Conditions That Feel Like Heartburn

Chances are you've experienced heartburn, or the burning feeling and pain in your chest after eating. Heartburn occurs when stomach acids back up into your esophagus, or the tube that carries food from your throat to your stomach. While heartburn usually isn't serious, some more concerning conditions may be mistaken for heartburn. Therefore, it’s important to know the differences between everyday heartburn and more serious conditions to get the treatment that is right for you.

Conditions That Have Heartburn as a Symptom

Sometimes the heartburn you have isn't just everyday heartburn, but can be one of the symptoms of an underlying condition. 

GERD

If you experience heartburn symptoms after a meal more than twice a week, you may have gastrointestinal reflux disease (GERD). GERD is a chronic condition that causes heartburn and regurgitation, or stomach acid that can flow into the throat and mouth. Other symptoms may include:

• Chest pain
• Nausea
• Difficulty swallowing
• Chronic cough
• Hoarse voice
• Difficulty breathing

Talk to your healthcare provider if you continue to experience GERD symptoms despite lifestyle changes and over-the-counter (OTC) medications for relief. They may be able to prescribe additional medications and create a treatment plan that is best for you.

Hiatal Hernia

A hiatal hernia can occur when the upper part of your stomach pushes into your chest through the hiatus, an opening in your diaphragm. This can impact the lower esophageal sphincter by creating a gap between the esophagus and stomach. As a result, stomach acid can escape and cause heartburn.

Minor hiatal hernias often do not present with symptoms. However, severe cases may cause heartburn, regurgitation, nausea, difficulty swallowing, and coughing—all of which mimic GERD symptoms. If these symptoms persist, talk to your healthcare provider to find the treatment that is right for you. Treatment for severe hiatal hernias can often include diet changes, medications, or surgery.

Stomach Ulcer

Stomach ulcers, or peptic ulcers, are sores that can appear on your stomach lining. If you have a stomach ulcer, you may experience heartburn, dull burning pain in your stomach, belching, nausea, a loss of appetite, and weight loss. Symptoms can:

• Arise on an empty stomach, such as between meals or while sleeping 
• Be temporarily managed with antacids (medicines that neutralize the acid in your stomach) and may go away when eating 
• Last several minutes to several hours
• Flare up and then go away over a period of several days or weeks

Stomach ulcers can be caused in a variety of ways. Some causes include:

• Prolonged non-steroidal anti-inflammatory drug (NSAID) use: NSAIDs are pain and inflammation-reducing drugs, such as Advil (ibuprofen), Bayer (aspirin), and Aleve (naproxen). They can damage the stomach lining when taken daily or for long periods of time.
• Bacterial infections: Harmful bacteria called H. pylori can infect your digestive system and damage the mucus lining of the stomach. The bacteria can often be found in contaminated food and water. Too much damage to the stomach lining can cause an ulcer.
• Tumors: Ulcers can also occur if you have Zollinger-Ellison syndrome, a rare condition that forms cancerous tumors in the stomach and pancreas. The cancer cells release a highly acidic hormone called gastrin which can damage stomach tissues and cause ulcers. 

Stomach ulcers can also lead to more serious complications. Reach out to your healthcare provider if you begin to feel light-headed, experience muscle weakness, have difficulty breathing, or notice blood in your vomit or stool.

Treatment options for stomach ulcers depend on the cause. Your provider may prescribe proton pump inhibitors (PPI) such as Nexium (esomeprazole) and Prilosec (omeprazole), histamine blockers like Pepcid (famotidine), or antibiotics to protect the stomach lining.

Pregnancy

You may experience heartburn if you are pregnant. When you're expecting, the female sex hormones estrogen and progesterone are elevated. These high levels can affect the function of the lower esophageal sphincter and create a gap between the stomach and esophagus. This can cause stomach acid to leak into the throat and produce heartburn symptoms.

Heartburn can get worse during the third trimester of pregnancy, as the uterus starts to put pressure on the stomach. This can force stomach acid to back up into the throat.

Typical prevention and treatment options may include:

• Eating five or six smaller meals throughout the day, rather than larger ones
• Eating yogurt to help reduce acid
• Avoiding lying down after eating
• Avoiding oily or spicy foods 
• Taking over-the-counter antacids
• Taking prescribed medications, such as PPIs and histamine blockers

Esophagitis

Esophagitis occurs when the lining of the esophagus becomes inflamed. This can happen if you experience acid reflux, take oral medications, or have allergies or asthma. Symptoms typically include heartburn, chest pain, regurgitation, and difficulty chewing and swallowing food.

Your healthcare provider may recommend the following treatments:

• Quitting or reducing tobacco or alcohol use
• Avoiding fatty, oily, and spicy foods and drinks
• Taking PPIs or antihistamine medication
• Stopping any medications that may cause esophagitis

Barrett's Esophagus

If GERD is left untreated, you may experience Barrett's esophagus. This occurs when too much stomach acid leaks into the throat and damages the lining of the esophagus. This condition can cause inflammation in the throat, heartburn, regurgitation, and difficulty swallowing food.

