Sudden heartburn may be caused by factors like anxiety, certain eating habits, health conditions, and medications. Heartburn is a burning sensation and pain in your chest after eating, often caused by stomach acid flowing back into your esophagus. While it is usually not serious, sudden heartburn can sometimes be mistaken for conditions like gallstones or heart disease, or even more severe conditions such as esophageal and stomach cancer. It’s important to differentiate between everyday heartburn and more serious health issues to seek appropriate treatment.

Conditions That Have Heartburn as a Symptom

Anxiety
Anxiety can worsen heartburn symptoms. A study found a cyclical pattern between anxiety and GERD (gastroesophageal reflux disease). GERD can worsen anxiety, and anxiety can intensify acid reflux. If you have frequent heartburn along with symptoms of anxiety, like difficulty sleeping or feeling restless, consider talking to a healthcare provider for treatment.

Barrett's Esophagus
Barrett's esophagus may develop if GERD is untreated. This condition occurs when stomach acid damages the lining of the esophagus. Symptoms include difficulty swallowing, heartburn, throat inflammation, and regurgitation. If left untreated, Barrett's esophagus can lead to esophageal cancer. Treatment options may include medications or surgery to remove damaged tissue or rebuild the esophagus.

Esophagitis
Esophagitis is inflammation of the esophagus lining caused by acid reflux, allergies, or medications. Symptoms include chest pain, difficulty swallowing, and heartburn. Treatment usually involves avoiding fatty or spicy foods, quitting tobacco, and taking medications like antihistamines or proton-pump inhibitors (PPIs).

Gastrointestinal Reflux Disease (GERD)
GERD is a chronic condition characterized by frequent heartburn and regurgitation. Symptoms may include chest pain, chronic cough, difficulty swallowing, and hoarseness. If lifestyle changes and over-the-counter treatments don't help, a healthcare provider may prescribe additional medications or recommend surgery.

Gastroparesis
Gastroparesis is a condition where stomach muscles are too weak to properly pass food into the small intestine, slowing digestion. People with diabetes are more likely to develop gastroparesis. Symptoms include belching, bloating, early fullness, heartburn, nausea, and upper abdominal pain. Seek medical assistance if you experience severe symptoms such as vomiting for more than an hour or difficulty breathing.

Hiatal Hernia
A hiatal hernia occurs when the upper part of the stomach pushes into the chest through an opening in the diaphragm. This can cause heartburn by affecting the lower esophageal sphincter. Severe symptoms may include coughing, difficulty swallowing, heartburn, and nausea. Treatment may include dietary changes, medications, or surgery.

Pregnancy
During pregnancy, elevated hormone levels can weaken the lower esophageal sphincter, leading to heartburn. The pressure of the uterus on the stomach in later stages of pregnancy can exacerbate heartburn symptoms. To treat heartburn during pregnancy, consider eating smaller meals, avoiding spicy foods, and using OTC antacids or prescribed medications like histamine blockers.

Stomach Ulcer
Stomach ulcers are sores on the stomach lining that can cause a dull burning pain, loss of appetite, belching, heartburn, nausea, and weight loss. Ulcers may result from bacterial infections, prolonged use of NSAIDs, or rare conditions like Zollinger-Ellison syndrome. Treatment may include antibiotics, PPIs, or histamine blockers to protect the stomach lining.

Conditions That Cause Heartburn-Like Pain

Gallstones
Gallstones are hard cholesterol deposits in the gallbladder that can block bile ducts, causing heartburn-like symptoms. Symptoms include dark-colored urine, jaundice, nausea, and sudden stomach pain that worsens when lying down. Severe cases require medical attention.

Heart Disease
Heart disease, including coronary artery disease, can cause chest pain similar to heartburn. Angina, cardiac arrhythmia, and heart attacks can all present with symptoms such as tightness in the chest, shortness of breath, and nausea. Seek immediate medical care if heartburn-like pain is accompanied by these symptoms.

Other Possible Conditions

Other health conditions that may cause heartburn-like pain include:

  • Achalasia: A rare disease where the esophagus struggles to move food into the stomach, leading to chest pain and regurgitation.

  • Eosinophilic esophagitis (EoE): Inflammation of the esophagus due to a buildup of white blood cells, causing difficulty swallowing and food impaction.

  • Esophageal diverticula: Pouches that form in the esophagus and can fill with food, causing regurgitation.

  • Esophageal cancer: This type of cancer may cause symptoms like difficulty swallowing, hoarseness, and heartburn.

  • Rumination syndrome: A condition where people intentionally regurgitate and re-chew food.

  • Stomach cancer: Early stages may cause GERD-like symptoms, but later symptoms include blood in stool, jaundice, and weight loss.

Eating Habits That Cause Heartburn

Certain foods and drinks may trigger heartburn symptoms, including:

  • Fatty, greasy, or spicy foods

  • Alcohol

  • Caffeine

  • Chocolate

  • Fizzy drinks

  • Highly acidic foods (e.g., oranges, tomatoes)

  • Mint

Additionally, eating too quickly or large meals can cause heartburn. Try eating smaller, more frequent meals and avoid eating three hours before bedtime.

Heartburn Symptoms in Women

While heartburn symptoms generally present similarly in both genders, studies suggest that women may report heartburn more often. Women may also experience heart attack warning signs that resemble heartburn, such as back pain, nausea, and shortness of breath.

When To See a Healthcare Provider

Consult a healthcare provider if you experience heartburn more than twice per week or if symptoms persist despite treatment. Seek medical attention immediately for severe symptoms like blood in vomit, chest pain, or difficulty breathing.

A Quick Review

Heartburn can indicate conditions like GERD, hiatal hernia, or stomach ulcers. In some cases, it may be caused by more serious conditions such as gallstones or heart disease. Lifestyle changes, medications, and surgeries are potential treatments. See a healthcare provider for a diagnosis and further treatment if heartburn persists or worsens.