Get urgent medical care if:

• You vomit material that is bloody or looks like coffee grounds.
• Your stools are black (like tar) or maroon.
• You have a burning feeling and a squeezing, crushing, or pressure in your chest. Sometimes people who think they have heartburn are having a heart attack.

Call your doctor if:

• You have heartburn often or it doesn't go away with a few weeks of self-care.
• You lose weight that you didn't want to lose.
• You have trouble swallowing (food feels stuck as it goes down).
• You have a cough or wheezing that does not go away.
• Your symptoms get worse with antacids or H2 blockers.
• You think one of your medicines may be causing heartburn. DO NOT change or stop taking your medicine on your own, without talking to your doctor first.

Heartburn is usually easy to diagnose from the symptoms you describe to your doctor. Sometimes, heartburn can be confused with another stomach problem called dyspepsia. If the diagnosis is unclear, you may be sent to a doctor called a gastroenterologist for more testing.

First, your doctor will do a physical examination and ask questions about your heartburn, such as:

• When did it begin?
• How long does each episode last?
• Is this the first time you have had heartburn?
• What do you usually eat at each meal? Before you feel heartburn, have you eaten a spicy or fatty meal?
• Do you drink a lot of coffee, other drinks with caffeine, or alcohol? Do you smoke?
• Do you wear clothing that is tight in the chest or belly?
• Do you also have pain in the chest, jaw, arm, or somewhere else?
• What medications are you taking?
• Are you vomiting blood or black material?
• Do you have blood in your stools?
• Do you have black, tarry stools?
• Are there other symptoms with your heartburn?

The following tests may be done:

• Esophageal motility to measure the pressure of your LES
• Esophagogastroduodenoscopy (upper endoscopy) to look at the inside lining of your esophagus and stomach
• Upper GI series

If you have not been able to improve your symptoms with home care, your doctor may prescribe medicine to reduce acid. These are stronger than over-the-counter medicines. Any sign of bleeding will need more testing and treatment.

Images

Hiatal hernia - X-ray

Heartburn

Gastroesophageal reflux disease

Hiatal hernia

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Heartburn Prevention

Review Date: 01/31/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)