Key takeaways:
Heartburn is usually a symptom of acid reflux. But other health conditions can cause heartburn pain too. Heart attacks and stomach ulcers are two examples.
Even if your heartburn is from acid reflux, this isn’t a harmless condition. Frequent episodes may mean you have GERD (gastroesophageal reflux disease), which can have long-term health complications.
If you have heartburn that won’t go away, seek medical attention. It can be nearly impossible to tell what’s causing your heartburn based on symptoms alone.
When you’re experiencing heartburn, you may take an antacid and forget about it. And many times, heartburn is truly just an episode of acid reflux.
But it can also be a symptom of something more serious. If you’re experiencing frequent or severe episodes of heartburn, it’s important to consider if something else could be going on.
Here, we’ll run through some other conditions that can cause or feel like heartburn. More importantly, we’ll help you figure out if it’s time to go to the doctor’s office or emergency room (ER).
What is heartburn?
Heartburn is a symptom that feels like a burning sensation in your chest. Many times, this is caused by acid reflux. Acid reflux occurs when acid in the stomach flows up into your esophagus. The esophagus isn’t meant to be exposed to this acid. So, it can irritate the esophagus lining and cause pain.
Is acid reflux and heartburn the same?
Many people use the term heartburn and acid reflux interchangeably. But they aren’t exactly the same thing. Technically speaking, heartburn is the symptom. Acid reflux is the process happening in the stomach and esophagus.
What causes acid reflux?
Certain medical conditions can cause acid reflux. One of the most common conditions is GERD (gastroesophageal reflux disease), which we cover in the next section.
But acid reflux isn’t always caused by an underlying medical condition. It can happen on occasion to anyone. Some things that can cause acid reflux are:
Extra pressure in the belly, from things like tight clothing or change in body position
Extra weight around the midsection
Substances like nicotine, alcohol, or caffeine
Food triggers, like citrus, tomatoes, and chocolate
Certain medications, like aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)
For many people, acid reflux happens every once in a while. But if it occurs two or more times a week, it might be a sign of GERD.
What is GERD?
GERD is a condition that causes frequent episodes of acid reflux. It often happens because the sphincter (ring of muscles) between your esophagus and stomach doesn’t close properly. Without a tight closure, contents of the stomach can travel up into your esophagus.
The classic symptoms of GERD include:
Heartburn
Pain in the center of the chest
Difficulty swallowing
A sour taste in the mouth
Bad breath
Sensation like there’s a lump in your throat
Cough
Nausea or vomiting
Sore throat and hoarseness
Bloating, gas, and belching
Is heartburn from GERD serious?
It can be. Beyond the impact on your quality of life, untreated GERD can lead to long-term damage to the esophagus. This can lead to:
Precancerous changes in the esophagus (Barrett’s esophagus)
Gastrointestinal (GI) bleeding
Scarring that results in trouble swallowing
What is the difference between GERD and acid reflux?
All these overlapping terms can get confusing. So, here’s a quick review:
Heartburn is a symptom of chest burning, often caused by acid reflux.
Acid reflux is when stomach acid travels up into the esophagus.
GERD is when episodes of acid reflux happen over and over again.
But not everyone with GERD has heartburn. And not everyone with heartburn has GERD.
Quiz: Is it acid reflux or a heart attack?
Conditions that can mimic heartburn
Many different conditions can cause heartburn. Below, we go through some conditions that:
Feel like acid reflux — but aren’t
Cause acid reflux — but are different from GERD
Heart attack
A heart attack can cause chest pain that feels similar to heartburn. It can be hard to tell the difference based on the pain alone. In fact, even healthcare professionals can’t predict whether someone’s chest pain is coming from the heart or stomach.
Some additional symptoms of a heart attack include:
Heaviness or pressure in the chest
Pain that worsens with exertion
Discomfort in the left shoulder, arm, or jaw
Shortness of breath
Clammy skin or cold sweats
Dizziness and feeling lightheaded
Nausea
But not everyone will have these symptoms. Don’t try and figure it out on your own. It’s important to take any type of chest pain seriously and get it checked out by a healthcare professional.
Gastritis
Gastritis is irritation in the lining of the stomach. So, gastritis and acid reflux can feel similar — and share some common causes. Medications like NSAIDs, dietary habits, and certain health conditions can lead to either one. But most often, gastritis is often caused by a long-term bacterial infection in the stomach called Helicobacter pylori (H. pylori).
