Causes and risk factors of heartburn 

A deliciously indulgent meal can be ruined by the onset of burning in your chest, chest pain and even coughing. But while occasional heartburn is normal and no cause for concern, frequent heartburn that interferes with your daily life could be a sign of a much more serious underlying condition. 
Heartburn is something almost everyone has experienced, and you can usually manage it by avoiding triggers like spicy or fatty foods and taking over-the-counter medicine. But if your heartburn is frequent, very painful, not responsive to over-the-counter medicine and a regular interference with your life, then it's time to learn more and speak to your doctor.
What causes heartburn?
Heartburn is caused by stomach acid getting into your esophagus — the digestive tube that carries food from your mouth to your stomach. The Mayo Clinic explains that this can happen when the bottom band of muscle in the esophagus weakens or relaxes abnormally, letting stomach acid flow back into the esophagus, causing a burning sensation. This is why many people experience worsened heartburn when they are bent over or lying down. 
But WebMD notes this isn't always the case. A hiatal hernia — a stomach condition that causes the upper stomach and esophageal sphincter to move higher — can also cause stomach acid to leak into the esophagus. Certain foods and lifestyle habits can also trigger heartburn:
- Eating large meals 
- Lying down after eating or bending over at the waist
- Being overweight or obese
- Eating right before going to sleep
- Consuming foods such as citrus, tomato, chocolate, mint, garlic, onions or spicy or fatty foods
- Drinking alcohol, carbonated drinks, coffee or tea
- Smoking
- Being pregnant
- Taking aspirin, ibuprofen, muscle relaxers or blood pressure medications
What are the symptoms of heartburn?
Heartburn is described by WebMD as being a burning pain or discomfort that might move from your stomach up into your chest area or throat. Other symptoms of heartburn, according to WebMD, include:
- Regurgitation: acid that backs up into your throat or mouth, leaving a sour taste
- Bloating
- Bloody or black stools
- Bloody vomiting
- Burping
- Dysphagia — a narrowing of your esophagus, which feels like food is stuck in your throat
- Hiccups that you can't get rid of
- Nausea
- Unexplainable weight loss 
- Wheezing, dry cough, hoarseness or constant sore throat
The Mayo Clinic says you need to see a doctor if:
- Your heartburn becomes frequent, occurring more than twice a week.
- The use of over-the-counter drugs isn't stopping your symptoms.
- You have difficulty swallowing.
- You experience frequent nausea or vomiting. 
- You experience weight loss because of difficulty eating or a poor appetite.
Treating and preventing heartburn
Many times, heartburn can be treated with over-the-counter medications, such as:
- Antacids, which neutralize stomach acid and generally provide quick relief
- H-2-receptor antagonists (H2RAs), which can reduce stomach acid. These don't work as quickly as antacids, but they can provide relief for longer.
- Proton pump inhibitors,  which also also reduce stomach acid (like Prevacid 24HR and Prilosec OTC)
But if you find yourself taking over-the-counter medications frequently to reduce your symptoms, it's important to speak to your doctor so she can determine if your condition is more serious.
You can often prevent heartburn by avoiding:
- Lying down, sleeping or bending over right after a meal
- Eating within 2 to 3 hours before bed
- Smoking
- Spicy foods
- Onions
- Citrus products
- Tomato products, like pasta sauce or ketchup
- Fatty or fried foods
- Peppermint
- Chocolate
- Alcohol, carbonated beverages, coffee or other caffeinated beverages
- Large or fatty meals
It's important to figure out what triggers your heartburn so you know what to avoid. However, if you notice that taking aspirin, ibuprofen, muscle relaxers, blood pressure medications or other prescriptions gives you heartburn, don't stop taking it before speaking with your doctor first. 
If you find yourself suffering from heartburn often, even when you avoid your triggers, you should make an appointment with your doctor so she can determine what the problem really is. It could be a weak esophagus, or even a hiatal hernia. If your doctor determines your heartburn is more serious, she may prescribe a prescription medication, a lifestyle change regimen or, in extreme cases, surgery.
Resources Mayo Clinic and WebMD does not give medical advice, diagnosis, or treatment.

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