Heartburn

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	Gastroesophageal reflux disease	Hiatal hernia
Hiatal hernia - X-ray

Heartburn is a painful burning feeling just below or behind the breastbone. It usually comes from the esophagus. The pain often rises in your chest and may spread to your neck or throat.

Pyrosis; Non-cardiac chest pain

Almost everyone has heartburn sometimes. If you have heartburn very often, you may have gastroesophageal reflux disease (GERD).

Normally when food or liquid enters your stomach, a band of muscle at the end of your esophagus closes off the esophagus. This band is called the lower esophageal sphincter (LES). If this band does not close tightly enough, contents from the stomach can back up (reflux) into the esophagus. This partly digested material can irritate the esophagus, causing heartburn and other symptoms.

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Heartburn is more likely if you have a hiatal hernia. A hiatal hernia is when the top part of the stomach sticks up into the chest cavity. This weakens the LES and makes it easier for acid to back up from the stomach into the esophagus.

Pregnancy and many medications can bring on heartburn or make it worse.

Drugs that can cause heartburn include:

• Anticholinergics (e.g., for sea sickness)
• Beta-blockers for high blood pressure or heart disease
• Calcium channel blockers for high blood pressure
• Dopamine-like drugs for Parkinson's disease
• Progestin for abnormal menstrual bleeding or birth control
• Sedatives for anxiety, or if you can't sleep (insomnia)
• Theophylline (for asthma or other lung diseases)
• Tricyclic antidepressants

If you think one of your medicines may be causing heartburn, talk to your doctor. NEVER change or stop taking medicine without talking to your doctor.

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).