What should you know about things that cause heartburn?

Heartburn commonly results when stomach contents move upwards into the food pipe, with meals, lying down and pressure on the abdomen often affecting symptoms. It may feel like burning behind the breastbone or a sour taste rising into the throat.

Acid reflux is a common explanation, and a hiatus hernia can make upward movement easier. Large or rich meals, eating close to bedtime, alcohol, smoking and individual food triggers may worsen symptoms. Gastritis and peptic ulcer disease can also cause upper abdominal discomfort that may be confused with heartburn. Obesity can increase pressure around the abdomen. Heartburn alone does not establish one of these conditions.

Notice which foods, drinks, medicines or positions bring symptoms on, and avoid only the triggers that clearly affect you. Choose smaller meals, remain upright after eating, and avoid lying down soon after food. Raising the head end of the bed may help night symptoms; extra pillows alone can bend the body and may not help. A pharmacist or clinician can advise whether acid reflux medication is suitable, especially if symptoms are frequent or you take other medicines.

Seek emergency help for chest pressure or pain with breathlessness, sweating, faintness, or pain spreading to the arm, back, neck or jaw. Arrange medical advice for frequent or persistent heartburn, painful or difficult swallowing, repeated vomiting, unexplained weight loss, black stools or vomiting blood. These features need assessment because heartburn-like symptoms can have causes beyond reflux.

Does my symptom pattern fit reflux, gastritis, a hiatus hernia or another cause? Could any of my medicines irritate the stomach? Should I try acid reflux medication, and for how long? Which chest or swallowing symptoms need urgent help?