Heartburn: Causes, Symptoms, and Treatment
Written by Sumiran Racherla, MD. Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Heartburn?
A primary care doctor can diagnose and treat most heartburn. If the cause is unclear or more tests are needed, you may be referred to a gastroenterologist, a doctor who treats stomach and digestive problems. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is heartburn?
Heartburn is a painful burning feeling just below or behind the breastbone. It often rises in the chest from the stomach. It may also spread to the neck or throat. Almost everyone has heartburn at some time.
It happens when stomach acid backs up into the esophagus, the tube that carries food from your mouth to your stomach. If you have heartburn more than twice a week, you may have GERD, which stands for gastroesophageal reflux disease. Treating heartburn matters, because over time reflux can damage the esophagus.
Symptoms
The main symptom is a burning feeling in the chest, behind the breastbone. It rises toward the throat. Other signs can include:
- A taste of food or stomach acid in the mouth, from stomach contents coming back up.
- Nausea.
- Trouble swallowing, or pain when swallowing.
- A cough that does not go away, or hoarseness.
Not everyone with GERD has heartburn. Other symptoms of GERD can include a long-lasting cough.
Causes and who gets it
A band of muscle at the bottom of the esophagus, called the lower esophageal sphincter (LES), normally closes after food enters the stomach. If it does not close tightly enough, acid can back up and irritate the esophagus.
Heartburn is more likely if you have a hiatal hernia. This is when the top part of the stomach pokes up into the chest. Pregnancy, being overweight, and smoking can also play a part. Many medicines can bring on heartburn or make it worse. Examples include some blood pressure medicines, asthma medicines, sedatives, and tricyclic antidepressants.
Never change or stop a medicine without talking to your provider first.
How doctors diagnose it
In most cases, heartburn is easy to diagnose from your symptoms. Your provider will do a physical exam and ask when it began, how long it lasts, what you eat, and what medicines you take.
If the cause is unclear, you may need more tests. An upper endoscopy looks at the inside lining of the esophagus and stomach. Esophageal pH testing checks how much acid comes up into the esophagus. Esophageal motility testing measures the pressure of the LES and the squeezing of the esophagus. An upper GI series is most often done for swallowing problems.
Treatment
Home changes are the first step. Avoid foods and drinks that trigger reflux, such as alcohol, caffeine, carbonated drinks, chocolate, citrus, peppermint, spicy or fatty foods, and tomato sauces. Eat smaller meals. Avoid bending over or exercising right after eating. Avoid eating within 3 to 4 hours of bedtime.
Also avoid tight belts and clothes. Lose weight if you are overweight, and stop smoking or using tobacco. Raise the head of your bed about 6 inches. Extra pillows do not work well, because you can slip off them.
If you still have no full relief, over-the-counter medicines can help. Antacids neutralize stomach acid. H2 blockers reduce acid production. Proton pump inhibitors stop nearly all acid production for many hours. If symptoms do not improve, you may need prescription medicine that is stronger than over-the-counter choices.
When to see a doctor
Sometimes people who think they have heartburn are having a heart attack. Call 911 or go to the emergency room if you have chest pain or discomfort lasting two minutes or more, or burning with a squeezing, crushing, or pressure feeling in the chest. Also call 911 or go to the emergency room if you have trouble breathing, faint, vomit material that is bloody or looks like coffee grounds, or have stools that are black like tar or maroon.
Contact your provider if heartburn is frequent or does not go away after a few weeks of self-care. Also call if you lose weight without trying, have trouble swallowing, have a cough or wheezing that does not go away, or feel worse after antacids or other treatment.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can review your symptoms and medicines, suggest lifestyle steps, and arrange follow-up. They can also refer you to a gastroenterologist if tests are needed.
Common questions
Is heartburn the same as GERD?
No, but they are linked. Heartburn is a symptom, and having it more than twice a week may mean you have GERD. You can also have GERD without heartburn.
How can I tell heartburn from a heart attack?
You cannot always tell by feel alone. Burning with a squeezing, crushing, or pressure feeling in the chest can be a heart attack. Call 911 right away if you have those signs.
Can medicines cause heartburn?
Yes, pregnancy and many medicines can bring on heartburn or make it worse. Examples include some blood pressure, asthma, and sleep or anxiety medicines. Do not stop a medicine on your own.
Does sleeping on extra pillows help heartburn?
No, extra pillows do not work well, because you can slip off them during the night. Instead, sleep with your head raised about 6 inches.
Sources
- MedlinePlus - Heartburn (Medical Encyclopedia)
- MedlinePlus - Heartburn
- National Institute of Diabetes and Digestive and Kidney Diseases - Symptoms and Causes of GER and GERD
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
