Heartburn: Signs and Symptoms and When it’s an Emergency

Heartburn, well, does just that… it burns. That burning sensation is caused by a backward flow, or reflux, of stomach acid into your esophagus. Your lower esophageal sphincter, the part where your esophagus connects to your stomach, prevents the contents of your stomach from escaping. But sometimes it relaxes or weakens and allows acid to flow backward into the esophagus. Since your esophagus isn’t resistant to acid the same way your stomach is, it can cause a painful, burning feeling in your chest.

Common heartburn symptoms include:

• Bitter or sour taste in the mouth
• Burning chest pain usually after eating or at night
• Chronic cough or sore throat from acid irritation
• Difficulty swallowing
• Hoarseness or voice changes
• Worsening pain when lying down or bending over

When you start to feel that tell-tale burning sensation in your chest, you may wonder how long your heartburn will last. Symptoms can last as little as a few minutes, or as long as several hours. Generally, however, the symptoms should begin to ease once you’ve properly digested your most recent meal. Healthy digestion typically takes around two hours, though it can take up to five hours for the small intestine to fully digest your foods.

Foods and Drinks That Trigger Heartburn

Here are some items you may want to avoid:

1. Alcohol drinks, such as wine and beer, relax the lower esophagus, allowing acids to escape from the stomach.
2. Caffeine in coffee, soda, and tea calms the lower esophagus, which can give you symptoms.
3. Carbonated beverages cause gastric distension. Don’t drink them at night, as they're known to cause nocturnal heartburn.
4. Chocolate not only has caffeine, but it also reduces lower esophagus pressure, research shows. But scientists still don't know if not eating chocolate can improve your heartburn.
5. Citrus fruits and juices are very acidic, which can trigger heartburn, especially if consumed on an empty stomach.
6. Coffee has both caffeine and acids, two things that cause heartburn. Try decaf or a low-acid roast.
7. Garlic and onion can cause pain in some people, but researchers aren't sure why. Raw onions do activate acid but cooking them helps.
8. High-fat foods such as French fries and pizza stimulate your stomach to produce more acid, irritating your esophagus. Greasy foods can also make heartburn more likely.
9. Peppermint is thought to also relax the LES. But we need more research to fully understand this.
10. Tomatoes are highly acidic and should be eaten occasionally if they give you symptoms.

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Heartburn vs. Heart Attack

Chest pain caused by heartburn can be like what you would feel if having a heart attack, which can be alarming. However, while you do feel a burning sensation in your chest in both cases, there are some key differences.

With heartburn you may:

• Experience it after eating or while laying down
• Feel a burning sensation in your chest
• Find you mouth tastes sour – as heartburn typically accompanies acid reflux
• Get relief from antacids

With a heart attack you may:

• Feel pain, tightness or aching in your chest or arms
• Feel tired, dizzy and lightheaded
• Find it hard to catch your breath
• Want to vomit

If you are experiencing chest pain but aren’t sure whether it’s heartburn, you should call 911 or go to your nearest emergency room.

Other Serious Conditions Related to Heartburn

Occasional heartburn is normal, but frequent or severe symptoms may indicate other conditions, such as:

1. Gastroesophageal Reflux Disease (GERD)
   • Heartburn more than twice a week
   • Persistent cough, sore throat, or wheezing
   • Regurgitation of food or acid

2. Esophagitis (Inflammation of the Esophagus)
   • Bleeding or black stools (signs of damage)
   • Chest pain unrelated to heartburn
   • Painful swallowing
3. Barrett’s Esophagus (Pre-cancerous Condition)
   • Chronic GERD symptoms
   • Increased risk of esophageal cancer

When to Go to the Emergency Room

• Chest pain that persists
• Difficulty swallowing or persistent sore throat
• Frequent heartburn (2 or more times a week)
• Symptoms persist despite over-the-counter medication
• Unintentional weight loss
• Vomiting blood or black stools

A doctor will determine if heartburn is a serious problem by evaluating symptoms, medical history, and diagnostic tests. Here’s how they assess the condition:

1. Medical History & Symptom Assessment

Frequency: Heartburn more than twice a week suggests GERD.
Severity: Intense, persistent, or worsening symptoms raise concerns.
Triggers: Certain foods, lying down, or exertion may indicate different conditions.

2. Diagnostic Tests

If symptoms indicate a bigger issue, a doctor may order:

Endoscopy – A flexible camera examines the esophagus and stomach for inflammation, ulcers, or Barrett’s esophagus.

pH Monitoring – A sensor measures acid reflux over 24 hours.

Esophageal Manometry – Tests how well the esophagus moves food to the stomach.

Barium Swallow X-ray – A special liquid highlights the esophagus on an X-ray to check for narrowing or damage.

Inform your health care provider if you had an episode of unexplained chest pain that went away within a few hours, and you did not seek medical attention. Both heartburn and a developing heart attack can cause symptoms that subside after a while. The pain doesn't have to last a long time to be a warning sign.

If you have persistent chest pain and you aren't sure it's heartburn, call 911 or go to the emergency room.

Common Remedies for Heartburn

Keeping tabs on your lifestyle and diet will have a positive impact on your overall health. Making these simple changes can help reduce or prevent heartburn.

Eat smaller meals – Large meals put pressure on the stomach.
Avoid trigger foods – Spicy, fatty, acidic, and caffeinated foods can worsen symptoms.
Don't lie down after eating – Wait at least 2-3 hours before lying down or going to bed.

Wear loose-fitting clothing – Wearing tight-fitting pants, jeans, or skirts can apply pressure to the part of your esophagus that connects to your stomach.
Elevate your head while sleeping – Raise the head of your bed by 6-8 inches to prevent acid reflux.
Maintain a healthy weight – Excess weight puts pressure on the stomach.
Quit smoking and limit alcohol – Both weaken the esophageal sphincter, leading to reflux.

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Find the Right Care for You at Bayhealth Total Care’s Emergency and Urgent Care Center

At Bayhealth Total Care’s Emergency and Urgent Care Center, our primary goal is to provide the residents of Sussex County with exceptional service and the proper billing for the care they need. Our combined emergency room and urgent care in Milton are fully equipped to handle everything from allergies to chest pain 24/7 with on-site labs, X-ray, ultrasound and CT.

Every patient at our ER and urgent care walk-in clinic is seen by an ER-trained physician at every visit, regardless of the level of care they need. Our approach makes care more affordable by avoiding the higher cost of the emergency room if patients only require urgent care services. Our ER and urgent care clinic is open 24/7.

Bayhealth Total Care’s Emergency and Urgent Care Center is located at 18383 Hudson Road, Milton, DE 19968.