Severe heartburn causes: what to know

Acid reflux occurs when stomach contents move upward into the oesophagus and irritate its lining. A hiatus hernia can make this movement easier. Gastritis inflames the stomach lining, while a peptic ulcer can cause burning upper-abdominal pain that may be confused with heartburn. Large meals, lying down after eating, alcohol, smoking, pregnancy, excess abdominal pressure, and some medicines may worsen symptoms. More than one factor can be present.

Keep a brief symptom diary covering meal timing, body position, medicines, and associated symptoms such as regurgitation, nausea, or trouble swallowing. Try practical changes such as smaller meals and remaining upright after eating. Review regular medicines with a pharmacist or clinician rather than stopping them yourself. Persistent, frequent, or changing symptoms deserve an assessment to identify the cause and choose treatment.

Seek emergency care for chest pain with breathlessness, sweating, faintness, or pain spreading to the arm, back, neck, or jaw. Get urgent help for vomiting blood, black stools, severe ongoing pain, repeated vomiting, unexplained weight loss, or food sticking when you swallow. These signs can point to bleeding, blockage, heart disease, or another condition needing prompt care.

Ask which causes fit your timing and symptoms, whether any medicine could be irritating your stomach, and whether examination, testing, or acid-reflux treatment is appropriate.