It’s important to diagnose and treat gastritis. Otherwise, it can lead to complications like bleeding, ulcers, and stomach cancer.
Peptic ulcers
Peptic ulcers are sores that develop in either the :
Lining of the stomach (which is known as a gastric ulcer)
First part of the intestine (which is a duodenal ulcer)
Like gastritis, there’s a lot of overlap between GERD and ulcers. But they’re different conditions, with different causes and complications.
Symptoms of a peptic ulcer include:
A deep, gnawing pain around the stomach
Burning pain, which can get worse or better with eating
Decreased appetite
Weight loss
Bloating
Vomiting of bright red or dark blood
Sticky, black stools
Without treatment, ulcers can erode a hole in the stomach or intestine. This is a life-threatening emergency that usually causes severe abdominal pain.
Gallstones
Sometimes, pain that gets worse after you eat isn’t heartburn — it may be gallstones. These are hard collections of cholesterol that form in the gallbladder, an organ that sits right next to the stomach.
The gallbladder is located on the right side of the abdomen. So, many people feel gallstone pain underneath the right ribs or around the stomach. But you may feel it in your chest too. Gallstone pain can also:
Come on suddenly
Radiate to the back or right shoulder
Trigger nausea and vomiting
For some people, the biggest problem with gallstones is that they’re very painful. But gallstones can also lead to some health complications. If they get lodged in the wrong place, they can lead to serious infections of the gallbladder. They can also lead to a painful condition called pancreatitis, an inflammation of the pancreas. Pancreatitis tends to cause severe pain around the stomach.
Gastroparesis
If you have gastroparesis, it takes much longer for food to pass from your stomach into your intestine. This delay in digestion can increase the chance of acid reflux. So it can trigger heartburn symptoms, although the underlying cause is different from GERD.
Other signs and symptoms are more unique to gastroparesis, such as:
Feeling full after a few bites
Vomiting undigested food
Weight loss and malnutrition
There are different causes of gastroparesis — from diabetes to medications like GLP-1 agonists. Gastroparesis can have a significant impact on your quality of life and nutrition, and there are plenty of treatment options. So it’s important to see a healthcare professional if you have this condition.
Hiatal hernia
A hiatal hernia is a type of hernia that occurs inside the chest. The top part of the stomach can sometimes slide upward, through a hole in the diaphragm. This pushes more of the stomach into the chest area, which can increase the likelihood of acid reflux.
Hiatal hernias are common. They affect up to 1 in 5 people. And they aren’t necessarily a cause for concern. Many people don’t have any problems or symptoms with a hiatal hernia. But when it causes GERD, it’s important to get treatment.
Other conditions
The above list is by no means a full list of all the conditions that can mimic heartburn. Examples of other conditions include:
Esophageal spasms
Pericarditis
Pleurisy, an irritation of the lining around the lung
The takeaway is that you shouldn’t try to figure out the cause of your heartburn alone. Ask a trusted healthcare professional for help.
When should I see a healthcare professional about heartburn?
If you’re questioning if your heartburn is acid reflux or something else, that’s a good reason to see a healthcare professional. Many different things can cause chest pain. And it can be hard to tell the difference between something harmless or serious. Gas can feel like a heart attack, and a heart attack can feel like gas.
Before we go into reasons to see your healthcare team, here are some reasons to go straight to the ER for chest pain:
You feel like you’re having a heart attack, regardless of your symptoms.
It feels like heartburn that won’t go away, or is getting worse.
You have pain that feels severe.
You have pain in your arms, neck, back, or jaw.
Physical effort makes the pain worse.
You have trouble breathing.
You have cold sweats.
You’re vomiting blood.
But even if you’re pretty sure your heartburn is from acid reflux, this isn’t a harmless condition. Long-standing reflux can lead to health complications. Contact your healthcare team right away if you have:
Heartburn two or more times a week
Difficulty swallowing
Hoarseness
Vomiting
Unintended weight loss
Dark or bloody stools (if you’re having a lot, go to the ER for that too)
Symptoms that wake you up at night
The bottom line
Heartburn is a common symptom. But there are times when you shouldn’t ignore it. Heartburn can be a warning sign of a more serious or long-term condition. So, if you find yourself reaching for an antacid more frequently, it’s a good time to talk to your healthcare team. They can make sure you don’t need any testing to look for other causes. And even if there’s nothing more serious going on, they can offer treatment to help your symptoms.
Why trust our experts?
References
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