What Causes Heartburn? Symptoms and Home Remedies

Heartburn is an uncomfortable, burning sensation felt behind the breastbone, caused by stomach acid escaping back into the esophagus (food pipe). It usually worsens after eating heavy, greasy, or spicy meals, when lying flat on your back, or when bending over. Also known as acid indigestion or acid reflux, this condition is fundamentally caused by the protective valve between the esophagus and the stomach failing to function properly.

In short:

• Heartburn occurs when stomach acid flows back into the esophagus.
• Overly fatty foods, chocolate, caffeine, alcohol, and stress are the most common triggers.
• Mild complaints can usually be managed by changing dietary habits.
• Symptoms like chest pain, difficulty swallowing, or black, tarry stools require immediate medical evaluation.
• Specialist physicians frequently use endoscopy for a definitive diagnosis and treatment planning.

What is Heartburn and How Does It Develop?

For our digestive system to function healthily, our stomach secretes a strong acid to break down food. The inner lining of the stomach is covered with a special mucous layer resistant to this acid. However, the inner lining of the esophagus does not have such a robust protective layer. At the point where the esophagus meets the stomach, there is a muscular valve called the lower esophageal sphincter. This valve opens as food passes into the stomach and then closes tightly to prevent stomach contents from coming back up.

When this valve relaxes or weakens for various reasons, stomach acid and digestive fluids escape back into the esophagus. The contact of acid with the sensitive tissue of the esophagus leads to a burning sensation in the chest area. Referred to as pyrosis in medical literature, this complaint is quite common among adults. Mild heartburn experienced less than twice a week is usually caused by occasional dietary missteps, whereas more frequently recurring episodes may indicate a chronic digestive system issue.

What Causes Heartburn? What Are the Risk Factors?

The answer to what causes heartburn—a complaint many people experience in their daily lives—is often hidden in dietary habits and lifestyle. Especially dishes frequently found in Turkish cuisine, such as those rich in tomato paste, heavily spiced, and deep-fried, can cause the valve to relax, facilitating acid reflux. In addition to acidic foods like raw onions, garlic, tomatoes, and citrus fruits, the consumption of chocolate, mint, overly steeped black tea, and traditional Turkish coffee can also directly increase complaints.

One of the most significant non-dietary risk factors is excess weight. Fat accumulation in the abdominal area applies physical pressure to the stomach, causing acid to be pushed upwards. Similarly, during pregnancy, the growing uterus presses against the stomach, and changing hormone levels relax the digestive system muscles, triggering a burning sensation. Smoking is a serious risk factor as it impairs the function of the lower esophageal sphincter. Furthermore, wearing tight clothing, using tight belts, lying down immediately after eating, and being under intense stress also disrupt the stomach acid balance, paving the way for symptoms to emerge.

Symptoms of Heartburn and Acid Reflux

The most characteristic symptom of heartburn is a hot, burning sensation that starts behind the breastbone and sometimes radiates to the neck and throat. This sensation is often accompanied by a bitter or sour fluid coming into the mouth. People frequently describe this condition as acid indigestion. Symptoms typically become more pronounced after a hearty meal, especially when lying down in bed during the evening hours.

While mild symptoms only appear after eating, different symptoms may be added to the picture in more serious cases. Chronic acid reflux can cause constant irritation in the throat, leading to a persistent dry cough, hoarseness, and a feeling of a lump in the throat. Some patients start their day with a bad taste in their mouth and a burning sensation in their throat when they wake up in the morning. This burning and pressure sensation in the chest is sometimes so severe that individuals may confuse the situation with a heart attack, experiencing great anxiety.

How is it Diagnosed at the Hospital?

For mild and infrequent complaints, doctors can usually make a diagnosis based on the symptoms described by the patient and their medical history. However, if complaints occur more than twice a week, lower the quality of life, or do not respond to basic treatments, further investigations are required. The most common and reliable diagnostic method used in the hospital is upper gastrointestinal endoscopy (gastroscopy). During this procedure, the esophagus, stomach, and duodenum are directly examined with a flexible tube equipped with a small camera at the tip, and a tissue sample (biopsy) is taken if necessary.

Besides endoscopy, a pH monitoring (acid measurement) test can be applied to measure the amount and duration of acid reflux. In this test, acid levels are recorded for 24 hours via a thin catheter or a small capsule placed in the esophagus. Additionally, a test called esophageal manometry, aimed at evaluating the contraction movements of the esophagus and the pressure of the valve, provides valuable information to physicians during the diagnostic process.

