Heartburn

Heartburn is a painful, burning sensation in the chest. It may feel worse in certain positions, such as lying down or bending over. It is caused by stomach acid backing up into the tube that carries food from the mouth down to the stomach (lower esophagus).

CAUSES

  • Large meals.

  • Certain foods and drinks.

  • Exercise.

  • Increased acid production.

  • Being overweight or obese.

  • Certain medicines.

SYMPTOMS

  • Burning pain in the chest or lower throat.

  • Bitter taste in the mouth.

  • Coughing.

DIAGNOSIS

If the usual treatments for heartburn do not improve your symptoms, then tests may be done to see if there is another condition present. Possible tests may include:

  • X-rays.

  • Endoscopy. This is when a tube with a light and a camera on the end is used to examine the esophagus and the stomach.

  • A test to measure the amount of acid in the esophagus (pH test).

  • A test to see if the esophagus is working properly (esophageal manometry).

  • Blood, breath, or stool tests to check for bacteria that cause ulcers.

TREATMENT

  • Your caregiver may tell you to use certain over-the-counter medicines (antacids, acid reducers) for mild heartburn.

  • Your caregiver may prescribe medicines to decrease the acid in your stomach or protect your stomach lining.

  • Your caregiver may recommend certain diet changes.

  • For severe cases, your caregiver may recommend that the head of your bed be elevated on blocks. (Sleeping with more pillows is not an effective treatment as it only changes the position of your head and does not improve the main problem of stomach acid refluxing into the esophagus.)

HOME CARE INSTRUCTIONS

  • Take all medicines as directed by your caregiver.

  • Raise the head of your bed by putting blocks under the legs if instructed to by your caregiver.

  • Do not exercise right after eating.

  • Avoid eating 2 or 3 hours before bed. Do not lie down right after eating.

  • Eat small meals throughout the day instead of 3 large meals.

  • Stop smoking if you smoke.

  • Maintain a healthy weight.

  • Identify foods and beverages that make your symptoms worse and avoid them. Foods you may want to avoid include:

  • Peppers.

  • Chocolate.

  • High-fat foods, including fried foods.

  • Spicy foods.

  • Garlic and onions.

  • Citrus fruits, including oranges, grapefruit, lemons, and limes.

  • Food containing tomatoes or tomato products.

  • Mint.

  • Carbonated drinks, caffeinated drinks, and alcohol.

  • Vinegar.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe chest pain that goes down your arm or into your jaw or neck.

  • You feel sweaty, dizzy, or lightheaded.

  • You are short of breath.

  • You vomit blood.

  • You have difficulty or pain with swallowing.

  • You have bloody or black, tarry stools.

  • You have episodes of heartburn more than 3 times a week for more than 2 weeks.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.