Here’s why your favorite meals are giving your esophagus grief.
You knew that late-night pizza was going to spell trouble later, but you just couldn’t resist; the smell was incredible. And right on schedule, at 2:45 AM, the pizza came back to haunt you with burning pain in your chest. Yep… It’s heartburn.
Contrary to popular belief, heartburn is not a medical condition all by itself, and it has nothing to do with your heart. Heartburn is actually a symptom of acid reflux, and it occurs in the esophagus (not your ticker).
“[Heartburn is] a burning sensation that occurs in the chest that is usually due to acid coming up from the stomach into the esophagus causing irritation,” says Roshini Raj, MD, a gastroenterologist at NYU Langone Health in New York City and co-founder of healthy living brand Tula.
What Causes Heartburn?
When food gives you upset stomach, it makes more intuitive sense. You know your stomach and intestines are in your midsection, so it’s logical that the cramping would happen there.
Heartburn, then, seems a tad confusing. Why would that spicy burrito cause pain in your chest?
What you’re actually feeling is irritation in your esophagus—not your heart or lungs, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This dyspepsia (pain in the chest) may occur as far down as the middle of your abdomen, since your esophagus stretches from your stomach to your throat.
Between the stomach and esophagus, you have something called an esophageal sphincter. It’s like a valve that separates the two organs.
Your esophageal sphincter allows food to pass through to the stomach, but its job is to keep it there. That’s because the stomach contains potent acids that help digest food. The lining of the stomach is designed to withstand that acid, but your esophagus is not.
“When someone feels heartburn, acid is coming backward up into the esophagus, and it’s causing irritation or burning in the lining of the esophagus,” says Dr. Raj. If the acid comes up far enough, you may also taste the stomach acid in your mouth.
Certain foods, eating habits, and health conditions can alter the effectiveness of the esophageal sphincter, causing it to relax or loosen. This causes backward flow of stomach acid, known as acid reflux. Some triggers of acid reflux include:
Carrying extra weight, especially in the abdominal area
Eating late at night and/or before lying down
Eating spicy, fatty, or acidic foods
What Is Gastroesophageal Reflux Disease (GERD)?
When acid reflux occurs frequently, your doctor may diagnose you with gastroesophageal reflux disease, commonly known as GERD. This condition is pretty common; it affects some 20 percent of the U.S. population, according to NIDDK. Learn more about the difference between heartburn or GERD here.
“There are people with acid reflux who don’t experience heartburn,” says Dr. Raj. Instead, they may experience other symptoms of GERD caused by acid in the esophagus, such as:
Dry, scratchy throat
Changes in your voice
“I think heartburn is so common that many people assume it’s a normal part of life,” says Dr. Raj. “The truth is, it’s not, and it could be a sign of something more serious going on in your body.”
If you experience heartburn (or other symptoms like nausea and trouble swallowing) more than twice a week, talk to your doctor about acid reflux. Not only can you doctor help you treat the GERD symptoms, but you may also figure out the underlying source of the problem to nix heartburn for good.
Dr. Raj is a gastroenterologist and associate professor of medicine at NYU School of Medicine, and an attending physician at NYU Langone Medical Center.
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Heartburn is one of the most
common symptoms of acid reflux and
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it refers to a burning sensation that
occurs in the chest that is usually due to
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acid coming up from the stomach into
the esophagus, causing irritation.
00:00:14,492 --> 00:00:19,973
00:00:19,973 --> 00:00:23,696
When someone feels heartburn,
acid is coming up from their stomach,
00:00:23,696 --> 00:00:25,967
flowing backwards up into the esophagus,
00:00:25,967 --> 00:00:30,285
and it's causing irritation or
burning to the lining of the esophagus.
00:00:30,285 --> 00:00:34,395
So they will feel a burning in their
chest area right behind their breastbone.
00:00:34,395 --> 00:00:35,955
Although it's called heartburn,
00:00:35,955 --> 00:00:38,585
heartburn is actually not at
all related to your heart.
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You're going to feel a burning
in your chest due to acid.
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And sometimes people may think it's
a heart-related pain because of
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the location, but this is something going
on in your esophagus, not your heart.
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We all have what's called
a lower esophageal sphincter
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which is a valve that really serves as a
gate to keep acid down into your stomach.
00:00:55,920 --> 00:01:00,450
But with certain foods, that sphincter
relaxes, or opens up too wide, and
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makes it easier for acid to come up.
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And that's why,
when you eat certain foods,
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you may experience acid reflux symptoms.
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When you're pregnant,
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the hormones that are involved can cause
that sphincter to relax, which is why many
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pregnant women experience
significant acid reflux symptoms.
00:01:15,170 --> 00:01:17,970
Carrying excess weight,
particularly in the abdominal area,
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can cause that lower esophageal sphincter
to be weaker and wider than it should be.
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Gastroesophageal reflux disease or GERD
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is when you frequently have acid coming
up from the stomach into your esophagus.
00:01:30,400 --> 00:01:33,400
There are people who've had acid
reflux who don't experience heartburn.
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Other symptoms of GERD include things
like nausea, trouble swallowing, frequent
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throat clearing, bad breath, a dry
scratchy throat or changes in your voice.
00:01:44,700 --> 00:01:48,370
I think heartburn is so common that
many people assume that it's a normal
00:01:48,370 --> 00:01:50,510
part of life and the truth is it's not,
00:01:50,510 --> 00:01:53,600
and it could be a sign of something
more serious going on in your body.
00:01:53,600 --> 00:01:57,847
If you're experiencing frequent heartburn,
so more than twice a week let's say, or
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you're requiring over the counter
medications very frequently,
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talk to your doctor about the acid reflux.
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Definition & facts for GER & GERD. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on April 21, 2021 at https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/definition-facts.)
Dyspepsia. Leawood, KS: American Academy of Family Physicians. (Accessed on April 21, 2021 at https://familydoctor.org/condition/dyspepsia/?adfree=true.)
GERD. Washington, DC: U.S. National Library of Medicine. (Accessed on April 21, 2021 at https://medlineplus.gov/gerd.html.)Symptoms & causes of GER & GERD. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on April 21, 2021 at https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes.)