Heartburn actually has nothing to do with your heart. When you eat, food travels down the esophagus to the stomach. There is a muscle separating the esophagus from the stomach known as the lower esophageal sphincter (LES), which closes during digestion and prevents the acid in your stomach from rising, or “refluxing” into the esophagus. Certain triggers (such as too much food) create pressure in the stomach and loosen the LES. This gives the acid in your stomach an opportunity to rise up the esophagus. When that stomach acid makes contact with your esophagus and throat, it causes irritation, and the result is heartburn.

Heartburn Triggers

Since heartburn centers on a malfunctioning lower esophageal sphincter, there are physical and lifestyle factors that increase your odds of experiencing heartburn. 

• Lifestyle Risk Factors
  • Sometimes heartburn is brought on by lifestyle choices, the most common being the types of food you eat. Foods that are spicy, fried, or acidic can trigger heartburn. If you lie down after eating or eat before bed, it is easier for stomach acids to drift into the esophagus. A full stomach produces more acid and lying down stretches the LES, pulling it open slightly, so acid flows easily into the esophagus. Alcohol and caffeine can also contribute, as does smoking.
  • In addition, certain blood pressure medications and muscle relaxers make it easier for heartburn to occur.

• Physical Risk Factors
  • There are common physical risk factors that create a conducive environment for heartburn. Being pregnant is one. Over half of pregnant women get heartburn because the added weight puts pressure to their stomach. This is also the case with being overweight.
  • Another factor is known as hiatal hernia, a condition where the stomach pushes above the diaphragm and into the esophagus. This allows acid reflux to easily occur.

Many a trip to the emergency room has been from chest pains. Sometimes the pain from heartburn is confused as a heart attack and vice versa. It can be hard to tell the two apart since the pain feels like it is in the chest. However, there are differences in the pain associated with heartburn and a heart attack. With heartburn, the pain usually comes after you have eaten, and normally will not spread beyond the chest area to the shoulders and arms. It is more of a burning sensation than tightness in your chest. And unlike a heart attack, heartburn does not bring on a cold sweat. However, if you are unsure of the cause, it is best to play it safe and seek care immediately.

If heartburn goes untreated and happens more than twice a week, you likely have a condition known as gastroesophageal reflux disease or GERD. GERD affects the esophagus and can be accompanied by a number of other symptoms. You may taste your food in the back of your throat or even vomit after eating. The acid can also adversely affect your throat causing hoarseness or soreness that does not go away. If untreated, GERD can severely damage the esophagus causing ulcers, narrowing of the esophagus, or even esophageal cancer.

There are a few ways to treat heartburn. The first is to make some changes to your lifestyle. You can get relief from heartburn symptoms by avoiding a number of foods that might trigger reflux.

• Chocolate
• Caffeine, alcohol, or carbonated beverages
• Acidic fruits and foods
• Garlic, onions, mint
• Fried foods
• Spicy foods

For someone who is overweight, a change in diet may also result in some weight loss, which can lessen heartburn frequency. In addition, eating food slower and in smaller portions can give the stomach time to process foods. Avoid eating before bed or lying down after a meal for about two hours.

In addition, some lifestyle changes may make things more comfortable. Raising the head of the bed can prevent acids from moving into the esophagus with a little help from gravity. Wearing loose clothing that does not restrict the stomach may help. Finally, for those who smoke, it might be time to put the pack down for good; smoking also triggers acid reflux.

In addition to lifestyle changes, medications are a common cure for heartburn relief. Medications that neutralize acid in the stomach are called antacids, while those that reduce the acid production in the stomach are known as acid reducers. Either of these medicines can be purchased over the counter without a prescription.

Antacids are the most common treatment for heartburn, designed to provide immediate, short-term relief. There is a wide variety of antacids available including calcium carbonate, sodium bicarbonate, bismuth subsalicylate, hydrotalcite, magnesium carbonate, and aluminum hydroxide.

On the other hand, acid reducers offer relief from heartburn symptoms for a longer period of time. They usually begin working within an hour of being taken. The two most common acid reducers that can be purchased over the counter are famotidine and ranitidine.

For people who have heartburn more than two days a week, proton pump inhibitors may be a better option. These medications act to diminish the amount of acid produced by the whole body instead of just in the stomach area. For heartburn that cannot be cured by acid reducers or antacids, proton pump inhibitors like omeprazole can provide long-lasting relief - though they do take more time to act than other medications.

For someone who experiences heartburn more than twice a week on a consistent basis without relief, it might be time to head to the doctor. There are a number of tests that can confirm a larger problem like GERD.

• Consultation: A doctor may diagnose GERD just by a description of symptoms without performing extensive tests.
• Endoscopy: An endoscopy gives doctors a chance to look at the esophagus closely by passing a tube down the throat. This can determine if the esophagus has been damaged by stomach acids.
• 24 hour pH probe: The best way to determine acid reflux, the 24 hour pH probe sends a tube into the esophagus. However, unlike an endoscopy, the tube remains in place for a day. It sits near the LES and checks the acid level near that area. If the results are high, it is an indication of GERD.
• Barium X-ray: By swallowing a chalky liquid known as barium, an X-ray can track the progress of the liquid through the body and point out any problems with the esophagus, stomach, or upper intestine.

Heartburn is a fairly common condition, but there are times when you should call your doctor. If you suspect a heart attack, don’t hesitate. If your symptoms are getting increasingly worse and include vomiting, difficulty swallowing, or a sore throat, it is an indication of a bigger problem. Also, pay attention to your weight. If you are losing weight at a rapid pace it is cause for concern. And finally, if over-the-counter medications are ineffective after two weeks, a closer look by a doctor is necessary.