What is Good for Heartburn? Home Care and Medical Treatment

The answer to what is good for heartburn—one of the topics patients are most curious about—consists of a combination of simple precautions to take at home and medical treatments under a doctor's supervision. The first change you can make at home is to reduce your portion sizes and eat your meals slowly, chewing well. Preventing the stomach from becoming overly full significantly reduces the risk of acid reflux. Not lying down for at least three hours after eating and avoiding snacking right before bedtime makes a big difference. Elevating the head of your bed by about 15-20 centimeters while sleeping makes it harder for acid to escape into the esophagus due to gravity. Additionally, chewing sugar-free gum can help neutralize the acid that escapes into the esophagus by increasing saliva production.

In the medical treatment phase, different groups of medications are used depending on the severity of the symptoms. For mild and sudden heartburn, antacid syrups or chewable tablets that quickly neutralize stomach acid are preferred. For a more permanent solution, H2 receptor blockers or proton pump inhibitors (PPIs) that reduce stomach acid production may be prescribed by a physician. For more detailed information on dietary adjustments, you can review our acid reflux diet guide to learn how to shape your daily habits.

Complications of Untreated Heartburn

Although heartburn may seem like a simple indigestion problem, it can lead to permanent damage to the esophagus when left untreated for a long time. The continuous contact of stomach acid with the esophageal mucosa causes severe inflammation called esophagitis. Over time, this inflammation can lead to tissue damage, bleeding, and narrowing (strictures) in the esophagus, creating difficulty swallowing.

One of the most serious complications is a condition called Barrett's esophagus. Constant acid exposure causes the structure of the cells in the lower part of the esophagus to change. This cellular change is considered a factor that increases the risk of esophageal cancer in the long term. Furthermore, chronic acid problems can sometimes be associated with sores in the stomach lining; such conditions can show similarities with stomach ulcer symptoms and must absolutely be evaluated by a specialist physician.

When to See a Doctor and Emergencies

If heartburn complaints do not pass despite lifestyle changes and over-the-counter antacids, or if they recur more than twice a week, you should definitely consult a specialist physician. Symptoms such as a feeling of food getting stuck or pain when swallowing (dysphagia), unexplained weight loss, persistent nausea, vomiting that looks like coffee grounds, or black, tar-colored stools can be harbingers of a more serious underlying digestive system disease.

However, not every burning sensation or pain in the chest area originates from the stomach. If the severe pressure and pain you feel in your chest radiate to your left arm, back, neck, or jaw, and are accompanied by shortness of breath, dizziness, and cold sweating, this situation could be a sign of a heart attack. When faced with such a scenario, you should call 112 emergency services without delay or go to the nearest hospital's emergency department.

The Process at BHT CLINIC İstanbul Tema Hastanesi

For your stomach and digestive system complaints, BHT CLINIC İstanbul Tema Hastanesi is by your side with its expert staff in the Gastroenterology Department. In cases requiring urgent intervention, such as severe chest pain, our emergency department, which provides uninterrupted service 24/7, quickly distinguishes between heart and stomach-related issues and initiates the necessary treatment. For your outpatient clinic visits, our physicians first perform a detailed physical examination and listen to the history of your complaints.

When coming to our hospital, having any previous blood tests, endoscopy reports, and a list of your regular medications with you will speed up the diagnostic process. In our endoscopy unit equipped with advanced technology, procedures are performed under light sedation (sleepiness), painlessly and safely for the comfort of our patients. Once the diagnosis is made, the most appropriate medical treatment and nutrition plan for you is meticulously created by our specialists.

Frequently Asked Questions

Why does heartburn occur during pregnancy?

The progesterone hormone secreted during pregnancy relaxes the digestive system muscles and the esophageal valve. Additionally, the growing uterus applies physical pressure to the stomach, making it easier for stomach acid to escape upwards. This condition usually resolves on its own after birth.

Is drinking milk good for heartburn?

Drinking cold milk can momentarily soothe the esophagus and alleviate the burning sensation. However, because the fat and proteins contained in milk can cause the stomach to secrete more acid, it may lead to complaints returning more severely than before a few hours later.

How is heartburn distinguished from a heart attack?

Heartburn usually starts after meals, is characterized by sour fluid coming into the mouth, and is relieved by antacid medications. Heart attack pain, on the other hand, is a severe feeling of pressure that increases with physical exertion, radiates to the arm or jaw, and is accompanied by shortness of breath and cold sweating. In case of doubt, you must absolutely visit the emergency department.

Can stomach-protecting medications be used continuously?

Medications that suppress stomach acid, such as proton pump inhibitors (PPIs), should be used for the duration and at the dose recommended by a physician. Their continuous use for many years without a doctor's supervision can impair the absorption of certain vitamins and minerals (like B12 and calcium).

Does stress increase stomach acid?

Intense stress can affect the body's nervous system, slowing down digestive processes and increasing sensitivity to pain. Furthermore, irregular eating, excessive caffeine, and smoking, which often increase during stressful periods, directly trigger heartburn complaints.

To protect your digestive system health and find permanent solutions to your complaints, you can book an appointment to consult with our specialist physicians.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.