Frequently Asked Questions About Heartburn  


Most people have or will experience heartburn occasionally. With all the different heartburn classifications out there, diagnosis and prevention can be confusing. Hi, I’m Dr. Frank McGeorge for Prilosec OTC, and today we’re going to discuss the differences between heartburn, frequent heartburn, acid reflux, and GERD. Let’s start with the basics. Heartburn refers to a burning discomfort that’s generally felt in the chest, just behind the breastbone. Now, this sensation results when harsh stomach acid comes in contact with, and irritates, the lining of the esophagus—that’s the tube-like structure that connects the mouth to the stomach. Now, there are varying degrees of heartburn that one can experience. Heartburn experts tend to use three categories to describe heartburn frequency: episodic, frequent, and persistent. On the less severe end of the spectrum is episodic or occasional heartburn, which refers to infrequent flare-ups that are fairly predictable. Now, heartburn that occurs two or more days a week is referred to as frequent heartburn. If you’re experiencing symptoms this regularly, you may want to consider taking a more proactive approach to treating the problem, rather than treating your symptoms each time they occur. Now, there are a number of heartburn medications available to treat frequent heartburn. Proton pump inhibiting, or PPI medications, like Prilosec OTC, work by directly blocking many of your stomach’s acid-producing pumps. Now, PPI may take one to four days for full effect, but it can provide zero heartburn for 24 hours with just one pill a day. Now, another commonly confused and highly searched term associated with heartburn is acid reflux. This is the term used to describe the action of the stomach’s acidic contents actually being pushed up into the esophagus. In other words, acid reflux is the action which causes the symptom. Separate and often confused with other categories of heartburn is gastroesophageal reflux disease, or GERD. This digestive disorder is caused by acid contents of the stomach regularly backing up into the esophagus. It’s the added presence of regurgitation or refluxing, difficulty swallowing, chronic cough, hoarseness, and a feeling of a lump in the throat that differentiates this digestive symptom set from heartburn, frequent heartburn, or even persistent heartburn condition. The difference is that GERD is a disease, and heartburn is its most common symptom. If you think you may have GERD, contact your doctor to discuss your symptoms. For more information on the causes and remedies for heartburn, be sure to watch our other videos. I’m Dr. Frank McGeorge for Prilosec OTC.

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What is heartburn?

Heartburn occurs when stomach acids reflux, or flow up, into the esophagus. Find out more about heartburn symptoms.

Prilosec OTC® is only indicated for the treatment of frequent heartburn. If you think you may have any of the symptoms described below, please talk to your doctor or healthcare provider.


What is the difference between heartburn and frequent heartburn?

Frequent heartburn is defined as heartburn occurring two or more days a week. Prilosec OTC is formulated for frequent heartburn. Find out more about frequent heartburn.


Why do stomach juices irritate the esophagus?

These juices, which are produced by the stomach to help the body break down food, contain a powerful acid called hydrochloric acid. While the stomach is naturally protected from this potent acid, the esophagusHEARTBURN GLOSSARYEsophagus: Tube connecting the mouth to the stomach; a passageway for food; part of the digestive system. does not share the same protective qualities as the stomach. So, if acidic stomach contents come into contact with the esophagus, the stomach’s skin-like lining can be irritated or injured and result in the sensation known as heartburn.


What causes heartburn?

Heartburn is caused when acidic stomach juices reflux—or flow backward—into the esophagusHEARTBURN GLOSSARYEsophagus: Tube connecting the mouth to the stomach; a passageway for food; part of the digestive system.. This generally occurs when the lower esophageal sphincter (LES)—the natural valve that keeps stomach acid in the stomach and out of the esophagus—relaxes or is not functioning properly. When functioning normally, the LES opens like a one-way valve that allows food into the stomach, but does not let it out the same way. However, at times the LES relaxes and allows stomach juices to flow upward into the esophagus. This relaxation exposes the esophagus to harsh acid from the stomach. Physicians refer to this as gastroesophageal reflux.


What is GERD?

GERD, or gastroesophageal reflux disease, is chronic, persistent heartburn, and results from the improper working of the ring of muscle that normally keeps food and acids inside the stomach. When this muscle doesn't work correctly, it allows acids to back up into the esophagus. Other signs of GERD include: regurgitation, difficulty swallowing, coughing, hoarseness, and a lump feeling in your throat. In some instances, these ailments surface even when heartburn's usual symptoms are absent. This can lead doctors to misdiagnose and patients to misunderstand these conditions because people with ear, nose, and throat (ENT) complaints often do not have heartburn symptoms. Prilosec OTC is only indicated for the treatment of frequent heartburn. If you think you may have GERD, please talk to your doctor or healthcare provider about having a diagnostic screening test. See other possible related conditions.


What is the difference between heartburn and acid reflux?
Acid reflux, or gastroesophageal reflux disease (GERD), is a chronic condition that causes a person’s liquid stomach contents—stomach acids, pepsin, and bile—to back up into the esophagus. Heartburn is the result of this action, but heartburn may also be a sign that some other trigger is at work. Just because you have heartburn, it does not necessarily mean that you have acid reflux. Acid reflux is a chronic condition characterized by irritation or inflammation of the esophagus. Some of the common symptoms of acid reflux include: chronic, persistent heartburn; regurgitation; drastic weight loss; discomfort and difficulty swallowing; coughing often; severe hoarseness or wheezing; a feeling of a lump in the throat; and interference with lifestyle or daily activities. If you think you may have this condition, speak with your healthcare professional about a diagnostic screening test. If left untreated, acid reflux can cause or contribute to a range of more serious health issues, such as ulcers of the esophagus and chronic coughing.


