What is heartburn

What Causes Heartburn

Heartburn occurs when digestive juices, primarily hydrochloric acid, flow backward from the stomach into the esophagus. The esophagus lacks the protective lining of the stomach, so acid irritates and inflames it, creating the characteristic burning sensation. This reflux happens when the lower esophageal sphincter (LES)—a ring of muscle that normally seals the stomach—becomes weakened, relaxed, or dysfunctional.

Common Triggers

Dietary triggers include spicy foods, citrus fruits, tomato-based products, chocolate, mint, and fatty or fried foods. Beverages that commonly trigger heartburn are coffee, tea, carbonated drinks, and alcohol, particularly red wine and beer. Lifestyle factors play significant roles: large meals, eating close to bedtime, lying down immediately after eating, and eating too quickly all increase heartburn risk. Smoking and secondhand smoke exposure weaken the LES muscle.

Risk Factors

Certain conditions and circumstances increase heartburn susceptibility. Pregnancy causes hormonal changes that relax the LES and increases abdominal pressure. Obesity puts excess pressure on the stomach. Age increases risk as the LES naturally weakens over time. Medications including aspirin, ibuprofen, blood pressure medications, and certain antidepressants can trigger heartburn. Stress and anxiety also contribute by affecting digestive function.

Symptoms and Diagnosis

The primary symptom is a burning sensation in the chest behind the breastbone, often radiating toward the throat. Some experience regurgitation of bitter-tasting liquid into the mouth. Symptoms typically appear 30 minutes to 2 hours after eating and worsen when bending over or lying down. Most people self-diagnose heartburn based on symptoms, though persistent cases warrant medical evaluation to rule out GERD or other conditions.

Treatment and Management

Lifestyle modifications are the first-line approach: eating smaller meals, avoiding trigger foods, not eating before bed, elevating the head while sleeping, and maintaining healthy weight. Over-the-counter antacids provide quick relief by neutralizing stomach acid. H2 blockers reduce acid production, while proton pump inhibitors are strongest for frequent heartburn. If symptoms persist despite these measures, prescription medications or further medical evaluation may be necessary.