Heartburn lasting 37 weeks: what to know

A burning feeling behind the breastbone may come from acid reflux, especially after meals or when lying down, but persistent chest or upper-abdominal symptoms should not be labelled from sensation alone. A review can check the pattern, triggers, medicines, swallowing, and response to treatment.

Acid reflux often presents with heartburn, sour fluid reaching the throat, belching, or symptoms that worsen after a large meal or on bending. A hiatus hernia can also present with reflux symptoms. Gastritis and peptic ulcer disease more often cause upper-abdominal discomfort, nausea, or pain related to eating, though symptom patterns can overlap.

The appointment may include questions about anti-inflammatory pain medicines, smoking, alcohol, meal timing, weight changes, and previous treatment. Difficulty swallowing, food sticking, painful swallowing, persistent vomiting, or unintended weight loss changes the assessment and should be reported clearly.

Record when the burning occurs and its relationship to meals, lying down, exercise, and medicines. Try smaller meals, avoid lying flat soon after eating, and identify personal food or drink triggers rather than removing broad food groups unnecessarily. If symptoms occur at night, raising the head end of the bed may reduce reflux.

A pharmacist or clinician can advise whether an antacid, alginate, or acid-suppressing medicine is appropriate and how it should be taken. Mention pregnancy, kidney or liver problems, other prescriptions, and any self-treatment already used. Persistent symptoms despite correctly taken medicine need reassessment, not repeated dose changes on your own.

Call emergency services for pressure, tightness, or pain in the chest that is severe, new, triggered by exertion, or accompanied by breathlessness, sweating, faintness, nausea, or pain spreading to the arm, jaw, shoulder, or back. Do not assume these features are indigestion.

Seek urgent assessment for vomiting blood, vomit resembling coffee grounds, black sticky stools, repeated vomiting, severe upper-abdominal pain, or sudden trouble swallowing. Promptly contact a clinician for food sticking, painful swallowing, anaemia symptoms such as unusual fatigue, or unexplained weight loss.

Ask which diagnosis fits the timing and location of your symptoms, whether any current medicine may aggravate them, how long to try the recommended treatment, and what would prompt further investigation. Confirm the correct timing of acid-reducing medicine in relation to meals.