What Causes Heartburn?

Large meals, lying down soon after eating, pregnancy and foods that relax the valve or irritate the oesophagus can bring on symptoms. Acid reflux may be occasional or frequent. A hiatus hernia can allow part of the stomach to move upwards and make reflux easier. Gastritis or a peptic ulcer can cause upper-abdominal burning that feels similar, but these are different problems. Extra abdominal pressure, including that associated with obesity, may also encourage reflux. Heartburn commonly feels behind the breastbone and may leave a sour taste, but chest pain should not automatically be attributed to digestion.

Note which meals, drinks, medicines or positions bring on symptoms. Try smaller meals, avoid lying down soon after eating, and raise the upper body during sleep if advised. Avoid smoking and seek advice before regularly using non-prescription remedies. A clinician can assess recurring symptoms and discuss acid reflux medication when appropriate. Persistent symptoms may need evaluation for reflux or another upper digestive condition.

Get emergency help for chest pressure or pain with breathlessness, sweating, faintness or pain spreading to the arm, jaw or back. Seek prompt medical care for difficulty swallowing, vomiting blood, black stools, repeated vomiting, unexplained weight loss or symptoms that are persistent or worsening. These features need assessment rather than self-treatment alone.

Could my symptoms be reflux, gastritis, a hiatus hernia or an ulcer? Which changes to meals or medicines are suitable for me? How long should I try treatment before review?