Heartburn Relief: Everything You Need to Know

• Heartburn occurs when someone experiences a burning sensation in their chest. It's often due to acid reflux, which is when food and stomach acid travel from the stomach up into the esophagus.
• This burning sensation usually goes away on its own, though there are some medications and home remedies that may relieve symptoms faster.
• When acid reflux occurs two or more times a week, someone may be diagnosed with gastroesophageal reflux disease (GERD), a chronic condition that requires attention from a healthcare provider.

Heartburn is a sensation of mild chest pain or a burning sensation in the chest that occurs when stomach acid rises into the esophagus. Ironically, heartburn has nothing to do with the heart, often going away on its own, although there are some steps you can take to help relieve heartburn faster and prevent it from returning.

For once-in-a-while cases, home remedies and over-the-counter medications may work. If your heartburn persists, it may be a sign of a chronic condition known as gastroesophageal reflux disease (GERD), which requires attention from a medical provider.

It's estimated that about 20% of Americans have GERD and even more experience heartburn occasionally. Continue reading to learn what to do when heartburn strikes, how to tell if it's GERD, and when to see a healthcare provider about this sensation.

Heartburn is the painful burning sensation in your chest that is most often caused by acid reflux. To understand why acid reflux occurs, we have to first define a few key parts of the upper GI tract:

• Esophagus: A tube that carries food from the mouth to the stomach.
• Stomach: A large organ that breaks down food with stomach acid so it's ready to travel to the small intestine.
• Lower esophageal sphincter (LES): A muscle between the stomach and esophagus that keeps the esophagus closed when not eating and opens to let food travel to the stomach after a meal.

Food and beverages flow down our digestive system - from the mouth, to the esophagus past the lower esophageal sphincter and to the stomach. When the LES works as intended, food remains in the stomach where it is broken down and sent to the small intestines. If the LES inappropriately relaxes, food and stomach acid backflow into the stomach (known as acid reflux), causing the sensation of heartburn.

When symptoms occur two or three times a week , it's considered gastro-oesophageal reflux disease (GERD), a chronic gastrointestinal (GI) disease.

How Common Is It?

One in five Americans are currently diagnosed with GERD. It's harder to estimate how many people have experienced heartburn or acid reflux without a GERD diagnosis, though both are quite common.

Who Is At Risk?

All adults are at risk. The LES can relax for many reasons because foods (like chocolate and spicy foods), some medications, certain eating patterns, and even medical conditions can temporarily disrupt the LES' function.. Risk factors for GERD include:

Acid Reflux vs Heartburn vs GERD

When discussing heartburn, there are three important medical terms to know, all of which refer to something a bit different:

• Heartburn: The symptom of chest pain that accompanies acid reflux or GERD.
• Acid reflux: A one-time occurrence of food traveling from the stomach back into the esophagus.
• GERD: A chronic condition marked by acid reflux two to three times a week (or more). It's also characterized by damage to the lining of the esophagus. This may cause reflux esophagitis, or inflammation in the esophagus lining.

While heartburn is a common symptom of acid reflux and GERD, it isn't the only one. Other symptoms include:

• Dry cough
• Hoarse voice
• Difficulty swallowing
• Trouble breathing or asthma-like symptoms
• Nausea

When heartburn occurs occasionally, many people look for ways to relieve symptoms at home. Natural remedies that may provide heartburn relief are:

• Taking a sip of water to wash stomach acid back down the digestive system.
• Chewing sugar-free gum helps neutralize stomach acid and stop the burn . Chewing gum with sugar may not provide the same benefit.
• Avoiding trigger foods that may worsen symptoms, such as spicy foods or chocolate.
• Dissolve baking soda, which has the same active ingredient as some over-the-counter heartburn medications, into four ounces of water or more and take one to two hours after eating.

Frequent heartburn often requires medication or medical care, especially if someone is diagnosed with GERD. Over-the-counter options that don't require a prescription from a doctor include:

• Antacids, which directly relieve mild heartburn.
• Some H2 blockers, which reduce stomach acid production.
• Some proton pump inhibitors (PPIs), which reduce acid levels and production more than H2 blockers.

For more severe cases of GERD, a healthcare provider may prescribe prescription-strength H2 blockers and PPIs . In severe cases, they may also recommend a minimally invasive surgery.

The most common surgery is fundoplication , which is when a surgeon attaches the stomach around the end of the esophagus in order to add pressure to the sphincter. In some cases a doctor may recommend weight loss surgery if the patient is obese since weight loss often helps to relieve GERD symptoms.. The most commonly suggested weight loss surgery is gastric bypass surgery.

One of the most effective ways to manage or prevent acid reflux is to implement consistent lifestyle changes that reduce the risk of future cases.

