Health · Everyday health
Heartburn and Acidity: Relief and Triggers
Quick answer
Heartburn is a burning feeling in the middle of the chest, often with a sour taste in the mouth, caused by stomach contents rising into the food pipe. Smaller meals, not eating close to bedtime, weight loss if needed, stopping smoking and raising the head of the bed all help. Chest pain that spreads or comes with sweating or breathlessness is treated as a heart emergency, not as acidity.
What does heartburn feel like?
The main symptom is a burning feeling in the middle of the chest, behind the breastbone. Many people also get a sour or bitter taste in the mouth as stomach contents come back up. Other signs include a cough or hiccups that keep returning, a hoarse voice, bad breath, bloating and feeling sick. It typically gets worse after eating, when lying down, and when bending over.
What is acid reflux, and when does it become a disease?
Acid reflux, or gastro-oesophageal reflux, is stomach contents travelling back up into the food pipe. Many people get this now and then. When it happens often enough to cause ongoing symptoms or damage, doctors call it gastro-oesophageal reflux disease, or GERD.
What triggers heartburn?
- Coffee, alcohol, chocolate, tomatoes, and fatty or spicy foods
- Large meals, and eating late at night
- Carrying extra weight, especially around the middle
- Smoking, including breathing in other people's smoke
- Pregnancy, partly due to hormone changes
- Stress and anxiety
- A hiatus hernia, where part of the stomach pushes up into the chest
- Stomach ulcers
- Some medicines, including anti-inflammatory painkillers such as ibuprofen, and certain prescription medicines for blood pressure, asthma and mental health
If you think a prescribed medicine is causing your symptoms, speak to your doctor about it. Do not stop taking it on your own.
What actually brings relief?
- Eat smaller meals more often instead of a few large ones.
- Stop eating 3 to 4 hours before you go to bed.
- Lose weight if you are overweight or living with obesity.
- Stop smoking and cut down on alcohol.
- Avoid tight belts and tight waistbands, which press on the stomach.
- Raise the head end of your bed by about 10 to 20cm, for example by placing sturdy blocks or bricks under the legs at that end, so your chest sits higher than your stomach. Simply piling up extra pillows can make symptoms worse.
- Find a way to wind down. Stress makes symptoms worse for many people.
- Keep a short note of what you ate before symptoms start. Triggers differ from person to person, and yours may not be on any list.
A pharmacist can suggest an antacid or alginate for short-term relief. These are often taken with or soon after food. They are for occasional use rather than something to take every day indefinitely, and needing them constantly is a sign to get checked.
When to see a doctor
Book an appointment if:
- you get heartburn most days
- lifestyle changes and pharmacy remedies are not working
- you have trouble swallowing or food feels stuck
- you are being sick often, or losing your appetite
- you are losing weight without trying
- you have vomit with blood in it, or black, tarry stools
When chest pain is an emergency
Heartburn and heart pain can feel alike, and burning chest discomfort can be either. Treat chest pain as an emergency if it is sudden and does not go away, if it feels like squeezing or pressure, if it spreads to your arm, neck, jaw, stomach or back, or if it comes with sweating, nausea, light-headedness or shortness of breath. You could be having a heart attack: call Rescue 1122 where available, or go to the nearest hospital emergency department. Do not drive yourself.
Frequently asked questions
Is heartburn the same as a heart problem?
No, but they can feel similar. Chest pain that spreads to the arm, neck, jaw or back, or comes with sweating or breathlessness, should be treated as a possible heart attack and needs emergency care immediately.
Does raising the head of the bed help?
Yes. Raising the head end of the bed by around 10 to 20cm keeps your chest above your stomach overnight. Stacking extra pillows is not the same thing and can make symptoms worse.
How long before bed should I stop eating?
Leave 3 to 4 hours between your last meal and lying down. Late, heavy meals are one of the most common triggers of night-time heartburn.
Are antacids safe to take every day?
They are meant for short-term relief rather than daily long-term use. If you need them most days, see a doctor to find out what is driving the symptoms.
In an emergency call Rescue 1122 where the service is available, or go to the nearest hospital emergency department.
Sources
- Heartburn and acid reflux — NHS
- Symptoms & Causes of GER & GERD — NIDDK (NIH)
- Treatment for GER & GERD — NIDDK (NIH)
- Chest pain — NHS