Abdominal pain and heartburn: causes and next steps

Heartburn is a burning feeling behind the breastbone that may rise towards the throat. Tell a clinician if your discomfort feels like pressure rather than burning, because heart and digestive symptoms can overlap.

Acid reflux can present with heartburn, a sour taste, belching, and discomfort high in the abdomen, often after eating or when lying down. Gastritis can cause upper abdominal soreness, nausea, or early fullness. Gallbladder problems may cause upper abdominal pain, particularly on the right, and are not explained by heartburn alone.

Pain lower in the abdomen, fever, repeated vomiting, bowel changes, or urinary symptoms point away from simple reflux and warrant a broader assessment. The timing, exact site, food triggers, medicines, and effect of movement help distinguish possible causes.

Try smaller meals, remain upright after eating, and notice whether rich, spicy, acidic, or caffeinated items trigger symptoms. Avoid smoking and tight clothing around the waist. A pharmacist can advise whether a short course of an antacid or acid-reducing medicine is suitable, taking account of pregnancy, other conditions, and medicines that may interact.

Keep brief notes on meals, pain location, burning, regurgitation, and night-time waking. Repeatedly treating symptoms without reviewing their pattern can delay recognition of another digestive problem.

Call emergency services for chest pressure or tightness with sweating, breathlessness, faintness, or pain spreading to the arm, jaw, back, or shoulder. Also seek urgent care for vomiting blood, black stool, severe sudden abdominal pain, a rigid abdomen, repeated vomiting, or difficulty breathing.

Book a clinical review for frequent symptoms, trouble or pain when swallowing, food sticking, persistent vomiting, unexplained weight loss, anaemia, or pain that wakes you repeatedly. New symptoms after starting an anti-inflammatory medicine also deserve review.

Describe whether burning rises from the upper abdomen, whether acid reaches your mouth, and which foods or positions affect it. Ask whether your medicines could be contributing, whether testing is appropriate, and how long to try treatment before returning.