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Get answers to your top questions about this pervasive digestive problem

By Katherine Solem 

Question #1: Why do I get heartburn?

Answer: Heartburn is caused by stomach acid backing up into the esophagus. Normally a band of muscles at the lower part of the esophagus (the esophageal sphincter) opens and closes to allow food and liquids to travel down into the stomach. If these muscles become weak or relaxed, stomach acid can flow back up, or "reflux," into the esophagus. This causes that characteristic burning sensation in the chest known as heartburn.

Question #2: What's the difference between heartburn and GERD?

Answer: Most people get heartburn every now and again. But when heartburn becomes chronic enough to warrant treatment, usually when you experience symptoms two to three times a week, it's called gastroesophageal reflux disease, or GERD.

Question #3: Why do I get heartburn at night?

Answer: It has to do with your body position. Lying down horizontally can put pressure on the esophageal sphincter and makes it easier for stomach acid to back up into your esophagus.

To control nighttime heartburn, try one of these tips:

• Elevate your head, shoulders and upper back so that it is about six inches higher than your stomach. To do this, place bricks or blocks under the head of your bed or use a wedge-shaped pillow under your mattress. (Using extra pillows just under your head won't work.)
• Sleep on your left side. Experts agree that this position is generally beneficial for heartburn sufferers. Studies show that lying on your left side helps promote digestion which helps to empty the stomach faster as compared to lying on your right side or back.
• Don't go to bed on a full stomach. Having a full stomach makes it more likely that stomach acid will back up into your esophagus. Don't eat or drink anything except water within three hours of bedtime.

Question #4: Does being overweight contribute to heartburn symptoms?

Answer: Yes, extra weight can cause heartburn by putting extra pressure on your stomach. This can cause reflux, or heartburn. In people who are overweight, losing just 10 to 15 pounds has been shown to relieve symptoms of chronic heartburn (GERD). Eating small, frequent meals can help you lose weight and is a good practice in general for preventing heartburn.

Question #5: Can foods in my diet contribute to heartburn symptoms?

Answer: Possibly. Certain foods are more likely to cause heartburn, including:

• Citrus fruits
• Chocolate
• Drinks with caffeine or alcohol
• Carbonated sodas
• Fatty and fried foods
• Mint flavorings like peppermint or spearmint
• Spicy foods
• Tomato-based foods, like spaghetti sauce, salsa, chili and pizza

To prevent heartburn caused by food:

• Limit your intake of the foods listed above to two-to-three times per week and keep serving sizes small.
• Eat slowly. Ideally, a meal should take at least 15 minutes to eat. This will aid in digestion and help prevent you from overeating.
• Drink a glass of water before every meal to help reduce the amount you eat.
• Eat a few smaller meals several times a day rather than eating two to three "traditional"-sized meals.

Question #6: Could my medication cause heartburn?

Answer: Certain medications can trigger heartburn even in those who never had it before. Talk to your doctor if you suspect your medication is triggering heartburn. But never stop taking any medication unless directed to do so by your doctor.

Question #7: Is heartburn serious?

Answer: If your heartburn is accompanied by chest pain or difficulty breathing seek medical attention as soon as possible as these can be signs of a heart attack.

Occasional heartburn is usually not serious and can be managed with over the counter medications such as antacids and by avoiding foods and other triggers that cause heartburn.

If you are having frequent heartburn symptoms (more than twice a week) or if over-the-counter medications do not relieve heartburn symptoms, make an appointment to see your doctor.

Question #8: How should I treat my heartburn?

Answer: There are several heartburn treatments ranging form over-the-counter and prescription medications to surgical options. Talk to your doctor about what treatment options are best for you, especially if you are experiencing heartburn several times a week on average. Frequent heartburn, or GERD, can cause damage to the esophagus. Learn more about heartburn treatment options.

Question #9: Can smoking cause heartburn?

Answer: Yes, smoking can cause heartburn. Smoking is believed to cause the esophageal sphincter to relax, thus allowing the back up of stomach acid. Also, smoking reduces the amount of saliva produced; saliva helps neutralize stomach acid. If you smoke, get help quitting. Your doctor can prescribe you medications to help.

Katherine Solem is a health writer and editor living in San Francisco.

See Also:

• 16 tips to tame heartburn
• Heartburn information and resources
• Learn more about gastroesophageal reflux disease (GERD)
• Get advice in our GERD Support Community
• Ask the GERD specialist your questions
• Digestive disorders? Talk to the GI doctor