Heartburn is caused by a number of things, but in most cases, it's acid reflux. That is, some of the digestive juices normally found in the stomach back up into the esophagus, the pipe between the stomach and mouth. These juices include hydrochloric acid, the corrosive substance used in industry to clean metal.
The stomach has a protective lining that shields it from the acid, but the esophagus has no such lining. That's why upwardly mobile stomach acid burns, sometimes so badly that you may think you're having a heart attack.
Overeating is the most common cause of heartburn. But it's not the only one. Some people get heartburn without overindulging. To squelch the fire, heed these tips from experts.
If you're experiencing heartburn regularly for no apparent reason, it's time to call your doctor, says Samuel Klein, M.D.
How regularly? As a rule of thumb, two or three times a week for more than 4 weeks, says Francis S. Kleckner, M.D. Although heartburn is most usually caused by simple acid reflux, he cautions that it can also be a sign of an ulcer.
See a physician right away if any of the following symptoms accompany your heartburn, says Dr. Klein. It could mean you're having a heart attack or other serious disorder.
• Difficulty or pain when swallowing
• Vomiting with blood
• Bloody or black stool
• Shortness of breath
• Dizziness or light-headedness
• Pain radiating into your neck and shoulder
In addition, know that heartburn caused by simple acid reflux is normally worse after meals. If your heartburn worsens before meals, it may be a sign of an ulcer.
Larry I. Good, M.D., is a former member of the Long Island Gastrointestinal Disease Group in Merrick, New York. He also was an assistant professor of medicine at the State University of New York at Stony Brook.
Francis S. Kleckner, M.D., is a gastroenterologist in Allentown, Pennsylvania.
Samuel Klein, M.D., is a William H. Danforth professor of medicine and nutritional science and director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis.
Daniel B. Mowrey, Ph.D., of Lehi, Utah, is a psychologist who specializes in psychopharmacology and who has been researching the use of herbs in medicine for 15 years. He also is president of American Phytotherapy Research Laboratory in Provo, Utah, and the author of Herbal Tonic Therapies.
Betty Shaver is an herbalist and a lecturer on herbal and other home remedies who is based in Grahamsville, New York.
"Never eat within 2 1/2 hours before bedtime," says Dr. Kleckner. A bulging stomach and gravity working together are a sure way to force stomach acid upward into the esophagus.
If you bend at the stomach, you'll be compressing it, forcing acid upward. "Bend at the knees," says Dr. Kleckner. "It's not only a way to control acid, it's also better for your back."
Think again of the toothpaste analogy, says Dr. Kleckner. "Many people can get relief from heartburn simply by wearing suspenders instead of a belt."
"It doesn't matter whether it's yours or someone else's tobacco smoke—avoid it," says Dr. Kleckner. It will relax your sphincter and increase acid production.
All those little bubbles can expand your stomach, producing the same effect on the sphincter as overeating, says Dr. Good.
Caffeinated drinks such as coffee, tea, and cola may irritate an already inflamed esophagus. Caffeine also relaxes the sphincter.