What is Heartburn?

Your esophagus is the tube that transfers food and liquids from your mouth to your stomach after you swallow. Heartburn usually occurs when acid from your stomach gets backwashed into your esophagus and irritates it. This is known as acid reflux.

What Does Heartburn Feel Like?

Patients often describe heartburn as a painful burning sensation, ranging from mild to severe in intensity. Although the burning originates in your esophagus, the pain can radiate to your chest, so it feels like it’s close to your heart. 

If your heartburn is the result of acid reflux, you may also experience:

• Burping and/or regurgitation of food (especially when lying down or bending over)
• A sour, bitter, or acidic taste in your mouth
• Nausea
• Pressure in your chest
• Difficulty swallowing 

What’s Causing My Heartburn?

The bottom of your esophagus has a valve—known as the lower esophageal sphincter (LES)—that opens when food is transferring from your esophagus to your stomach.

Your LES is meant to close right after the food enters your stomach in order to protect your esophagus from stomach acid. However, certain things can gradually cause your LES to weaken, thus enabling acid reflux and triggering heartburn. These things include:

• Spicy, rich, or acidic foods/drinks (coffee, chocolate, citrus fruits, tomato sauce, alcohol)
• Eating too quickly
• Lying down soon after eating
• Smoking
• Exposure to second-hand smoke
• Obesity
• Pregnancy
• Tight clothing
• Certain medications, such as aspirin, ibuprofen, birth control pills, benzodiazepines, and blood pressure medications
• A hiatal hernia, when the top of your stomach bulges up over your diaphragm

If you only have heartburn occasionally, it is likely due to intermittently experiencing or engaging in one or more of the factors listed above.

If you are experiencing heartburn frequently, it may be due to one of the following conditions:

• Gastroesophageal reflux disease (GERD): When your LES is perpetually weakened due to chronic acid reflux (i.e., having acid reflux more than twice a week). Around 20% of the U.S. adult population have GERD.
• Barrett’s esophagus: When chronic acid reflux alters the cellular makeup of your esophageal lining.
• Eosinophilic esophagitis: When inflammation triggered by white blood cells in your esophagus leads to esophageal dysfunction—which, when untreated, can cause your esophagus to narrow due to scar tissue buildup.
• Achalasia: When the muscles in your esophagus don’t function correctly to push food down into your stomach.