The Difference Between Heartburn and Indigestion

As they are different conditions, heartburn and indigestion can have very different causes. But there is some overlap.

Heartburn

Heartburn occurs when stomach acid backs up into your esophagus due to a weak or relaxed lower esophageal sphincter. It may also be a symptom of a chronic condition called gastroesophageal reflux disease (GERD).

Over time, GERD may damage the esophagus, leading to complications such as esophageal cancer or Barrett’s esophagus.

Risk factors for heartburn include:

• being overweight or obese
• pregnancy
• smoking or secondhand smoke exposure

In some cases, certain foods can trigger heartburn. These include:

• fatty foods
• alcohol
• coffee
• chocolate
• fried foods
• spices
• tomatoes
• onions
• garlic
• peppermint
• citrus fruits/juices

Indigestion (dyspepsia)

Some of the same food triggers for heartburn may bring on a case of indigestion, including caffeine, spicy or acidic foods, and alcohol. Indigestion may also be caused by eating large meals or eating too fast.

Indigestion could also be caused by underlying GI disorders, including:

• stomach cancer
• GERD
• irritable bowel syndrome (IBS)
• lactose intolerance
• gallbladder disease
• peptic ulcers
• gastritis
• bacterial infections, such as Helicobacter pylori
• gastroparesis

Anxiety and depression may also upset the stomach on a regular basis in some people, leading to indigestion issues. Research also suggests that indigestion may have a genetic component.

Both heartburn and indigestion may be treated with over-the-counter (OTC) products, such as:

• Antacids for mild, occasional heartburn symptoms. Antacids work by neutralizing stomach acid. They may be taken as soon as you experience symptoms, or before eating trigger foods to prevent them. Antacids aren’t meant to be taken every day, unless otherwise instructed by your doctor. Daily use can cause GI upset.
• Proton pump inhibitors (PPIs) for long-term treatment. PPIs work by decreasing the amount of acid in your stomach, allowing your esophagus to heal.
• Histamine-H2-receptor antagonists (H2 blockers). These are also designed to decrease stomach acid, but they aren’t as strong as PPIs.

Ask your doctor before taking any herbal remedies for GI issues, as you may unintentionally make your heartburn or indigestion worse.

Occasional heartburn or indigestion is largely preventable. Prevention methods are the same for both conditions.

Here are some of the ways you can help decrease a flare-up of heartburn and indigestion symptoms:

• Eat smaller, more frequent meals. Chew your food slowly to help aid digestion.
• Avoid your specific food triggers. If you’re not sure what foods trigger your symptoms, consider eliminating common culprits from your diet and slowly adding them back in. Examples include coffee, spices, onions, and acidic fruits.
• Eliminate fried, fatty foods from your diet. These foods are common triggers for heartburn and indigestion.
• Don’t eat within a few hours before bedtime. Also, avoid laying down or bending over after meals.
• Avoid drinking alcohol and smoking. This can help the lower esophageal sphincter to properly function.
• Consider raising the head of your bed. Experts recommend raising the upper part of your mattress by 6 to 8 inches. This may be accomplished via an adjustable mattress, or by adding a wedge underneath a traditional mattress.
• Lose weight, if your doctor recommends it. Excess body fat can place more pressure on your upper abdomen and esophageal sphincter, triggering both indigestion and heartburn, respectively.
• Avoid tight-fitting clothes. This can prevent pressure around the lower esophageal sphincter and the abdomen.

These preventive measures may also help alleviate symptoms of chronic heartburn or indigestion, but you’ll need to see your doctor to help treat the underlying causes to help prevent further complications.

If your symptoms of heartburn and/or indigestion don’t improve after a few weeks of home remedies and preventive measures, see your doctor.

Chronic heartburn or indigestion issues could be a sign of an underlying medical condition that needs treatment. To get to the root of chronic indigestion or heartburn issues, your doctor may order a few tests, including:

• a physical exam of your abdomen
• acid probe tests to measure when (and how much) stomach acid reaches back into your esophagus
• imaging tests, such as X-rays and endoscopies (especially if you’re over the age of 60), to look at your esophagus and stomach
• blood or stool tests to rule out bacterial infections that may be causing indigestion

Call your doctor if you experience any of the following symptoms that could indicate GI complications:

• pain in your abdomen that doesn’t go away
• frequent vomiting
• blood in vomit or stools
• tar-colored stools
• difficulty swallowing
• yellowing of the skin or eyes (jaundice)
• appetite loss
• unintentional weight loss

Seek emergency medical attention if heartburn or indigestion are accompanied by the following potential symptoms of a heart attack:

• pain or squeezing sensations in your chest that spread to your arms, back, neck, and jaw
• dizziness or lightheadedness
• sudden fatigue
• cold sweats
• shortness of breath
• nausea or vomiting

Both heartburn and indigestion have similar causes, and may be alleviated with similar lifestyle changes and OTC treatments.

It’s important, however, that you determine whether your symptoms are heartburn- or indigestion-related, so you can discuss them with your doctor.

If you find that you need antacids every day, or if your heartburn or indigestion symptoms last longer than a few weeks, you may need to see your doctor for further testing.

Treating an underlying GI issue can help alleviate your symptoms while also preventing further complications.