Heartburn is caused by stomach acids irritating the lower part of the esophagus. Heartburn happens when the valve at the top of your stomach called the lower esophageal sphincter (LES) doesn’t close. These acids then enter the esophagus, which does not have the resistant stomach lining that would protect it from these corrosive chemicals. This creates a type of chemical burn.

The statement given by lay person to describe the pain in the chest that hurt so much it feels like it’s on fire. It usually occurs after heavy meals.

Heartburn is common, and an occasional episode is generally nothing to worry about. However, many people battle heartburn regularly, even daily. Frequent heartburn can be a serious problem, and it deserves medical attention. Frequent or constant heartburn is the most common symptom of gastroesophageal reflux disease (GERD).

Signs & Symptoms

Symptoms of heartburn can present in many forms, include:

  • Burning sensations in the chest below the breastbone (the sternum).
  • Chest pain, especially after bending over, lying down or eating.
  • Burning feeling in the throat or a hot, sour or salty-tasting fluid at the back of the throat.
  • Belching
  • Chronic coughing
  • Hoarseness
  • Wheezing or other asthma-like symptoms appearing in adulthood .


In chronic heartburn, the diagnosis of gastroesophageal reflux (GERD), Barrett’s esophagus, a peptic ulcer or cancer are possible. Consult your doctor to confirm the diagnosis. The complication include Oesophagitis, strictures and Barret’s oesophagus.


Most people can manage the discomfort of heartburn with lifestyle modifications and over-the-counter medications. But if heartburn is severe, these remedies may offer only temporary or partial relief. If you have GERD, you may need newer, more potent medications to reduce symptoms. In chronic heartburn, you might be able to find relief by changing what you eat and drink. It is also helpful to quit smoking. Over-the-counter antacids or bismuth subsalicylate can neutralize stomach acid and is sufficient for occasional heartburn. If this does not work, famotidine, nizatidine, cimetidine, ranitidine, lansoprazole or omeprazole may be prescribed to reduce the stomach acid production. Metoclopramide may also be prescribed to hasten stomach emptying.


Surgery may be required to repair the lower oesophageal sphincter and stop the reflux (the backwards flow from the stomach to the oesophagus) of acids. This is done using a laparoscope and requires only a short hospital stay. Gastroscopy is performed once in all patients before surgery to rule out the presence of complications such as Barrett’s oesophagus (a potentially cancerous condition of the oesophagus, and the result of a long-term exposure of the oesophagus to acid that has flowed backwards from the stomach) or cancer of the oesophagus. If Barrett’s oesophagus is found, yearly gastroscopy to rule out the progression to malignancy (cancer) is necessary.


Dietary measures

Changes in dietary habit may help reduce the symptom of heartburn:

  • Try to identify and avoid the foods that affect you the most. The worst offenders are hot and spicy food especially curry, carbonated drinks and preserved food.
  • Try cutting back on fried and fatty foods. Bloating may results from eating fatty foods. Fat delays stomach emptying and can increase the sensation of fullness.

Lifestyle modification

  • Try smaller meals. Eat several small meals throughout the day instead of two or three larger ones.
  • Eat slowly, chew your food thoroughly and don’t gulp. If you have a hard time slowing down, put down your fork between each bite.
  • Don’t eat when you’re anxious or upset. Take meals in a relaxed situation and eat slowly. Eating when you’re stressed can cause indigestion and heartburn.
  • Stop smoking. Cigarette smoking can cause.
Last Reviewed : 28 August 2020
Writer : Dr. A. Khalek Abd. Rahman
Reviewer : Dr. Nor Faizah bt. Ghazali