What is heartburn?

Heartburn is a burning pain or warmth usually felt in your chest, behind the breastbone, after eating. It happens when fluids in your stomach flow back into your esophagus. The esophagus is the tube that carries food from your throat to your stomach. The acid and bile from your stomach can burn and irritate your esophagus, throat, and vocal cords. The burning pain is called heartburn and the backward movement of stomach fluids is called reflux.

What is the cause?

When you swallow food and liquids, they flow down the esophagus to the stomach. A ring of muscle around the lower end of this food pipe opens up and lets the food go into your stomach. Normally, the muscle then closes and keeps stomach contents from going back into your esophagus. If the ring of muscle is weak or too relaxed or has too much pressure working against it, it doesn’t stay closed and stomach acid and food can flow backwards into your esophagus.

Changes in your body during pregnancy, especially hormone changes, may cause or worsen heartburn. The problem is more common during the last months of pregnancy, when the growing baby presses against your stomach and your hormones are at high levels. One in four pregnant women have heartburn daily.

Foods that may make heartburn worse are:

• Foods high in fat
• Sugar
• Chocolate
• Peppermint and other mint flavorings
• Onions and garlic
• Acidic foods, like oranges or tomatoes
• Spicy foods
• Caffeine drinks, such as coffee and tea
• Carbonated drinks, such as colas
• Alcohol

What are the symptoms?

Symptoms may include:

• Burning pain or warmth in your chest or throat, usually close to the bottom of your breastbone (the main symptom)
• Bitter or sour taste in your mouth
• Belching and a feeling of bloating or fullness in your stomach
• Frequent unexplained dry cough

Heartburn usually happens 30 to 60 minutes after a large meal, especially if you bend down, lie down, or lift something heavy after you have eaten. You may feel better when you sit up.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You will probably not need to have any special tests.

How is it treated?

To feel better and prevent problems:

• Follow the full course of treatment prescribed by your healthcare provider.
• Take nonprescription antacids after meals and at bedtime, according to your provider’s recommendation. Don’t start taking an antacid without first checking with your provider. Also, don’t take baking soda (sodium bicarbonate). It tends to cause swelling and can make you very sick.
• Eat smaller, more frequent meals. Avoid overeating and late-evening snacks or meals.
• If certain foods or drinks seem to cause your symptoms or make them worse, avoid those foods.
• If you smoke, try to quit. Smoking can increase stomach acid. Talk to your healthcare provider about ways to quit smoking.
• Wear loose fitting clothes without belts.

It may also help if you:

• Sit up during meals and don’t lie down for at least an hour after eating. It’s best to not eat for 2 to 3 hours before you go to bed.
• Raise the head of your bed 6 to 8 inches by putting the frame on wood blocks. If you cannot raise the frame of the bed, try placing a foam wedge under the head of your mattress. Sleeping on your left side may also help. Just using extra pillows will not help.
• Chew sugarless gum after meals. Some studies have shown that this decreases reflux.

Talk to your provider if you do not get relief and your heartburn gets worse.