Heartburn is one of those symptoms almost everyone has had and very few describe the same way. Some call it burning, others pressure, others a sour taste that arrives at 2am. It is common, usually harmless, and occasionally a sign of something worth looking at properly. If the discomfort is severe or new to you, an after-hours GP consultation or a telehealth appointment with a doctor is available when your regular clinic is closed.
What is heartburn, and what does it feel like?
Heartburn is a burning discomfort behind the breastbone, caused by stomach acid moving up into the oesophagus - the tube connecting throat to stomach. The name is misleading: it has nothing to do with the heart, which is precisely why it causes so much confusion.
People describe heartburn symptoms in a few consistent ways:
- A burning that starts behind the breastbone and rises towards the throat
- A sour, bitter or acidic taste at the back of the mouth
- Pressure or tightness in the chest, sometimes mistaken for a cardiac problem
- Discomfort that worsens after eating, bending over, or lying flat
- A persistent dry cough, hoarseness or a lump-in-the-throat feeling
- Burping, bloating or nausea alongside the burning
Timing is often the giveaway. Heartburn typically appears within an hour of eating and improves when you sit or stand upright. Pain that arrives during exertion and eases with rest is a different pattern entirely, and should never be dismissed as reflux.
Heartburn causes
At the top of the stomach sits a ring of muscle that normally stays shut. Heartburn happens when it relaxes at the wrong moment, or when stomach pressure pushes acid past it.
Common triggers include large or late meals, fatty, fried and spicy food, tomato and citrus, chocolate, coffee, alcohol and carbonated drinks. Smoking and vaping relax that muscle, as does lying down soon after eating - which is why symptoms cluster at night.
Other contributors are structural: extra weight around the abdomen, a hiatus hernia, and pregnancy.
Heartburn occurring more than twice a week over a sustained period is generally called gastro-oesophageal reflux disease (GORD), and deserves assessment rather than ongoing self-management.
How to get rid of heartburn: relief at home
For occasional symptoms, what works comes down to gravity, volume and timing.
- Stay upright for two to three hours after eating - no lying down on a full stomach
- Raise the head of the bed 10-20cm with blocks under the legs - extra pillows bend the body at the waist and can worsen reflux
- Eat smaller meals more often instead of one large evening meal
- Identify your own triggers - they vary a lot between people - and reduce those rather than everything at once
- Loosen tight waistbands and belts, which raise stomach pressure
- Stop smoking and vaping, both of which worsen reflux
Milk is worth a mention because it is so commonly recommended: it soothes briefly, then its fat and protein can stimulate more acid, so the relief is short-lived.
Heartburn tablets and other medicines
Several types of heartburn tablet are sold in Australian pharmacies - broadly, antacids that neutralise acid for short-term relief, and medicines that reduce acid production for longer control. Which suits you depends on how often symptoms occur and what else you take.
Speak with your pharmacist or doctor before starting any of them, and always read the label. They can interact with other prescriptions, and needing them regularly beyond a couple of weeks is a reason to see a doctor rather than keep buying them - symptoms masked by medication can delay a diagnosis.
Heartburn in pregnancy
Pregnancy heartburn is very common and not a sign anything is wrong. Two things drive it: hormonal changes relax the muscle at the top of the stomach, and later the growing uterus presses upward. That is why symptoms often begin in the first trimester, settle, then return more forcefully in the third.
Heartburn pregnancy relief
The measures above all apply, and a few matter more during pregnancy:
- Small, frequent meals rather than three larger ones - stomach capacity is genuinely reduced
- Finishing eating two to three hours before bed
- Sleeping propped up, with the bed head raised rather than stacked pillows
- Sleeping on the left side, which is recommended in later pregnancy for other reasons as well
- Avoiding your triggers, which may differ from your pre-pregnancy ones
On medicines: do not take anything for heartburn during pregnancy, including products you used before, without checking first with your doctor, midwife or pharmacist. Some options are considered suitable in pregnancy; others are not.
Heartburn or heart attack?
This is the question that matters most, and the two can be genuinely hard to tell apart. Heartburn usually burns, follows a meal, worsens lying down and eases upright. Cardiac pain is more often pressure, tightness or heaviness, may come on with exertion, and can spread to the jaw, neck, back or either arm, often with sweating, nausea or breathlessness.
Those patterns are a guide, not a test. Heart attacks in women, older adults and people with diabetes frequently present atypically.
When to see a doctor about heartburn
Book an appointment if you have:
- Heartburn more than twice a week, or lasting beyond two weeks
- Difficulty or pain swallowing, or food feeling like it sticks
- Unintentional weight loss
- Vomiting blood, or bowel motions that are black and tarry
- Ongoing vomiting, or persistent hoarseness and cough
- Heartburn that is new and you are over 50
- Symptoms that return as soon as you stop over-the-counter medicines
Getting advice after hours
Reflux has a habit of peaking at night, long after clinics have closed. 13CURE takes bookings Monday to Friday from 6pm through to 8am, Saturdays from 12pm, and 24 hours on Sundays and public holidays. Consultations are bulk billed for eligible Medicare and DVA cardholders - the bulk billing GP page explains eligibility. A bulk billed telehealth appointment suits most heartburn questions, and a home doctor visit may be available depending on location, listed on the areas we cover page.
