When to Seek Medical Care

• Call your health care provider if your heartburn continues to bother you despite lifestyle modifications and use of antacids or low doses of acid blockers. Call if you have heartburn more than 3 times a week for over 2 weeks. Your provider will prescribe medications or make other recommendations to help your pain.
• Seek emergency medical care. Chronic heartburn can sometimes lead to serious complications that require immediate medical attention. Go to a hospital's emergency department if you have any of the following symptoms:
  • Throwing up blood or passing blood in your stools
  • Severe pain, dizziness, or lightheadedness
  • Difficulty swallowing
  • Dehydration
  • Unintentional weight  loss

NOTE: The pain of heartburn can often be confused with pain that is actually due to more serious heart problems, such as a heart attack. If you or a family member has a history of heart disease, you need to be particularly aware of this possibility. If your pain is accompanied by sweating, nausea, vomiting, difficulty breathing, or is worse with activity, you may need to have your heart evaluated immediately.

Self-Care at Home

For mild or occasional symptoms, simple lifestyle modifications can be helpful.

• Avoid large meals.
• Avoid caffeine (coffee, teas, some soft drinks).
• Avoid foods or drinks that reduce pressure on the lower esophageal sphincter such as chocolate, peppermint, caffeine-containing beverages, and fatty or fried foods.
• Avoid foods that damage the esophagus such as spicy foods, citrus fruits and juices, tomatoes and tomato sauces.
• After eating, beware of activities that force acid back into your esophagus. Such activities include lifting, straining, coughing, and wearing tight clothing.
• Use gravity to your advantage. Avoid lying down within 3 hours of meals. If you suffer from nighttime heartburn, elevate the head of your bed when sleeping. Place 6-inch blocks underneath the head of the bed, or place a wedge under the mattress. Simply using more pillows under your head will not help. In fact, it may worsen the heartburn by increasing the pressure on your stomach.
• weight loss if you are overweight.
• Stop smoking.
• Limit alcohol intake.
• Antacids such as Maalox, Mylanta, Tums, or Rolaids can also be helpful. Antacids work by neutralizing acid. They should be taken 1 hour after meals or when heartburn symptoms occur
• Low doses of drugs that block the production of stomach acid are available over-the-counter. Some examples include cimetidine (Tagamet), ranitidine (Zantac), and famotidine (Pepcid).

Prevention

Many cases of heartburn can be prevented by simple lifestyle modifications in diet, activity, and habits. Watching what kinds of foods you eat and how much you eat can influence your symptoms. Also, pay attention to your body position after eating. Don't lie down. Limit alcohol intake, quit smoking, and lose weight to improve not only your heartburn symptoms but also your overall health.