Heartburn: Symptoms, Triggers, Remedies, and When it’s an Emergency

Heartburn, well, does just that — it burns. That burning sensation is caused by a backward flow, or reflux, of stomach acid into your esophagus. When it’s working properly, a ring of muscle at the bottom of the esophagus, known as your lower esophageal sphincter, or LES, acts as a valve, and prevents the contents of your stomach from escaping. But sometimes it relaxes or weakens and allows acid to flow backward into the esophagus.

Since your esophagus isn’t resistant to acid the same way your stomach is, it can cause a painful, burning feeling in your chest. When acid reflux becomes chronic, it is often referred to as gastroesophageal reflux disease, or GERD.

Common heartburn symptoms include:

• Bitter or sour taste in the mouth
• Burning chest pain usually after eating or at night
• Chronic cough or sore throat from acid irritation
• Difficulty swallowing
• Hoarseness or voice changes
• Pressure in the throat
• Worsening pain when lying down or bending over

When you start to feel that telltale burning sensation in your chest, you may wonder how long your heartburn will last. Generally, the symptoms should begin to ease once you’ve properly digested your most recent meal. Healthy digestion typically takes around two hours, though it can take up to five hours for the small intestine to fully digest your foods. In some cases, however, symptoms can last as little as a few minutes, or as long as several hours or days.

Foods and drinks that trigger heartburn

Here are some items you may want to avoid:

1. Alcohol drinks, such as wine and beer, relax the lower esophagus and allow acids to escape from the stomach.
2. Caffeine in coffee, soda and tea calms the lower esophagus, allowing acid reflux that can give you symptoms.
3. Carbonated beverages cause gastric distension. Don’t drink them at night, as they're known to cause nocturnal heartburn.
4. Chocolate not only has caffeine, but research shows it also reduces lower esophagus pressure. Yet scientists don't know if avoiding chocolate can reduce your heartburn.
5. Citrus fruits and juices are acidic, which can trigger heartburn, especially if consumed on an empty stomach.
6. Coffee has both caffeine and acids, two things that cause heartburn. Try decaf or a low-acid roast.
7. Garlic and onion can cause pain in some people, but researchers aren't sure why. Raw onions do activate acid but cooking them helps.
8. High-fat foods such as fried foods (removed as the main reason pizza causes acid reflux is the combination of garlic, tomato sauce and dough) can stimulate your stomach to produce more acid, irritating your esophagus. Greasy foods can also make heartburn more likely.
9. Peppermint is thought to also relax the LES; however, more research is needed to fully understand this.
10. Tomatoes are highly acidic and should be eaten only occasionally if they give you symptoms.

Common remedies for heartburn

Keeping tabs on your lifestyle and diet will have a positive impact on your overall health. Making these simple changes can help reduce or prevent heartburn:
 

Eat smaller meals – Large meals put pressure on the stomach.
Avoid trigger foods – Spicy, fatty, acidic and caffeinated foods can worsen symptoms.
Don't lie down after eating – Wait at least 2-3 hours before lying down or going to bed.

Wear loose fitting clothing – Wearing tight fitting pants, jeans, or skirts can apply pressure to your mid-section and then to the part of your esophagus that connects to your stomach.
Elevate your head while sleeping – Raise the head of your bed by 6-8 inches to prevent acid reflux.
Maintain a healthy weight – Excess weight puts pressure on the stomach.
Quit smoking and limit alcohol – Both weaken the esophageal sphincter, leading to reflux.

Other serious conditions related to heartburn

Occasional heartburn is normal, but frequent or severe symptoms may indicate other conditions, such as:

1. Gastroesophageal Reflux Disease (GERD)
   • Heartburn more than twice a week
   • Persistent cough, sore throat or wheezing
   • Regurgitation of food or acid

2. Esophagitis (Inflammation of the Esophagus)
   • Bleeding or black stools (signs of damage)
   • Chest pain unrelated to heartburn
   • Painful swallowing
3. Barrett’s Esophagus (Precancerous Condition)
   • Chronic GERD symptoms
   • Increased risk of esophageal cancer

Medical assessment and evaluation of heartburn

A doctor will determine if heartburn is a serious problem by evaluating symptoms, reviewing medical history, and performing diagnostic tests. Here’s how they assess the condition:

1. Medical history and symptom assessment

Frequency: Heartburn more than twice a week suggests GERD
Severity: Intense, persistent or worsening symptoms raise concerns
Triggers: Certain foods, lying down or exertion may indicate different conditions

2. Diagnostic tests

If symptoms indicate a bigger issue, your doctor may order testing:

Endoscopy – Uses an endoscope, which is a thin, flexible tube with a camera, to examine the esophagus and stomach for inflammation, ulcers or Barrett’s esophagus

pH Monitoring – Measures acid reflux over 24 hours with a sensor

Esophageal Manometry – Monitors how well the esophagus moves food to the stomach

Barium Swallow X-ray – Check for narrowing or damage with a special liquid that highlights the esophagus on an X-ray

Inform your health care provider if you’ve had an episode of unexplained chest pain that went away within a few hours, and you did not seek medical attention. Both heartburn and a developing heart attack can cause symptoms that subside after a while. The pain doesn't have to last a long time to be a warning sign.

Heartburn vs. heart attack

Chest pain caused by heartburn can mimic some of the symptoms of a heart attack, which can be alarming. However, while you do feel a burning sensation in your chest in both cases, there are some key differences.

With heartburn, you may:

• Experience it after eating or while lying down
• Feel a burning sensation in your chest
• Find that your mouth tastes sour from acid reflux
• Find it hard to catch your breath
• Get relief from antacids and acid reducers

With a heart attack, you may also:

• Feel pain, tightness or aching in your chest or arms
• Feel tired, dizzy and lightheaded
• Find it hard to catch your breath
• Want to vomit

If you are experiencing chest pain but aren’t sure whether it’s heartburn or a symptom of a heart attack, you should call 911 or go to your nearest emergency room.

When to seek immediate medical care

Don’t ignore these signs:

• Chest pain that persists
• Difficulty swallowing or persistent sore throat
• Frequent heartburn (two or more times a week)
• Symptoms persist despite over-the-counter medication
• Unintentional weight loss
• Vomiting blood or bleeding/black stools
• If you are experiencing chest pain but aren’t sure whether it’s heartburn or a symptom of a heart attack, you should call 911 or go to your nearest emergency room.

Find the right care for you at UF Health Emergency & Urgent Care Centers

Before encountering medical problems, learn where you can get help fast. Make a list of the emergency and urgent care offices near you and save them in your phone. For life-threatening medical emergencies, call 911 immediately or go to the emergency room.

At UF Health Emergency & Urgent Care Centers, our primary goal is to provide the residents of Northeast Florida and Southeast Georgia with exceptional service, while ensuring they are charged only for the level of care they need. Our combined emergency room and urgent care is fully equipped to handle everything from allergies to fractures to chest pain, with on-site labs, CT, ultrasound, and X-ray, all under one roof. The ER and urgent care centers are open 24 hours a day, 7 days a week.
No appointment is necessary — just walk in when you need care!

Find the UF Health Emergency & Urgent Care Center in Jacksonville nearest you at https://euc.ufhealthjax.org/locations.