What Does Heartburn Feel Like?   

What Does Heartburn Feel Like?

Young woman with blonde hair clutching her chest in pain, suffering from heart burn
Clinical Contributors to this story:
Elizabeth John, M.D.

For a condition so common—striking between 18 percent and 27 percent of adults in the United States at any given time—gastroesophageal reflux disease (GERD), known colloquially as reflux, can show up in surprisingly diverse ways. The most common presentation is heartburn.

Heartburn is the reflux of stomach acid into the esophagus, the tube that carries food from the mouth to the stomach. Symptoms can be unique to each person, says Elizabeth John, M.D., gastroenterologist at Mountainside Medical Group.

What Heartburn Can Feel Like

Dr. John says patients often describe heartburn symptoms in different ways:

  • Burning sensation in the chest, commonly when lying down
  • Pain right under their sternum, also called the breastbone
  • Regurgitation or nausea
  • Sensation radiating to the neck
  • Extreme chest pain

Many people also confuse heartburn with GERD. But heartburn is actually the most common symptom or presentation of GERD, a chronic condition that can lead to several potentially serious complications if untreated.

“GERD can also show up in unusual ways, including chest pain, chronic cough, hoarseness, tooth erosions or feeling like something is stuck in the throat,” Dr. John says. “GERD is a very complex diagnosis and can have some very serious implications.”

Triggers and Risk Factors

Many people know what triggers their bouts of heartburn, including:

  • Eating fatty or spicy foods, citrus fruits, tomato products or dark chocolate
  • Drinking caffeine or alcohol
  • Eating large meals or late at night
  • Taking certain medications

But these triggers differ from overall risk factors for developing heartburn and GERD, Dr. John notes:

  • You’re at higher risk of developing GERD if you’re pregnant, over 50 or a smoker.

  • Other predisposing factors include being overweight or obese; having a hiatal hernia, or bulging of the top of the stomach above the diaphragm; or certain connective tissue disorders.

  • For some, the circular band of muscle around the base of the esophagus—which normally relaxes to allow foods and drinks to flow to the stomach before closing again—doesn’t work properly, allowing stomach acid to flow back into the esophagus.

“If you have heartburn once in six months, it’s probably not GERD,” Dr. John says. “But if you have it once a week, you likely have GERD.”

Watch for Alarm Signs

Repeated exposure to stomach acid can prove dangerous for the esophagus over the long term, Dr. John says. Complications include a narrowing of the esophagus known as peptic strictures, damage to the lining of the esophagus, a precancerous condition called Barrett’s esophagus  and esophageal cancer.

Certain “alarm signs” should alert you that GERD may be leading to a bigger problem, Dr. John says:

  • Trouble or pain when swallowing, which might indicate a blockage or severe inflammation
  • Weight loss
  • Tar-like stools or vomit that looks like coffee grounds
  • Anemia, which can be triggered by blood loss inside the esophagus
  • Over-the-counter heartburn medications such as proton pump inhibitors or H2 blockers don’t improve symptoms

“If you have any of these signs, it’s definitely time to see a doctor,” Dr. John says.

Next Steps & Resources:

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.



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