Heartburn – causes, symptoms and other complications


Heartburn is a burning sensation in the chest which often happens with a bitter taste in the mouth or throat. The symptoms of this condition can get worse when you eat some large meal or when you are lying down. In the most cases you can treat the symptoms of this condition at your home and you will notice a success in it. But if you have noticed that frequent heartburn makes it difficult to swallow or eat, then these symptoms may be a sign of some serious medical problem.

Causes for heartburn

This condition is usually happening when contents from your stomach back up into your esophagus. Heartburn is a symptom of gastroesophageal reflux disease – GERD and this condition is caused by acid refluxing back into your esophagus [1]. We know that esophagus is a tube which is carrying the food and fluids from our mouths into our stomachs. The esophagus is connecting our stomach as a juncture which is known as cardiac or lower esophageal sphincter. If the lower esophageal sphincter is functioning properly, then it closes when the food leaves our esophagus and it enters the stomach. But there are some people in which the cardiac sphincter is not functioning properly or it can become weakened. This can lead to contents from your stomach leaking back into your esophagus. Stomach acids can irritate your esophagus and they can cause you symptoms of heartburn. This condition is also known as reflux. Also there are some cases in which heartburn can be a result of a hiatal hernia. [2] This is happening when part of your stomach is pushing through your diaphragm and into your chest. This condition is also a very common condition during pregnancy. When woman is pregnant, then the progesterone hormone can cause the lower or cardiac esophageal sphincter to relax. [3] This is allowing stomach contents to travel into your esophagus which is causing an irritation. There are some common foods and drinks which are stimulating the increased stomach acid secretion setting for the stage for the heartburn.

heartburn Following are other health conditions or lifestyle choices which can worsen your heartburn

  • Taking certain medications, such as aspirin or ibuprofen [4]
  • Alcohol [5]
  • Carbonated beverages [6]
  • Lying down immediately after eating [7]
  • Acidic juices such as pineapple, orange and grapefruit juices [6]
  • A hiatal hernia where a portion of your stomach lies within your chest instead of the in your abdomen, can affect the way the LES works and also this is one of the risk factors for reflux. Hiatal hernias by themselves are causing no symptoms. When the LES fails, then the heartburn is happening. [2]
  • Naproxen
  • Pregnancy can cause increased pressure within the abdominal cavity and it can affect the LES function fails that heartburn occurs [3]
  • Eating spicy foods [7]
  • Primary diseases of the esophagus can also prevent the heartburn as a symptom. These include among others, sarcoidosis and scleroderma.
  • Consuming caffeine or chocolate [7]
  • Acidic foods such as oranges, grapefruit and tomatoes [6]
  • Being overweight or obese. Obesity can also cause increased pressure in your abdomen and thus reflux in the same way. [8]
  • Smoking and the consumption of foods that are high in fat can affect the function of your lower esophageal sphincter which is causing to relax from your stomach and it allows the acid to reflux into your esophagus. [9]

Complications: In the most cases heartburn is not a condition for which you should be concerned about. But if you have this symptom frequently, then this may be a sign that you have a serious underlying disease and you need a treatment about it. If you do not get treatment for serious heartburn, then you can develop additional health problems such as inflammation of the esophagus which is also known as Barrett’s esophagus or esophagitis. Barrett’s esophagus can cause changes in the lining of your esophagus which is increasing your risk of getting esophageal cancer. If you have long – term heartburn, then this can also affect the quality of your life. If you have noticed to do the everyday activities and you have a frequent heartburn, then you need to talk with your doctor as soon as possible.


[1] Clarrett DM. Gastroesophageal reflux disease (GERD). Missouri Medicine. 2018;115(3):214–8.

[2] Van Herwaarden MA, Samson M, Smout AJPM. Excess gastroesophageal reflux in patients with hiatus hernia is caused by mechanisms other than transient LES relaxations. Alimentary Tract. 2000;119(6):1439-46.

[3] Costigan KA, Sipsma HL, DiPietro JA. Pregnancy folklore revisited: the case of heartburn and hair. Birth. 2006;33(4):311-4.

[4] Masuda T, Yano F, Omura N, et al. Effect of low-dose aspirin on chronic acid reflux esophagitis in rats. Digestive Diseases and Sciences. 2018;63(1):72-80.

[5] Chen S, Wang J, Li Y. Is alcohol consumption associated with gastroesophageal reflux disease? Journal of Zhejiang University-Science B. 2010;11(6):423–8.

[6] Johnson T, Gerson L, Hershcovici T, et al. Systematic review: the effects of carbonated beverages on gastro‐oesophageal reflux disease. Alimentary Pharmacology & Therapeutics. 2010;31(6):607-14.

[7] Richter JE. Advances in GERD: Current developments in the management of acid-related GI disorders. Gastroenterology & Hepatology. 2009;5(9):613–5.

[8] Emerenziani S, Rescio MP, Guarino MPL, Cicala M. Gastro-esophageal reflux disease and obesity, where is the link? World Journal of Gastroenterology. 2013;19(39):6536–9.

[9] Kahrilas PJ, Gupta RR. Mechanisms of acid reflux associated with cigarette smoking. Gut. 1990;31(1):4–10.


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