What is heartburn?
Heartburn is the common name for a burning sensation felt in the chest, usually just behind the breastbone. Despite its name, it has nothing to do with the heart. It happens when acid from the stomach travels back up the food pipe (oesophagus) towards the throat, a process called acid reflux. The lining of the oesophagus is not as well protected against acid as the stomach, so this causes the characteristic burning feeling.
Heartburn is extremely common and most people experience it occasionally, often after a large or rich meal. It can also bring a sour or bitter taste in the mouth, and may feel worse when lying down or bending over. While usually harmless and short-lived, frequent or persistent heartburn can be a sign of a condition called gastro-oesophageal reflux disease (GERD) and is worth addressing.
Common triggers
Heartburn is often brought on by particular foods, drinks and habits, which vary from person to person. Recognising your triggers helps you avoid them. Common triggers include:
- •Large or rich, fatty meals
- •Spicy foods
- •Coffee, alcohol and fizzy drinks
- •Citrus fruits, tomatoes and chocolate
- •Eating late or lying down soon after eating
- •Being overweight, which increases pressure on the stomach
- •Smoking
- •Stress, for some people
How to relieve and prevent heartburn
Most heartburn can be managed effectively with simple changes and remedies. For quick relief, antacids available from pharmacies neutralise stomach acid, and a pharmacist can advise on suitable options. To prevent heartburn, several measures help:
- •Eat smaller, more frequent meals rather than large ones
- •Avoid eating within a few hours of lying down or going to bed
- •Identify and limit your personal trigger foods and drinks
- •Raise the head of your bed slightly if heartburn is worse at night
- •Maintain a healthy weight
- •Avoid tight clothing around the waist
- •Cut down on smoking and alcohol
When heartburn needs attention
Occasional heartburn is normal and usually nothing to worry about. However, frequent heartburn — generally more than twice a week — or heartburn that persists despite lifestyle changes and antacids, should be checked by a doctor, as it may be GERD and benefit from stronger treatment such as acid-reducing medicines.
Certain symptoms always warrant prompt medical attention: difficulty or pain when swallowing, food getting stuck, unexplained weight loss, persistent vomiting, or signs of bleeding such as black stools or vomiting blood. Importantly, because the chest is involved, it is worth remembering that heart problems can sometimes feel like heartburn. If chest pain is severe, spreads to the arm, jaw or back, or comes with breathlessness or sweating, treat it as a possible emergency and seek urgent help rather than assuming it is heartburn.
Heartburn in pregnancy
Heartburn is very common during pregnancy, affecting many women, particularly in the later stages. There are two main reasons: hormonal changes relax the valve between the stomach and the food pipe, making it easier for acid to travel up, and as the baby grows, the womb presses on the stomach, increasing the pressure. This combination makes pregnancy heartburn especially common and sometimes persistent.
The good news is that pregnancy heartburn, while uncomfortable, is usually harmless and tends to resolve after the baby is born. Many of the same self-help measures apply: eating smaller, more frequent meals, avoiding trigger foods, not eating late, and propping yourself up rather than lying flat. Some remedies are suitable in pregnancy, but it is important to check with a midwife, pharmacist or doctor before taking any medication, as not all are recommended.
If heartburn in pregnancy is severe, persistent, or not helped by these measures, it is worth speaking to your midwife or doctor, who can recommend safe and effective treatment. There is no need to simply endure significant discomfort, as help is available.
When heartburn becomes a longer-term problem
While occasional heartburn is normal, frequent or persistent heartburn can indicate gastro-oesophageal reflux disease (GERD), where reflux happens often enough to cause troublesome symptoms or affect daily life. This is worth addressing, both for comfort and because long-standing acid exposure can irritate and inflame the lining of the food pipe over time.
Long-term reflux is very treatable. Alongside the lifestyle measures that help with occasional heartburn, doctors can prescribe acid-reducing medicines such as proton pump inhibitors, which are highly effective for frequent or persistent symptoms. The aim is both to relieve symptoms and to protect the food pipe from the effects of repeated acid exposure.
Because persistent heartburn occasionally signals something that needs closer assessment, doctors take ongoing reflux seriously, particularly when there are warning symptoms or it begins later in life. Seeking help for frequent heartburn allows both effective relief and appropriate checks where needed, rather than relying indefinitely on over-the-counter antacids.