Severe heartburn: what to know

Heartburn is a burning sensation behind the breastbone that may rise toward the throat, often after eating or when lying down. Acid reflux can also cause a sour taste, regurgitation, hoarseness, or an irritating cough. Gastritis, a hiatus hernia, and peptic ulcer disease can produce upper abdominal or chest discomfort with different patterns. Heartburn alone cannot confirm its cause.

Eat smaller meals, avoid lying down soon after eating, and notice which foods, drinks, or medicines trigger symptoms. Raising the upper body during sleep may help night-time reflux. A pharmacist can explain suitable short-term acid-relief options and how to use them safely. Arrange a medical review when symptoms recur, disturb sleep, cause swallowing difficulty, or need frequent self-treatment.

Call emergency services for chest pressure or pain with sweating, breathlessness, faintness, nausea, or pain spreading to the arm, back, neck, or jaw. Seek urgent care for vomiting blood, black stools, severe persistent pain, repeated vomiting, or food becoming stuck. These features can indicate a problem beyond ordinary reflux and should not be assessed only with home remedies.

Ask whether your pattern fits acid reflux, whether medicines or a hiatus hernia may contribute, and whether you need testing for persistent symptoms or swallowing changes.