Heartburn is a common upper gastrointestinal disorder that becomes even more frequent in the elderly. Fortunately, for most people managing this condition is easy—it’s usually enough to make simple lifestyle changes and avoid common triggers. Here’s everything you need to know about heartburn, its symptoms, and available treatments.
What Is Heartburn?
Heartburn, also called acid reflux, is an uncomfortable burning sensation in your chest, just behind your breastbone. Heartburn symptoms typically appear shortly after eating and can last anywhere from a few minutes to a few hours or longer.
How common is heartburn
According to the American College of Gastroenterology, heartburn affects an estimated 60 million Americans at least once a month and around 15 million adults daily. In fact, most people experience heartburn at some point in their life.
Gastro-oesophageal reflux disease
You may be diagnosed with a chronic condition known as gastro-oesophageal reflux disease (GERD) if you experience:
- Mild heartburn that occurs two or more times per week, or
- Severe heartburn one or more times per week.
GERD is a long-lasting and more serious form of acid reflux. It has been linked to conditions like:
- Chronic cough
- Respiratory problems
- Inflammation and narrowing of the esophagus
- Barrett’s esophagus which may lead to esophageal cancer.
What Causes Heartburn?
Heartburn occurs when stomach acid travels back up your esophagus, the tube that carries food and fluids from your mouth into your stomach.
The esophagus connects to the stomach at a juncture known as the lower esophageal sphincter (LES). If the LES muscles are functioning properly, they close when food leaves the esophagus and enters the stomach. However, if these muscles are weakened, stomach acid can flow back into the esophagus, causing a burning feeling.
Risk factors
Some people are more likely to experience heartburn than others. You are at a higher risk of developing heartburn if:
- You have weak lower esophageal sphincter muscles due to aging
- You have hiatal hernia, a condition when the upper part of your stomach penetrates through the diaphragm, usually due to a weakness or tear
- You are pregnant
- You smoke or are exposed to secondhand smoke
- You are overweight or have obesity
- You take certain medications, such as aspirin, ibuprofen, sedatives, or blood pressure medications.
Common triggers
In many cases, heartburn is triggered by lifestyle habits, such as:
- Eating large portions of food
- Eating too close to bedtime
- Wearing tight clothes and belts
- Smoking
- Increased stress and anxiety.
In addition, some foods and beverages can also cause heartburn. Read on to find out what they are.
What Are Some Foods That Cause Heartburn?
If you frequently experience heartburn, you may find that certain foods and drinks trigger your symptoms, for example:
- Carbonated drinks
- Caffeinated beverages
- Alcohol
- Chocolate
- Citrus fruits
- Citrus juices
- Onions
- Cheese
- Tomatoes
- Tomato-based products
- Peppermint
- Fried foods
- High-fat foods
- Spicy foods.
These foods make your stomach produce more acid, irritating your digestive system.
Symptoms of Heartburn
While the most common symptom of heartburn is a burning feeling in your chest, you may also experience symptoms like:
- Pain in your chest
- A burning feeling in your throat
- A bitter or acidic taste in the mouth
- A hot, sour, or acidic taste in the back of your throat
- Coughing and hoarseness.
The above symptoms can range from mild to extremely uncomfortable. They may get worse after you eat, when you’re lying down, bending over, or exercising.
Some people who experience heartburn believe they’re having a heart attack as some symptoms, especially chest pain, can be very similar. However, despite its name, heartburn has nothing to do with the heart at all.
In the following section, we explain how heartburn is treated.
Treatment for Heartburn
In the vast majority of cases, heartburn can be managed by introducing simple lifestyle changes or taking over-the-counter medications.
Lifestyle changes
To alleviate your heartburn symptoms, you may want to try the following:
- Avoid foods that trigger heartburn
- Maintain a healthy weight
- Eat slowly
- Eat meals at least three to four hours before going to bed
- Wait at least two hours after a moderate-sized meal before exercising
- Cut back on the size of the portions or eat fewer small meals
- Quit smoking
- Wear loose-fitting clothes.
Over-the-counter medications
The most common over-the-counter medications for heartburn include antacids and acid blockers.
Antacids
Antacids help neutralize stomach acid, thus providing quick relief of heartburn symptoms. These medications are used to soothe an upset stomach, indigestion, and stomach ache. Some antacids also contain simethicone, an anti-foaming agent which reduces gas.
Antacids that don’t require a prescription include:
- Tums
- Rolaids
- Maalox
- Gaviscon
Some antacids may act like a laxative if they contain magnesium or sodium bicarbonate. Other common side effects include constipation, white or pale bowel movements, and stomach cramps, while more serious ones may occur with overdose or overuse. You should avoid taking antacids if you have bowel inflammation or symptoms of appendicitis.
Acid blockers
Acid blockers, also called histamine H2 blockers, can relieve heartburn, acid indigestion, and sour stomach by reducing the production of stomach acid.
Acid blockers that you can buy without a prescription include:
- Pepcid
- Tagamet
Common side effects of acid blockers include headache, dizziness, and diarrhea. Very rare adverse effects like kidney disease, fractures, infections, and vitamin deficiencies are mostly associated with the long-term use of these medications.
When to see a doctor
Although occasional heartburns are common and usually not serious, acid reflux that occurs frequently may be an indication of a more serious health problem. It is important to reach out to your doctor if:
- Your heartburn is persistent
- Your heartburn symptoms become more frequent or more severe
- You experience heartburn more than two times a week
- You experience excessive hoarseness or wheezing
- You have difficulty swallowing
- Your heartburn causes you to vomit
- You experience substantial and unexpected weight loss
- Your heartburn symptoms persist even after taking prescription medicines
- Your discomfort interferes with your daily activities.
You should seek immediate medical attention if:
- You have difficulty breathing
- You experience severe or projectile vomiting
- Your vomit contains green or yellow bile.
Prescription medications
If over-the-counter antacids and acid blockers don’t relieve your symptoms, your doctor may prescribe stronger versions of these medications or proton pump inhibitors.
Prescription-strength acid blockers
Stronger acid blockers, such as Pepcid and Tagamet in higher doses, can be used to block stomach acid and treat GERD, stomach and duodenal ulcers, and erosive esophagitis.
Along with acid blockers, your doctor may recommend taking antacids that will control your symptoms until the acid blockers start working. Make sure to take your acid blocker medicines regularly for as long as prescribed by your doctor, even if your symptoms get better and you no longer have any pain.
Proton pump inhibitors
Proton pump inhibitors (PPIs) are drugs that work by turning off the gastric (proton) pump that produces hydrochloric acid in your stomach. This way, they help reduce the amount of gastric acid.
Proton pump inhibitors include:
- Aciphex
- Nexium
- Prevacid
- Prilosec
- Protonix
PPIs are generally well tolerated and have few adverse effects associated with short-term use, such as headache, rash, dizziness, nausea, abdominal pain, constipation, and diarrhea.
Some PPIs, including Prevacid, Nexium, Zegerid, and Prilosec, can also be purchased over the counter.