Heartburn is usually the unfortunate, but temporary, consequence of a spicy meal or other dietary choice. But when heartburn returns repeatedly, it may be a symptom of a potentially serious health problem.

When stomach acid works its way up into your esophagus, the uncomfortable feeling in your chest is called “acid reflux” or “heartburn.”

Knowing what triggers your heartburn is important to avoid or reduce acid reflux. It’s also important to recognize the symptoms that indicate your heartburn is more than a fleeting reaction to what you just ate or drank.

Heartburn can be a symptom of potentially severe esophageal conditions, so if the frequency and intensity of your heartburn episodes increase, you’ll want to get medical help.

This article reviews the symptoms, causes, and treatment of mild to more serious cases of heartburn.

Heartburn occurs when stomach acid moves from your stomach into your esophagus and irritates the lining of the esophagus.

Usually, after you drink or swallow food, a small muscular ring called the “lower esophageal sphincter (LES)” closes to prevent stomach acid from entering the esophagus. If the sphincter doesn’t close tightly, the result may be acid reflux.

Some of the factors that cause the LES to weaken or lose its shape include:

Chronic heartburn may be a symptom of GERD

When heartburn becomes a chronic difficulty, it could be a symptom of a condition called “gastroesophageal reflux disease (GERD).”

According to the American College of Gastroenterology, you may want to consider seeing a doctor and getting a possible evaluation for GERD if lifestyle and dietary changes don’t stop heartburn episodes or if you need to take heartburn-relieving over-the-counter medications at least twice a week.

You may want to talk with a doctor if there are other heartburn symptoms that could indicate damage may be ongoing, including:

  • choking or coughing due to a feeling of acid in the chest
  • difficulty swallowing
  • vomiting or coughing up blood
  • weight loss

Occasional bouts of heartburn are unlikely to cause serious complications. Instead, heartburn can cause discomfort and may make sleeping or lying flat difficult.

When GERD is present, some of the more severe complications include:

Esophagitis

Esophagitis is inflammation of the esophagus and a possible cause of ulcers or bleeding. The National Institute of Diabetes and Digestive and Kidney Diseases also reports that esophagitis can be a risk factor for more serious conditions, such as esophageal stricture and Barrett’s esophagus.

Esophageal stricture

Inflammation and irritation of the esophageal lining can cause the esophagus to narrow. Esophageal stricture can make swallowing more difficult and lead to complications, ranging from choking to malnourishment from reduced food consumption.

Barrett’s esophagus

Barrett’s esophagus is an uncommon condition, affecting an estimated 1.6–6.8% of the general population. It develops when the lining of the esophagus becomes damaged by continual exposure to stomach acid.

Barrett’s esophagus can also lead to a type of cancer called “esophageal adenocarcinoma.”

Lifestyle and dietary changes can sometimes be enough to relieve or prevent heartburn episodes. You may also need medications to help reduce your symptoms.

Lifestyle changes

Heartburn and the overproduction of stomach acid are usually responses to the foods and beverages you consume. Avoiding triggers is the key to reducing heartburn episodes.

Your trigger foods and drinks may be different than those that bother someone else, but among the more common heartburn triggers are:

  • alcohol
  • chocolate
  • coffee
  • greasy foods and high fat foods, including whole fat dairy products
  • peppermint
  • spicy foods

Other helpful lifestyle tips to reduce or prevent heartburn include:

  • maintaining a moderate weight to reduce pressure on the LES
  • quitting smoking, if you smoke — smoking not only weakens the LES but can further irritate the lining of your esophagus
  • sleeping with your upper body slightly elevated, especially if you consumed a possible heartburn trigger or are going to sleep within a few hours after eating

Medications

There are 3 classes of heartburn medications:

  • Antacids (Mylanta, Rolaids, Tums): Antiacids change the nature of your stomach acid to make it less irritating.
  • H2 blockers (Tagamet, Pepcid): H2 blockers reduce the volume of stomach acid in your system.
  • Proton pump inhibitors (Prevacid, Nexium, Prilosec): Proton pump inhibitors also reduce the amount of stomach acid, but they’re more powerful than H2 blockers and aren’t designed for immediate heartburn relief.

Does drinking water help relieve heartburn?

Drinking water can help dilute the stomach acid in your system. A 2019 study further suggests that frequent, but small sips of water may be especially effective in easing the discomfort of heartburn.

Other beverages, such as herbal teas and plant-based milks, may also be helpful. Ideally, you may want to avoid carbonated drinks and those that are especially acidic, such as fruit juices.

Heartburn can be either a nuisance after a heavy meal or the first symptom of a more serious condition.

For many people, avoiding foods and beverages that trigger heartburn is the easiest way to prevent the pain and discomfort of acid reflux.

Other lifestyle changes, such as quitting smoking and maintaining a moderate weight, can also help. If your efforts to curb heartburn episodes are ineffective, and you start to experience more frequent and more intense difficulties, you may want to talk with a doctor soon.

Heartburn is a common symptom of GERD, which, in turn, can be a risk factor for more severe medical concerns.