Heartburn is a common sensation characterized by a burning feeling in the chest, just behind the breastbone. This discomfort arises when stomach acid flows back up into the esophagus, the tube connecting the throat to the stomach, irritating its delicate lining. Understanding its typical duration and influencing factors is important for management.
Understanding Typical Duration
A single episode of heartburn typically lasts from a few minutes to several hours, depending on its trigger and stomach emptying speed. For many individuals, the sensation subsides once the irritant, such as food or certain beverages, moves out of the stomach. Stomach emptying can take anywhere from two to five hours, with richer and fattier meals requiring more time to break down.
Mild, occasional heartburn often resolves quickly, sometimes within minutes, especially if simple adjustments are made, such as sitting upright or taking an antacid. Infrequent heartburn is generally not a cause for concern and can be managed with minor interventions.
What Makes Heartburn Last Longer
Several factors can extend the duration of a heartburn episode, often related to dietary choices and physical actions. Consuming fatty, acidic, or spicy foods, as well as caffeine and alcohol, can significantly prolong heartburn symptoms. These substances can either directly irritate the esophagus or relax the lower esophageal sphincter (LES), the muscle that usually prevents acid from flowing back up.
The quantity of food eaten also plays a role; overeating can stretch the stomach, which may cause the LES to loosen and allow acid to reflux more easily. The timing of meals is another important consideration, as eating close to bedtime can lead to heartburn that lasts longer into the night. Lying down soon after eating or bending over can worsen symptoms because gravity no longer helps keep stomach contents in place, facilitating acid reflux.
Certain medications can also contribute to prolonged heartburn. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, some antibiotics (e.g., tetracyclines, clindamycin), specific blood pressure medications (calcium channel blockers, beta blockers), bisphosphonates (for bone health), and certain antidepressants are known culprits.
When Heartburn Lingers
Heartburn that occurs frequently, specifically two or more times a week, or that persists for extended periods like weeks or months despite lifestyle adjustments, may indicate a more chronic underlying condition. The most common reason for such persistent heartburn is Gastroesophageal Reflux Disease (GERD). With GERD, the lower esophageal sphincter does not function properly, allowing stomach acid to repeatedly flow back into the esophagus, causing ongoing irritation and discomfort.
Heartburn-like symptoms can also be indicative of other conditions. These include esophageal ulcers, which are sores in the esophageal lining, and esophagitis, which is inflammation of the esophagus. Esophagitis can result from chronic acid reflux, infections, or certain medications.
A hiatal hernia can also cause persistent heartburn. This condition occurs when a portion of the stomach bulges upward through the diaphragm into the chest cavity, which can weaken the barrier between the stomach and the esophagus and facilitate acid reflux. While small hiatal hernias might not cause symptoms, larger ones can lead to chronic heartburn and other digestive issues.
When to Consult a Doctor
It is advisable to consult a healthcare professional if heartburn is severe or occurs with high frequency, such as multiple times a week. Medical attention is also warranted if over-the-counter medications or basic lifestyle changes do not alleviate the symptoms.
Specific symptoms signal a need for prompt medical evaluation. These include difficulty swallowing (dysphagia), a sensation of food getting stuck in the throat or chest, or pain when swallowing. Other concerning signs are unexplained weight loss, a chronic cough, persistent hoarseness, vomiting blood, or passing black, tarry stools.
Chest pain that radiates to the arm or jaw, or is accompanied by shortness of breath, sweating, or lightheadedness, should be immediately evaluated in an emergency setting. These symptoms can sometimes mimic heartburn but may indicate a heart attack, requiring urgent medical care. Additionally, any new onset of heartburn in older adults should be assessed by a doctor to rule out underlying conditions.