer. If you enjoy fried foods, try smaller portions, chew them completely, and wash them down with more water than usual to avoid heartburn.
Foods high in acids can bring on heartburn. Citrus fruits and juices, dressings prepared with vinegar, and dishes prepared with tomatoes are common culprits for heartburn. Try not to eat large portions of acidic foods on an empty stomach.
A Final Word
If you’re unable to handle your heartburn symptoms on your own, you should consult with your doctor. For chronic heartburn, doctors will often take an X-ray of the stomach, or schedule an endoscopy to look for ulcers. An endoscopy is a tube that is inserted into the digestive system with a tiny camera that looks for obstructions and lesions. It’s also possible to test your stomach acid to determine its pH, and to see exactly how much acid is in your stomach. There are many effective treatments a doctor can offer for chronic heartburn, so there’s no reason to suffer with it without seeking help.