9 Serious Conditions That Mimic Heartburn
Heartburn or something else?
Heartburn-like pain is a common symptom of gastroesophageal reflux disease (GERD). But several other conditions can cause a burning feeling in your chest.
Most of the time, your doctor will be able to identify whether you have heartburn or GERD by doing tests.
Here are nine other conditions that can cause heartburn-like pain.
"The major key is if you're getting heartburn when you're doing strenuous or moderate activity," says Ryan Madanick, MD, a gastroenterologist and assistant professor of medicine at the University of North Carolina School of Medicine, in Chapel Hill.
If you're 50 or older and getting heartburnespecially if you haven't had this kind of pain beforeit can raise suspicion of angina. Suspicions can also be raised if you're younger but have heart risk factors such as hypertension, diabetes, or a family history of heart disease. For more information, check out Heartburn or Heart Attack? How to Tell the Difference.
Pain may be cramping, dull, or sharp, and often strikes minutes after you eat.
If you're experiencing stomach pain after meals that doesn't improve after you take an over-the-counter acid-suppressing medication, gallstones should be suspected, says Joel Richter, MD, a gastroenterologist and chairman of the department of medicine at Temple University School of Medicine, in Philadelphia.
Acid-suppressing medications may relieve ulcer pain. But ulcers are usually caused by Helicobacter pylori, a type of bacteria that inflames the stomach lining, so you will need to take antibiotics to clear the infection.
Certain anti-inflammatory drugs (such as aspirin, ibuprofen, and naproxen), and osteoporosis drugs called bisphosphonates, can also cause stomach ulcers.
This can push food and stomach acid up into the esophagus, causing heartburn. Other signs of hiatal hernia include chest pain, belching, and nausea. If you have heartburn due to hiatal hernia, your doctor will typically prescribe acid-suppressing drugs, and recommend lifestyle changes like eating smaller meals, avoiding alcohol, and not eating right before bed. In rare cases, surgical repair may be warranted.
"If you have heartburn, it might be a sign of esophageal cancer, but it's highly unlikely," he says. Your doctor may decide to order an upper endoscopy to examine your esophagus if you've got long-standing heartburn, especially if you smoke or drink heavily, both of which are risk factors for esophageal cancer.
This test involves passing a tube with a light and a camera at one end down your throat into your esophagus. During the test, your doctor can look for abnormal areas as well as collect tissue samples to test for cancer.
Treatment can include dietary changes such as eating smaller meals, avoiding fat and fiber, medications, and, for people with very severe symptoms, inserting a feeding tube or an implanted device that emits electrical pulses mimicking stomach contractions.
The esophagus can also become inflamed from taking certain painkillers and osteoporosis medications, particularly if the pills are taken without water, allowing them to remain in the esophagus.
A third type of esophagitis, called eosinophilic esophagitis, occurs when white blood cells known as eosinophils invade the esophagus. The condition is often allergy-related, so treatment requires identifying and avoiding the offending foods. Doctors may also prescribe steroid medications to ease inflammation.
Pleuritis or costochondritis
Pleuritis is most commonly caused by a viral or bacterial infection, and resolves when the infection does.
Costochondritisan inflammation of the cartilage anchoring ribs to the breastbonecan cause sharp pain along the breastbone or sternum. It can be related to injury or infection, and typically is treated with anti-inflammatory medicines, pain relievers, and rest.
Reducing anxiety and stress through, for example, exercise, relaxation, and therapy, can also ease heartburn.
Dr. Madanick says that, as with other conditions that masquerade as GERD, "many times the only times we will see a patient…is when the over-the-counter medications haven't worked, because the medications tend to be very effective for treating simple heartburn."