Heartburn causes: what should you know?

The irritated food pipe can create burning behind the breastbone, a sour taste, regurgitation, cough, or hoarseness. Large meals, lying down after eating, bending over, smoking, pregnancy, and some medicines can make reflux easier to notice. [Hiatus Hernia](/conditions/hiatus-hernia/) can also affect the barrier between the stomach and food pipe. Heartburn does not by itself identify one single condition; [Gastritis](/conditions/gastritis/) and [Peptic Ulcer](/conditions/peptic-ulcer/) can cause upper-abdominal discomfort with different mechanisms.

Keep a short symptom diary, noting meals, timing, posture, and medicines. Choose smaller portions, eat slowly, and stay upright after food. Avoid a late meal if that reliably brings symptoms at bedtime. A pharmacist or clinician can review medicines and discuss [Acid Reflux Medication](/treatments/medical-management/acid-reflux-medication/). If symptoms are persistent, an assessment may check for [Acid Reflux](/conditions/acid-reflux/) or another explanation.

Book an appointment if heartburn keeps returning, disrupts sleep, causes difficulty swallowing, or leads to ongoing cough or voice change. Seek urgent help for severe or persistent chest pain, breathlessness, fainting, vomiting blood, or black stools. These warning signs need assessment rather than treatment based only on presumed reflux.

Ask whether your pattern fits reflux, whether another condition should be considered, which medicine is appropriate, and whether weight, smoking, or a current prescription could be contributing.