Whether you're in the middle of a deliciously greasy slice of pizza or right about to drift off to sleep, heartburn always seems to strike at the worst moments. And once it arrives, there's no ignoring it. When you're experiencing heartburn, it honestly feels like there's a fire in your chest, and it can also bring with it uncomfortable bloating or stomach pains.
The explanation for why this happens is pretty straightforward. "Normally, we chew food, swallow it, it goes into our oesophagus, and it should go down into the stomach to spend time getting digested," says Felice Schnoll-Sussman, MD, a gastroenterologist at New York Presbyterian Hospital who is also director of The Jay Monahan Center for Gastrointestinal Health at Weill Cornell Medicine. But "in some people, for a variety of reasons, the food or fluid or acid that's in the stomach may not stay in the stomach."
In fact, the awful sensation we know as heartburn is just one symptom of acid reflux, a common condition in which stuff from your stomach finds its way upwards, Dr. Schnoll-Sussman says. The good news: There are some very simple things you can do to make it happen less frequently.
Most commonly, reflux happens because the sphincter at the bottom of your oesophagus weakens or relaxes too often, Dr. Schnoll-Sussman explains. When that happens, the sphincter can't keep what's in your stomach from getting into the oesophagus — where it can cause that classic burning sensation and, possibly, do some damage to the oesophageal lining.
That definitely sounds kind of gross and scary, but reflux is actually incredibly common, even among babies and kids. People who are pregnant often experience reflux, because the growing uterus puts extra pressure on the stomach. Weight gain can make reflux more likely for similar reasons.
For most people, a little heartburn every once in a while isn't anything to worry about. Although it's unpleasant, over-the-counter medications and (if necessary) changes in diet are enough to treat most cases, explains Dr. Schnoll-Sussman.
"However, there are some negative consequences of long-standing reflux," she says. If your reflux becomes chronic, it turns into gastroesophageal reflux disease (GERD), which can cause inflammation, scarring, or ulcers in the oesophagus. The most worrying possibility, though, is the development of a condition called Barret's oesophagus, which, in a small subset of patients, can go on to become oesophageal cancer.
So, if you have reflux that doesn't go away no matter what you do, or you notice you're starting to have trouble swallowing, or you have to change the size of the food you eat in order to swallow, see your doctor. She can do tests, prescribe medications, and suggest diet changes to help get your oesophagus back in working order before you develop even more serious complications.