What is esophagitis?
When stomach acids repeatedly back up into the esophagus, they can injure the esophagus’ sensitive lining. That injury can lead to uncomfortable inflammation called esophagitis. Eventually, the acid wears away at the esophagus, causing bleeding. If the bleeding is heavy enough, blood can pass into the digestive tract and show up as dark, tarry stools. Esophagitis can cause ulcers–sensitive, open sores on the lining of the esophagus. In a small percentage of people, long-term acid exposure from GERD leads to a condition called Barrett's esophagus (BE). In BE, new cells form to take the place of those damaged by acid reflux.


Are heartburn at day and heartburn at night different conditions?

Both heartburn at day and heartburn at night result from stomach acid reflux. However, lying horizontally to sleep at night makes it more likely you will experience more stomach acid reflux than when sitting up or standing.


What are some common treatments for heartburn?

Antacids Antacids neutralize the acid in your stomach. Antacids are commonly taken after you eat or when pain begins. Antacids provide immediate, temporary relief.

H2 Blockers H2 blockers relieve heartburn symptoms by reducing acid production. They begin working within an hour and can last for 12 hours. H2 blockers begin working relatively quickly, but may not block heartburn as long with a single pill when compared to PPIs.

Proton Pump Inhibitors When you eat, millions of tiny pumps in your stomach produce acid to break down food. Heartburn occurs when these excess acids reflux into your esophagusHEARTBURN GLOSSARYEsophagus: Tube connecting the mouth to the stomach; a passageway for food; part of the digestive system.. PPIs (such as Prilosec OTC) work by directly blocking many of these pumps. A PPI may take one to four days for full effect, but it can effectively block frequent heartburn for 24 hours with just one pill.


Are there certain foods that cause heartburn?

Yes, there are common foods and lifestyle factors that cause heartburn to flare up, and these are known as heartburn triggers. Paying attention to your body and how it reacts to these triggers helps you make smart choices:

• Citrus fruits

• Spicy foods

• Chocolate

• Garlic

• Onions

• Fatty foods

• Tomatoes or tomato-based products

• Peppermints

• Black pepper

• Vinegar

• Caffeinated or carbonated beverages

• Alcoholic beverages


Are there steps I can take to fight frequent heartburn?

Yes. There are several lifestyle choices, all of which contribute to reduce the chance of frequent heartburn.

Reduce stress: Stress can contribute to heartburn and make you more likely to overeat. Make time for yourself, prioritize responsibilities, and try to keep things in perspective to reduce stress in your life.

Exercise regularly: It will help you manage stress and keep you healthier overall. Exercising also helps you sleep better. Talk to your doctor before you start any exercise program.

Control portions: Decrease the size of portions at mealtimes. Your stomach won't need to produce as much acid as with a big meal, and less acid means less chance of acid refluxHEARTBURN GLOSSARYAcid reflux: The backflow of stomach acid into the esophagus, also known as gastroesophageal reflux (GERD)..

Stop smoking: Smoking relaxes the valve at the top of your stomach, allowing excess stomach acid to reflux into your esophagusHEARTBURN GLOSSARYEsophagus: Tube connecting the mouth to the stomach; a passageway for food; part of the digestive system..


Do I have to give up everything I love to control my heartburn?
With good advice from your healthcare professional, you should be able to develop a healthy plan to help control your heartburn. A healthy plan will let you keep eating the foods you love and continue doing your usual activities. Given the many recent advancements in our understanding and treatment of heartburn, even the most severe heartburn sufferers generally find that they can control their heartburn through heartburn medications and some simple lifestyle changes.


What does heartburn have to do with heat?

Many heartburn sufferers experience the burning sensation known as heartburn and associate the discomfort with intense heat. However, the discomfort is not caused by temperature but by the irritation resulting from the presence of acid in the esophagusHEARTBURN GLOSSARYEsophagus: Tube connecting the mouth to the stomach; a passageway for food; part of the digestive system..


How does stress contribute to heartburn?

Gastrointestinal symptoms have long been associated with stress, fear, and anxiety. The perception of heartburn can increase during stress. Numerous clinical studies confirm the correlation between stress and heartburn.

Stress also can contribute to reflux by causing heartburn sufferers to engage in behaviors that trigger acid production (i.e., turning to high-fat comfort foods, smoking, drinking caffeine, or eating late at night). Stressful life events (anxiety, tension, and stress) can increase sensitivity to refluxed acid, reducing the threshold for pain and increasing the frequency and/or severity of heartburn symptoms. In addition, stress may increase a person's sensitivity to the pain caused by a heartburn episode.


Will exercise increase the incidence and severity of heartburn? How?

To date, very little research has been conducted to explore this link. However, a recent study published in the Oklahoma Foundation for Digestive Research found that 43% of elite athletes experienced an increase in heartburn symptoms after exercising.

Researchers believe that certain exercises increase abdominal pressure and push stomach contents into the esophagusHEARTBURN GLOSSARYEsophagus: Tube connecting the mouth to the stomach; a passageway for food; part of the digestive system., thus contributing to heartburn symptoms. For example, weight lifters seem to get heartburn from tensing stomach muscles and cyclists tend to get heartburn from hunching over handlebars. However, more research is necessary to establish a definite link between heartburn and exercise.


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If you've experienced the heartburn-stopping power of Prilosec OTC—or you're curious to know how it can work for you—watch this video for an in-depth look at how one pill a day can mean zero heartburn for 24 hours.*

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