What should you know about prolonged heartburn?

Heartburn is a burning feeling behind the breastbone caused when stomach contents move upwards and irritate the food pipe. Acid reflux is a common cause, and a hiatus hernia can make upward flow easier. Gastritis or a peptic ulcer may cause upper abdominal burning or discomfort that can be confused with heartburn. Body weight, meals close to bedtime, large or fatty meals, alcohol, smoking, and certain medicines may worsen reflux in some people. The pattern and associated symptoms matter, so persistent burning should not be self-diagnosed from one sensation alone.

Keep a brief record of meals, lying down, medicines, and symptoms to identify personal triggers. Try smaller meals, remain upright after eating, and avoid going to bed soon after a meal. Raising the head of the bed may help night symptoms; extra pillows alone can bend the body and may be less useful. Ask a pharmacist or clinician before starting or continuing acid-reflux medicine, especially if you take other medicines, are pregnant, or have a long-standing problem. Arrange a review if symptoms need frequent self-treatment or interfere with sleep, eating, or daily activities.

Get emergency help for chest pressure or pain with sweating, breathlessness, faintness, or pain spreading to the arm, back, neck, or jaw, because heart problems can feel similar to heartburn. Seek prompt medical assessment for difficulty or pain when swallowing, food sticking, vomiting blood, black stools, repeated vomiting, unexplained weight loss, or severe persistent pain. A clinician should also review heartburn that starts later in life, changes pattern, or does not improve with appropriate treatment.

Ask whether your symptoms fit acid reflux, gastritis, a hiatus hernia, or another cause; whether any current medicine may be aggravating them; and how long a treatment trial should last. Ask which warning signs require urgent care and whether you need tests if symptoms continue.