Heartburn is a pain in the chest caused by stomach acids backing up into the esophagus. The esophagus is the tube connecting the mouth to the stomach. Heartburn is very common. About one third of adults report occasional symptoms and 10 percent report daily symptoms. Occasional attacks pose little threat. The pain can be intense and alarming. Heartburn sends some people to the emergency room thinking they are having a heart attack.

A weakness in the valve between the esophagus and stomach allows reflux, or backing up, of strong stomach acids. This most often occurs 30 to 60 minutes after a meal or when the person lies down. There may be spitting up of some stomach contents into the mouth. In some cases, a person may lose their voice, have asthma symptoms, or a cough.

Frequent reflux may damage the lining of the esophagus. Reflux during sleep may stay in the esophagus longer, leading to more damage. If reflux occurs over many years, there is a risk of cancer or a tightening of the base of the esophagus. Most people with heartburn have mild conditions with minimal damage to the esophagus.

Treatment of reflux disease starts with lifestyle changes. Foods to avoid include:
* fatty foods,
* coffee,
* alcohol,
* tomato products,
* citrus juices,
* colas, and
* chocolate.

Eat small, frequent meals and quit smoking. If overweight, many patients note relief after losing weight. Avoid lying down or bending over within 3 hours of a meal. Elevating the head of the bed helps prevent nighttime reflux.

Antacids should be taken when symptoms arise. Common products include Maalox, Mylanta, and Gaviscon. Gaviscon appears to work best because it floats at the top of stomach contents. Most people respond well to antacids and lifestyle changes. If you do not, your provider may try drugs that cut down on acid production. Cases that do not respond to therapy may need surgery. See your healthcare provider if you have recurrent heartburn that does not respond to lifestyle changes. Seek emergency care if heartburn symptoms happen along with shortness of breath, excessive sweating, or weakness.

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