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Q: What causes heartburn?

There’s a small band of muscle at the bottom of your esophagus, the tube that carries food from your mouth to your stomach. Normally when you swallow, this muscle opens to allow food to pass through, then closes again behind it, like a trap door. When that little muscle fails to close properly, stomach acid can flow back up into the esophagus, causing an uncomfortable burning sensation in your chest. In some cases, the stomach acid and contents travel further up into the throat. This can cause a bitter taste, voice changes, difficulty swallowing or a feeling of something stuck in the throat. Most people can control occasional heartburn with lifestyle changes, like avoiding caffeine, alcohol, tobacco or fatty foods that trigger the symptoms, avoiding lying down after eating a meal, and maintaining a healthy weight. Over-the-counter medications can also help.

But if your symptoms continue even with medication, or if your heartburn is especially severe and includes symptoms like nausea and vomiting, you should see a doctor. Treatment might include prescription medication or surgery.

Finally, if you are experiencing chest pain or pressure, especially in combination with other symptoms like difficulty breathing or pain in the arm or jaw, seek immediate help; it could be symptoms of a heart attack.

David S. Crow, MD


David S. Crow, MD
71 Kanoa St., Suite 101
Wailuku, HI 96793