Can Heartburn Be Something Serious?

If you feel a burning sensation in your chest after a meal, you would think of heartburn. More so, if you have had a heavy, fatty, or spicy meal. But is that the only thing? Or could there be other causes of heartburn? Can heartburn be something serious?

Heartburn is one of the typical symptoms of gastroesophageal reflux disease (GERD). But heartburn can also be a symptom of other conditions, some of which can be serious.

What Does Heartburn Feel Like?

Heartburn is an uncomfortable feeling behind the breastbone, with a burning sensation or sometimes even pain. The discomfort can move upwards causing burning in the throat.1 Heartburn may also cause a sour or bitter taste at the back of your mouth or throat, which may also make you feel nauseated. Heartburn may last for a few minutes or a few hours. It is often noted after a heavy meal or bending or lying down soon after a meal.

While occasional heartburn is common, often occurring due to some faulty dietary or lifestyle habits, frequent heartburn may be a cause of concern. Repeated heartburn could be due to acid reflux, which itself is a risk factor associated with other gastroesophageal conditions. This happens when the lower esophageal sphincter (LES) becomes weak and gets relaxed when not needed.2 Normally, this sphincter closes the opening and does not allow the stomach acid to enter the esophagus. However, when the LES relaxes when not needed, it allows the backflow of stomach acid into the esophagus. The regurgitation of stomach contents and acid into the esophagus results in a burning pain in the chest and throat region.

Can Heartburn Be Something Serious?

Heartburn is common after a heavy meal or excessive intake of certain foods or stimulants like coffee, smoking certain medications like anti-inflammatory drugs. It is also commonly seen during pregnancy.

However, there are other conditions too that may present with symptoms similar to heartburn. It is important to know the other causes of heartburn or acid reflux and the conditions that may mimic heartburn. This can give an idea that heartburn can be something serious too, requiring timely medical attention.

Angina/Heart Attack

Angina, also called chest pain is caused when the blood flow to the heart gets interrupted. This may present with symptoms similar to heartburn and maybe neglected in mild cases. When discussing if heartburn can be something more serious, this condition must be surely considered. Heartburn like symptoms occurring suddenly after exertion, strenuous activity or sometimes heavy meals may lead to suspicion of angina.

Heartburn is often accompanied by reflux of stomach contents, burning pain in chest and throat, regurgitation, and a sour taste in the mouth. Angina or heart attack may occur with the tightness of chest, nausea, heartburn, shortness of breath, dizziness, and fatigue.3 Ageing, high blood pressure, diabetes, high blood cholesterol, being overweight, and smoking increase the risk of a heart attack.

Esophagitis/Gastritis

Sometimes heartburn is not just acid reflux but can be due to something more serious in the digestive system. Esophagitis is the inflammation of the esophageal lining while gastritis is the inflammation of the gastric mucosal lining. These conditions are often a result of frequent acid reflux that can result in a burning pain in the chest. This could be one of the underlying conditions that cause heartburn. Esophagitis and gastritis can be caused due to intake of certain chemicals or substances that harm the mucosal lining. The condition often worsens on taking painkillers, certain food items, or due to allergic reactions. Proper diagnosis and appropriate treatment can help control the symptoms and reduce heartburn.

Gall Bladder Disease

Gall stones are the commonest gall bladder disease but they rarely show any symptoms. In most cases, gallstones present with complaints when a stone obstructs the bile duct or an acute condition like cholecystitis. The symptoms include pain in the center or right upper part of the abdomen, sometimes also the right shoulder blade and burning in the chest and throat. It may be accompanied by nausea and vomiting. The pain may be dull or sharp and often comes after a meal. When considering if heartburn could be something serious, gall stones are one of the conditions to be evaluated. The treatment used for acid reflux may not provide any relief or may relieve some symptoms but if the pain persists, a thorough evaluation is needed.

Hiatus Hernia

A hiatus hernia occurs when some part of the stomach bulges through the diaphragm towards the chest cavity. This can result in acid reflux resulting in symptoms like chest pain, burning pain with nausea. This too is one of the conditions that may cause heartburn but can be something more serious and needs timely evaluation and treatment. Acid reflux treatment may help to some extent, along with diet and lifestyle modifications. However, in severe cases, surgery may be advised.

Stomach Ulcer

Stomach ulcers occur when the gastric mucosal lining develop sores that are painful and cause great difficulty. It may cause acid reflux, heartburn, burning pain in the chest and throat, gnawing pain in the stomach, usually related to food intake. Certain foods or medicines like pain killers may worsen the pain while some foods may offer relief. Antacids may offer temporary relief but as the stomach ulcers are mostly caused due to Helicobacter pylori, antibiotics may be needed. A stomach ulcer is one of the serious conditions that heartburn can be related to and needs to be treated in time to prevent complications.

Esophageal Cancer

Although rare, heartburn can also be due to something serious like esophageal cancer. Repeated and frequent acid reflux or heartburn, burning pain in the throat, regurgitation of food and water causing irritation and a sour taste in the throat, pain behind the sternum can be some of the signs that need attention. Alcohol and smoking can worsen heartburn and also increase the risk of cancer.

Costochondritis

Costochondritis is the inflammation of the cartilage around the ribs and the breastbone. This can occur due to injury, infection, inflammatory conditions, bone, and joint problems. The symptoms include pain around the chest area with burning pain behind and around the sternum. These may appear as heartburn and may often be overlooked.

Anxiety/Stress

Anxiety and stress or sometimes panic attacks can present with symptoms similar to heartburn. While anxiety cannot cause acid reflux, it can worsen an existing problem. Some people also have both acid reflux and anxiety making the situation even more complicated. However, if the condition does not improve with acid reflux treatment, it may be an indication that anxiety is resulting in symptoms like heartburn. Relaxation therapies, exercise, and counseling can help relieve anxiety and stress.

Gastroparesis

Gastroparesis is a slow movement of the food through the stomach, which can mimic heartburn. This can be due to improper functioning of the nerves, as a nerve complication of poorly controlled diabetes or other causes. This condition may present symptoms like heartburn but needs to be properly diagnosed and treated.

Warning Signs That Heartburn Can Be Something Serious

Heartburn caused due to occasional acid reflux may get better with the necessary diet and lifestyle changes and with some medications. However, if it occurs often it may be a cause of concern, as it could be due to a serious underlying gastric problem. Also, sometimes heartburn can be a sign of something serious or a condition that needs immediate medical help.

Some of the warning signs that heartburn can be something serious include the following

  • Frequent heartburn
  • Nausea and vomiting
  • Gastrointestinal complaints
  • Difficulty swallowing
  • Severe chest pain or squeezing sensation
  • Sweating
  • Fatigue or exhaustion
  • Sudden dizziness

People having heartburn due to acid reflux-related conditions often respond well to treatment with antacids along with lifestyle changes. Avoiding certain types of food, limiting alcohol, quitting smoking is advised. Other lifestyle measures like avoiding lying down soon after eating, raising the head when sleeping, and maintaining an ideal weight can help relieve the symptoms.

However, if you do not see any improvement in symptoms or experience other complaints or warning signs it is best to consult your physician immediately.

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