#1: Maintain a Healthy Weight

Lifestyle adjustments that help you maintain a healthy weight indirectly reduce the risk of heartburn:

• Lose weight if needed: If you are currently overweight or obese, consider working with a registered dietitian or your primary care provider to create a safe, sustainable weight loss plan.
• Exercise regularly: The CDC recommends 150 minutes of aerobic activity and two strength training sessions at a minimum each week. That exercise doesn't have to be extreme, and you can modify it to your activity level, whether you have high or limited mobility . If it's difficult to stay consistent on your own, consider joining an exercise program or class at a local gym or community center for support.
• Reduce stress: Experiencing high levels of stress may cause emotional eating and disrupt appetite regulation , creating physiological cues to eat more. It may also disrupt the digestive process , meaning the body may store more fat from food. Reducing stress may help address these issues and help you feel better overall. Common stress management techniques include meditation, breathwork , journaling, and attending therapy.
• Increase non-exercise activity: Formal workouts aren't the only way to burn calories . By walking more often, taking regular breaks from sitting, and moving more outside of exercise, we can also maintain a healthy weight.

#2: Eat Smaller Meals

Large meals mean more stomach contents may come back up if acid reflux strikes, making heartburn more painful. Larger meals also produce more stomach acid, increasing the chances of acid reflux occurring. Eating smaller, more frequent meals can help combat this. No matter the meal's size, stop eating when full. There's also recent research suggesting that eating slowly helps prevent heartburn.

#3: Avoid Tight Clothing

GERD doesn't come with a dress code, but avoiding tight clothing may be a good idea. When clothing is tight around the waist or chest, it can squeeze the upper GI tract, relaxing the LES.

#4: Adopt Certain Bedtime Habits

We digest food best when upright so it's always a good idea to walk after eating and to give yourself 2-3 hours to digest your meal before bedtime. When we lie down, our GI system struggles with digesting food . It may also help to sleep on your left side. If you experience acid reflux after lying down, elevate your head, potentially with a wedge pillow.

#5: Follow a GERD Diet

A GERD diet requires someone to avoid certain trigger foods and eat others that help prevent acid reflux.

If experiencing heartburn often, trigger foods to enjoy sparingly or not at all are:

• Spicy foods
• Citrus fruits
• Alcohol
• Carbonated beverages
• Chocolate
• Coffee, especially in high quantities

For those with GERD, certain foods may neutralize stomach acid , providing additional relief when heartburn occurs:

• Aloe vera juice
• Chamomile
• Ginger
• Foods with prebiotics , such as apples, unprocessed apple cider vinegar, asparagus, legumes, onions, tomatoes, and garlic.

Foods with probiotics , like miso, cucumber pickles, yogurt, kefir, and kombucha

If heartburn occurs every once in a while, it can be treated at home, though it may be beneficial to bring it up during your next annual wellness check . When it occurs two times a week or more, seek medical care.

Other signs to see a primary care provider or gastroenterologist about heartburn include:

• Acid reflux is not getting better with over-the-counter treatments.
• You lose weight unintentionally.
• It's accompanied by coughing or wheezing that doesn't go away.
• Swallowing food is difficult.
• You believe a medication you take is causing symptoms. Don't stop the medication unless recommended by a medical provider.

A primary care provider or an expert in GI conditions, such as a gastroenterologist, can review symptoms and medical history . They may be able to pinpoint the most likely cause of your heartburn and will create a tailored plan that may include medications, lifestyle changes, and surgery in severe cases.

Seek urgent medical care if heartburn is accompanied by:

• Bloody vomit
• Black or bloody stools
• Intense pressure or a crushing sensation in the chest

The last symptom in particular may be a sign of a heart attack , which some people may mistake for heartburn in its early stages.

Diagnosing Acid Reflux and GERD

If symptoms suggest GERD, a doctor may order medical tests to confirm a diagnosis. This isn't necessary in all cases, and many individuals are diagnosed with GERD based on symptoms and history alone.

When tests are required, they may include:

• Upper gastrointestinal (GI) endoscopy: When a tube with a camera is placed in the upper GI tract to view the esophagus, LES, and stomach
• Esophageal pH monitoring: A test that can detect if there is stomach acid in the esophagus

How to stop heartburn fast?

To stop heartburn fast, consider over-the-counter heartburn medications, such as antacids or H2 blockers. Taking slow sips of water to wash the stomach acid back into the stomach may also help.

Why won't my severe heartburn go away?

If severe heartburn won't go away, seek medical attention. A healthcare provider can help diagnose what is causing this sensation and ways to relieve it and prevent it from returning.

What can I drink to stop heartburn?

Drinking water is one of the best ways to stop heartburn because it helps stomach acid flow back into the stomach. Alkaline water or herbal teas may offer the same effect.