Alternate Names: Pyrosis; Stomach acid; Acid stomach

Considerations: The backup of acid from the stomach into the esophagus causes irritation.

Common Causes:

• gastroesophageal reflux disease
• esophageal spasm
• drugs such as aspirin or NSAIDs

Home Care: Consult a health care provider about discontinuing medications that cause heartburn (such as sedatives, calcium channel blockers - oral, and anticholinergics). NEVER CHANGE MEDICATION WITHOUT CONSULTING YOUR HEALTH CARE PROVIDER.

Avoid coffee, alcohol, tobacco, large meals, and citrus fruits. Avoid eating 2 to 3 hours prior to bedtime. Avoid tight fitting clothing.

Elevate the head of the bed 4 to 6 inches. Lose weight if needed. (Talk with your health care provider before beginning an exercise program.)

Call If:

• there is vomiting of black, coffee ground-like, or bloody material.
• the stools are black in color (like tar).
• the problem becomes frequent or is prolonged.

What To Expect: The medical history will be obtained and a physical examination performed.

Medical history questions documenting heartburn in detail may include:

• time pattern
  • When did it begin?
  • How long did it last?
  • Is this the first time you have had heartburn?
• diet information
  • What is your usual diet like?
  • Do you drink excessive amounts of coffee?
  • Do you drink alcohol?
  • Have you recently eaten a spicy meal?
• other aggravating factors
  • Do you smoke?
  • Do you wear clothing that is tight in the chest or abdomen?
  • Are you overweight?
• radiation
  • Does the pain also appear in the chest, jaw, arm, or elsewhere?
• other
  • What medications are being taken?
  • Are you vomiting blood?
  • Are you vomiting a coffee ground-like or black material?
  • Is there blood in the stools?
  • Are there black, tarry stools?
  • Are there other symptoms accompanying the heartburn?

• barium swallow or upper GI series
• esophageal motility and acidity lab studies
• esophagoscopy