Heartburn 101: Causes, Symptoms and Treatment
A burning sensation in the center of your chest, behind the breastbone, is a common symptom associated with heartburn. This feeling of discomfort can also move to areas in the neck and throat and is often triggered by various lifestyle factors including eating, lying down, and bending over. Heartburn is not uncommon. Between 20-30 percent of adult Americans experience heartburn symptoms weekly. The American College of Gastroenterology estimates that at least 15 million American experience heartburn daily.
What is heartburn?
The common sensation of burning that is most associated with heartburn is due to acid reflux, stomach acid that has traveled back up into the esophagus. Normally, food and drink travels down the tube-like esophagus to the stomach to be broken down and digested by stomach acid. A valve at the bottom of the esophagus, the esophageal sphincter, can open and close to allow food and fluids into the stomach. However, if this sphincter is not functioning properly, stomach acid can leak back up the esophagus leaving a burning sensation in the chest and throat. This may explain the bitter taste in the throat or mouth, a symptom that may worsen after eating a large meal or from lying down.
Heartburn Symptoms and Causes
Symptoms of heartburn are often associated to a feeling of warmth or heat in the middle of the chest or throat caused by stomach acid. This sensation may even reach the jaw. Because the esophagus is experiencing irritation from the stomach acid, the burning sensation is also attributed to an indigestion-like pain followed by a bitter or foul taste in the mouth.
Both health conditions and lifestyle choices may be contributing to heartburn. Health conditions that may cause reflux include pregnancy, overweight, hiatal hernia, gastroesophageal reflux disease (GERD), and medications including anti-inflammatory drugs and aspirin.
Lifestyle choices such as smoking can increase risk for heartburn. Even wearing tight clothes and belts can contribute to heartburn. A higher stress level can also increase chances of having heartburn. Eating habits that contribute to increased risk include certain foods and drinks like spicy foods, fatty or fried foods, alcohol, coffee (or caffeinated beverages), carbonated beverages, citrus products, chocolate, tomato-based foods, and peppermint. Meals that are large in quantity, high-fat, or eating close to bedtime are also more likely to cause heartburn.
It’s important to listen to your body and try to identify the symptoms and causes that lead you to experiencing heartburn. You may not experience the same things as your friends or family, so taking note of what you feel will better help your doctor determine the right course of treatment.
Types of Heartburn
While heartburn is common, experts divide it into three categories to define its frequency: episodic, frequent, and persistent. Heartburn that is episodic or occasional is typically infrequent. It can often be predictable and occurs less than once a week. These are usually predictable flare-ups that can be treated with antacids or acid controllers (H2 blockers).
Frequent heartburn occurs two or more days within a week. If you’re having symptoms that often, you may want to take a proactive approach by reducing the excess acid production that’s causing the frequent heartburn. Prilosec OTC is indicated to treat frequent heartburn at the source.
Persistent heartburn is ongoing. These episodes can be painful and long-lasting, occurring most days if not all of the time. While occasional heartburn is common and not serious, persistent heartburn could indicate a chronic condition and should be assessed by a doctor.
Adjusting eating habits and lifestyle choices can help with reducing heartburn symptoms. There are also some over-the-counter drugs that can assist as well including antacids, proton-pump inhibitors (PPIs), and histamine-2 (H2) blockers (also known as acid controllers).
Antacids: Antacids help to neutralize the stomach acid that causes the burning sensation. They often come in chewable tablet-form allowing for fast, short-term (1-3 hours) relief.
Histamine-2 (H2) blockers/ Acid Controllers: H2 blockers help to reduce stomach acid production to help relieve acid reflux. The relief typically lasts 12 hours after each dose.
Proton-Pump Inhibitors (PPIs): PPIs, like Prilosec OTC, work to reduce the production of stomach acid, block heartburn.* PPIs typically take anywhere from 1-4 days for full effect but can provide 24 hours of relief with just one pill in the morning.* Talk to your doctor about PPIs and ask about Prilosec OTC to understand if it could be the right treatment for you.
Resources (accessed July’20)
*It’s possible while taking Prilosec OTC. Proton Pump Inhibitors like Prilosec OTC work differently to treat frequent heartburn for 14 days. Compared to how antacids and H2 blockers work for heartburn. Use all heartburn medications as directed. Do not take for more than 14 days or more often than every 4 months unless directed by a doctor. Not for immediate relief.
†^IQVIA ProVoice™ Survey, Jan 2005 – Mar 2020
**PG Calculation based in part on Buying Households reported by the Nielsen Company through its Homescan Panel service in the US for Prilosec OTC for the period of 8/31/03 through 6/25/16