Heartburn: Causes, symptoms, and treatments

What is heartburn?

As the name suggests, heartburn is the term given to an uncomfortable burning sensation in the chest due to stomach acid moving upwards through the digestive system towards the throat. This movement of stomach acid is called acid reflux and is a common condition in pregnant women. Recurring heartburn is sometimes referred to as gastro-oesophageal reflux disease, or GORD.

What causes heartburn?

There are a wide range of factors that can contribute to the onset of heartburn. Sometimes the direct cause might not be apparent, but the following have been linked to triggering episodes of heartburn and acid reflux:

External factors

• Heightened stress or periods of anxiety

• Smoking

• Certain food and drink including caffeine, alcohol, fatty or spicy foods, tomatoes, and chocolate

• Taking certain medicines like anti-inflammatories such as ibuprofen

Other medical conditions

• Obesity

• A stomach ulcer

• Increased hormone levels (progesterone and oestrogen)

• A bacterial infection in the gut

• A hiatus hernia

Heartburn and acid reflux can occur more frequently in pregnancy for a number of reasons, including the shift in hormone levels associated with being pregnant. As your baby grows, it can put increased pressure on your stomach which can lead to heartburn and indigestion. This can occur at any stage during the pregnancy, although it’s more common in the second and third trimesters. Antacid medicines can help ease symptoms and your pharmacist will be able to advise which medications are suitable for use during pregnancy.

What are the symptoms of heartburn?

As well as the burning sensation in your chest, heartburn and acid reflux can also be characterised by the following symptoms:

• Recurring hiccups or a cough

• A raspy voice

• Nausea and bringing up undigested food

• Smelly breath

• An unpleasant taste as a result of stomach acid

• Feeling overly full and bloated

• Burping

When caused by heartburn, indigestion, and acid reflux, these symptoms will usually be most prominent shortly after eating, when bending forward, or when lying down.

Available treatment options for heartburn

While it’s not thought to pose a serious risk to health, heartburn and acid reflux can cause discomfort and inconvenience, having a negative impact on our lives. There are treatments however that can ease symptoms and reduce the risk of heartburn and indigestion. These include over-the-counter and prescription-only medicines, as well as things you can do yourself at home to manage the condition. It's important to note that persistent or severe symptoms should be discussed with a healthcare professional to rule out more serious conditions like gastro-oesophageal reflux disease (GORD) or other digestive issues.

Antacids work by neutralising stomach acid and don’t need a prescription from your doctor. They’re often combined with an alginate which provides a cooling, protective layer to help prevent the burning sensation. Popular brands include Gaviscon and Pepto-Bismol, and you can buy these from a pharmacy or supermarket. They’re intended for short-term relief of symptoms and won’t treat the underlying cause of heartburn and acid reflux. If you experience long-term recurring heartburn, have a chat with your GP.

Proton pump inhibitors (PPIs) are a group of medicines that reduce the production of stomach acid and prevent it from building up, helping to limit acid reflux and heartburn. Common PPIs include Omeprazole and Lansoprazole. These preventative medicines are usually taken once a day. Omeprazole can be purchased from a pharmacy while Lansoprazole is only available with a prescription.

Lifestyle changes and home remedies can help to reduce your risk of experiencing heartburn and acid reflux. Regular activity such as a 30-minute walk each day can help you maintain a healthy weight. You might want to try smaller meals spread out across the day rather than the traditional three meals morning, noon, and night. Loose-fitting clothes around your waist can also reduce pressure and discomfort on your stomach. If you’re not sure whether certain food and drink is triggering your heartburn and acid reflux, keep a food diary for a week or so and note down when your symptoms occur to identify any patterns. If you’re a smoker and want to know more about resources available to help you quit, visit our Stop Smoking Advice hub.  

When to seek urgent medical attention

If you experience a burning sensation in your chest along with any of the following symptoms, call 999 immediately as it could mean you’re having a heart attack:

• Shortness of breath or difficulty breathing

• Pressure or tightness in your chest spreading to your arms, neck, or back

• Sudden light-headedness or dizziness

• Nausea and/or vomiting

• Hot or cold sweats

• A sudden anxiety attack

Learn more about heart attacks and how you can reduce the risk of experiencing one in our Heart Health article.