In rare cases, Barrett's esophagus can develop into esophageal cancer. It is recommended to visit your healthcare provider to learn about your prevention and treatment options. Treatments may include medications or surgery to remove affected tissue or destroy unhealthy cells. In serious cases, the esophagus may be removed and rebuilt using parts of the stomach and intestines.

Gastroparesis

Gastroparesis, or gastric emptying, is a condition that slows down digestion. This happens when the stomach muscles become too weak to pass food into the small intestine. This condition can also occur if you have diabetes due to damage to the vagus nerve, which controls stomach muscles.

When digestion is delayed, people with gastroparesis may experience heartburn, indigestion, belching, bloating, and nausea. It is advised to seek immediate medical care if you also experience:

• Sudden sharp or heavy stomach pain
• Elevated or abnormally low blood sugar levels
• Blood in the vomit or vomiting for more than one hour
• Difficulty breathing 
• Fever
• Fainting
  

Anxiety

Anxiety can worsen heartburn symptoms. Studies have found a cyclical pattern between GERD and anxiety. Research suggests that having anxiety can worsen acid reflux symptoms and living with GERD can negatively affect emotional well-being and cause anxiety. Along with heartburn, symptoms of anxiety can include periods of intense worry, the inability to focus, feeling restless, and difficulty falling asleep.

If you're experiencing frequent heartburn with anxiety, speak to your healthcare provider. They may recommend treating your underlying anxiety in tandem with your heartburn.

Conditions That Cause Heartburn-Like Pain

Serious conditions like heart problems or gallstones can mimic heartburn. If you experience heartburn-like pain with additional symptoms, you may consider seeking more immediate medical attention.

Heart Disease

Sharp chest pains and heartburn are a couple of signs of heart disease. Heart disease is a general term for several conditions that affect the heart. There are different types of heart disease, but the most common is coronary artery disease (CAD) which clogs your arteries and blocks blood flow to your heart.

Heart disease can lead to other serious heart conditions:

• Heart attack: Symptoms of a heart attack such as chest pain and indigestion can mimic heartburn. Other symptoms may include pain and numbness in the limbs, nausea, difficulty breathing, dizziness, and fatigue.
• Cardiac arrhythmia: When the blood flow to your heart muscle gets blocked, you may notice a change in your heartbeat rhythm. This irregular heartbeat is called arrhythmia and can cause symptoms such as sharp chest pains, fainting, shortness of breath, and chest pounding. 
• Angina: When there is limited blood flow to your heart muscle, you may experience a type of pain called angina. Symptoms include severe pain in your chest, fullness in your stomach, and tightness in your upper body including the arms and neck. 

If you or a loved one experiences sudden heartburn symptoms such as a burning feeling in your throat or sharp chest pains, seek medical care immediately to rule out any serious heart conditions or receive treatment to prevent heart failure.

Gallstones

Gallstones are hard stones made of cholesterol that can form in the gallbladder, a pear-shaped organ behind the liver which stores bile. You can develop gallstones if there is too much cholesterol in your bile or if the gallbladder doesn’t empty itself completely. Most of the time you may not feel any symptoms with gallstones. However, if the gallstones block your bile duct, they can cause heartburn-like symptoms.

Common signs of gallstones include:

• Sudden stomach and chest pain that worsens when lying down 
• Heartburn and indigestion after eating
• Fever
• Nausea and vomiting
• Jaundice, or the yellowing of the skin and eyes
• Dark-colored urine

Gallstone complications can be very serious. Reach out to your healthcare provider if you experience symptoms that last several hours or abdominal pain that does not resolve with medication.

When to See a Healthcare Provider

If you experience heartburn symptoms more than two times a week or your symptoms do not resolve with lifestyle changes and medication, you may consider reaching out to your healthcare provider. Seek immediate medical attention if you begin to experience sudden serious symptoms such as sharp chest pains, shortness of breath, vomiting, or blood in your stool. 

Your symptoms may just be everyday heartburn. However, you may still consider seeing your provider so they can rule out underlying health conditions. When you visit a provider, you can expect them to ask about your medical history, perform laboratory or imaging tests, and talk to you about treatment options. 

A Quick Review

While occasional heartburn after eating is common, it may also be a sign of more serious health conditions such as GERD, hiatal hernias, or stomach ulcers. In severe cases, heartburn can also mimic symptoms of heart disease and gallstones. Medications, lifestyle adjustments, and surgeries are among treatment options for these cases. 

If your heartburn is persistent and resistant to treatment, see your healthcare provider for proper diagnosis and treatment options that are best for you.