Heartburn is an uncomfortable or burning pain in the middle of your chest, just behind your breastbone. This pain may be called heartburn but it has nothing to do with your heart. It is caused by stomach acid that travels up towards your oesophagus/food pipe (acid reflux).

In general, this feeling can occur after eating a heavy meal and may worsen when lying down or bending over.

Having occasional heartburn is common and is not considered a cause for alarm as it can be managed with lifestyle changes and nonprescription medications. But if you have it often which makes it difficult to eat or swallow, you may have a more serious condition called gastro-oesophageal reflux disease (GERD).

If heartburn has been bothering you for a long time, it’s a good idea to consult the best gastroenterologist in Hyderabad, Dr. K V Dinesh Reddy.

Who is Likely to Experience Heartburn?

Heartburn is a common occurrence, particularly after eating rich, acidic or spicy meals. It can also occur when there is excess pressure on your stomach, such as during pregnancy. Your risk increases if you eat soon before bedtime, are overweight (BMI > 25), or obese (BMI > 30). Certain medicines, including specific antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs), may trigger heartburn. Other causes of occasional heartburn include smoking, vaping, and using tobacco products.

Symptoms of Heartburn

Heartburn feels like acid burning in your chest, which is very similar to what it is. Your oesophagus, the swallowing tube that begins in your throat, runs down the centre of your chest to your stomach. Heartburn starts in this tube, but it usually spreads across your chest and into your throat. This sensation can be mild or very uncomfortable.

You may experience:

1. A burning feeling in your throat
2. Pressure or pain behind your breastbone
3. Difficulty swallowing
4. Worsening pain when lying down or bending over
5. A sour, acidic, or bitter taste in your mouth
6. Coughing or hoarseness

In general, heartburn lasts anywhere from a few minutes to a few hours. It usually goes away once the last meal you ate has passed out of your stomach. Once your stomach is empty, nothing is left to come back up.

Depending on what you had, it might take two to five hours for your stomach to digest. Fatty, spicy and rich meals take a little longer to break down in your stomach.

Heartburn can sometimes be mistaken for other types of chest pain, making it difficult to differentiate from conditions like heart attacks or oesophagal disorders.

Heartburn vs. heart attack

Although heartburn and heart attacks both cause chest pain, they are not related. The biggest difference is in how they feel—heartburn causes a burning sensation, while a heart attack typically feels like tightening or pressure in the chest.

Along with a burning sensation in the chest, heartburn caused by acid reflux may also lead to burping, nausea, a sour taste in the mouth, and regurgitation of food.

In some cases, acid reflux can cause additional symptoms such as stomach bloating, hiccups, chronic cough, worsening asthma, sore throat, and laryngitis. You may also experience difficulty swallowing or feel as if there is a lump in your throat.

If you are unsure about your symptoms, it’s always recommended to consult the best gastroenterologist in Hyderabad.

Why Does Heartburn Occur?

Heartburn occurs when the lower oesophagal sphincter (LES), the valve at the bottom of your oesophagus, doesn’t close properly. Normally, the LES stays closed to keep food and stomach acids in your stomach and only opens when you swallow. However, if it is weak and remains slightly open or opens at the wrong time, stomach acid can leak back into the oesophagus, causing a burning sensation known as heartburn.

What causes the LES valve to weaken is not fully understood, but it could be due to the underlying factors, such as:

1. Smoking or inhaling smoke
2. Extra pressure from weight, tight clothing, or pregnancy
3. Hiatal hernia (when part of your stomach pushes through the diaphragm)
4. Eating a heavy meal that stays in your stomach longer
5. Gas and indigestion, as bubbles rise through your digestive tract
6. Lying down too soon after eating
7. Certain foods like coffee, chocolate, citrus fruits, mint, and tomato sauce
8. Some medications, including birth control and blood pressure drugs
9. Often, multiple factors work together to trigger heartburn.

Heartburn Treatment in Hyderabad

Most patients with heartburn find relief through simple lifestyle and dietary changes. Here are a few do’s and don’ts to prevent heartburn.

What You Should Do:

• Eat smaller, more frequent meals throughout the day instead of large portions.
• Wait a few hours after eating before lying down to prevent acid from rising into the oesophagus.
• Elevate the head of your bed using blocks or books to reduce nighttime reflux.
• Maintain a healthy weight, or lose weight if you need to so the abdominal pressure is reduced.
• Sleep on your left side to keep your lower oesophagal sphincter elevated above your stomach contents.
• Find ways to relax, as stress can contribute to acid reflux.

What You Should Avoid:

• Avoid trigger foods and drinks, including acidic, high-fat, and spicy foods, as well as chocolate, alcohol, mint, and carbonated drinks. Be mindful of the foods and drinks that trigger your heartburn and try to avoid them.
• Avoid wearing tight clothing around your waist, which can put pressure on your stomach.
• Stop smoking, as it weakens the lower oesophagal sphincter.
• Limit alcohol intake, as it can trigger acid reflux.

If lifestyle changes and over-the-counter medications don’t provide relief, or if you experience heartburn weekly, have unusual symptoms, or struggle with swallowing and maintaining adequate nutrition. It’s always important to consult the best gastroenterologist in Hyderabad. The doctor may advise a few tests like an X-ray, endoscopy, ambulatory acid probe test (oesophagal pH monitoring), and oesophagal motility testing (oesophagal manometry) to confirm a diagnosis and rule out other issues. If the diagnosis confirms heartburn the doctor may prescribe antacids or alginates or could recommend surgery that can help ease your symptoms.