Causes

When you eat, a muscle at the lower end of your esophagus (called the LES) relaxes and opens to admit food to your stomach. The LES then closes to prevent stomach acid from washing back up the esophagus. Heartburn occurs when the LES does not close completely. Acid and bile from the stomach then come back up the esophagus, causing a burning sensation.

The following things can make heartburn worse:

• Cigarette smoking
• Coffee and other drinks that have caffeine
• Alcohol
• Citrus fruits
• Tomato products
• Chocolate, mints, or peppermints
• Fatty or spicy foods
• Onions
• Being overweight
• Aspirin, ibuprofen, or naproxen
• Other medications (check with your doctor)

Treatment

Heartburn can be easily treated with changes in diet and with over-the-counter medications (see Self-Care, below). However, it can also be a sign of a more serious illness, such as ulcers or other gastrointestinal problems. Sometimes pain in the chest may be mistaken for heartburn when it’s really a heart attack or heart disease.

Heartburn that is not treated properly can cause ulcers, difficulties swallowing, scarring and narrowing of the esophagus, or other serious problems. If you have heartburn that won’t go away, see your doctor.

Self-Care

There are many things you can do that will reduce or relieve heartburn. Use the following self-care steps, and call your doctor if your symptoms do not improve after 2 weeks:

• Don’t smoke.
• Don’t overeat. Try more frequent, smaller meals, rather than large ones.
• Relax during mealtimes. Eat slowly and chew thoroughly.
• Lose weight if you are overweight.
• Avoid tight-fitting clothes and tight belts.
• Try to eat at least 2 to 3 hours before lying down or exercising. If you take naps, try sleeping in a chair.
• Eat high-protein, low-fat meals.
• Sleep with the head of your bed elevated. To do this, place 4- to 6-inch blocks under the legs at the head of the bed.
• Avoid foods and other things that can cause heartburn.
• Take antacids or acid controllers for temporary relief.
• Avoid chewing gum to decrease the volume of air you swallow.

Additional self-care steps can be found in Gastroesophageal Reflux Disease.