Why Am I Getting Heartburn All of a Sudden?

Chances are you have had heartburn, the burning feeling and pain in your chest after eating. Getting heartburn all of a sudden may be the result of anxiety, certain eating habits, health conditions, and medicines.

Heartburn occurs when stomach acid flows back into your esophagus, the tube that carries food from your throat to your stomach. Usually, heartburn is not a serious concern. 

Other times, some people may mistake gallstones or heart disease for sudden heartburn. In rare cases, esophageal and stomach cancer may cause heartburn-like pain. Knowing the differences between everyday heartburn and more severe illnesses is essential to getting the proper treatment.

Conditions That Have Heartburn as a Symptom

Sometimes, your heartburn is not just everyday heartburn but can be a symptom of an underlying health condition. 

Anxiety

Anxiety can worsen heartburn symptoms. A study published in 2019 found a cyclical pattern between gastrointestinal reflux disease (GERD) and anxiety. You may have GERD if you have heartburn symptoms after a meal more than twice per week.

Anxiety may worsen acid reflux symptoms. Likewise, GERD can negatively affect emotional well-being and cause anxiety.

Along with heartburn, anxiety symptoms can include:

• An inability to focus
• Difficulty falling asleep
• Feeling restless
• Periods of intense worry

Speak to a healthcare provider if you have anxiety and frequent heartburn. They may advise treating your underlying anxiety in tandem with your heartburn.

Barrett's Esophagus

You may develop Barrett's esophagus if you have untreated GERD. Barrett's esophagus occurs when too much stomach acid leaks into your throat and damages the lining of your esophagus.

Barrett's esophagus may cause symptoms like:

• Difficulty swallowing food
• Heartburn
• Inflammation in the throat
• Regurgitation, or stomach acid that flows into your mouth and throat

In rare cases, Barrett's esophagus may develop into esophageal cancer. Consult a healthcare provider to learn about prevention and treatment options. 

Treatment may include medicines or surgery to destroy unhealthy cells or remove the affected tissue. In severe cases, a surgeon may remove and rebuild your esophagus using parts of your intestines and stomach.

Esophagitis

Esophagitis occurs when the lining of your esophagus becomes inflamed. Acid reflux, allergies, asthma, and certain medicines may cause esophagitis.

Esophagitis symptoms typically include:

• Chest Pain
• Difficulty chewing and swallowing food
• Heartburn
• Regurgitation

A healthcare provider may advise treatments like:

• Avoiding fatty, oily, and spicy foods
• Reducing or quitting tobacco or alcohol use
• Stopping any medicines that cause esophagitis
• Taking an antihistamine medication or proton-pump inhibitors (PPIs) like Nexium (esomeprazole) and Prilosec (omeprazole)

Gastrointestinal Reflux Disease

GERD is a chronic health condition that causes heartburn and regurgitation.

Other GERD symptoms may include:

• Chest pain
• Chronic cough
• Difficulty swallowing
• Hoarse voice
• Nausea

Talk to a healthcare provider if you continue to have GERD symptoms despite lifestyle changes and over-the-counter (OTC) medicines. They may prescribe additional medicines or recommend surgery.

Gastroparesis

Gastroparesis, or gastric emptying, happens when stomach muscles become too weak to pass food into your small intestine. As a result, digestion slows down. 

People with diabetes are more likely to develop gastroparesis than others. Diabetes may damage the vagus nerve, which controls stomach muscles.

Gastroparesis may cause symptoms like:

• Belching
• Bloating
• Feeling full too soon or long after eating a meal
• Heartburn
• Nausea
• Pain in your upper abdomen

Seek medical assistance right away if you have symptoms like:

• Blood in your vomit or vomiting for more than one hour
• Difficulty breathing
• Elevated or abnormally low blood sugar levels
• Fainting
• Fever
• Sudden sharp or heavy stomach pain
  

Hiatal Hernia

A hiatal hernia can occur when the upper part of your stomach pushes into your chest through the hiatus, an opening in your diaphragm. 

A hiatal hernia can impact the lower esophageal sphincter by creating a gap between your esophagus and stomach. As a result, stomach acid can escape and cause heartburn.

Often, minor hiatal hernias do not cause symptoms. In contrast, severe cases may cause symptoms like:

• Coughing
• Difficulty swallowing
• Heartburn
• Nausea
• Regurgitation

Talk to a healthcare provider if those symptoms persist. Treating severe hiatal hernias may include diet changes, medications, or surgery.

Pregnancy

The female sex hormones estrogen and progesterone elevate during pregnancy. Those high hormone levels may affect the function of the lower esophageal sphincter, creating a gap between your esophagus and stomach. Stomach acid may leak into your throat and cause heartburn symptoms.

Heartburn can worsen during the third trimester of pregnancy as your uterus places pressure on your stomach. As a result, stomach acid flows back up into the throat.

A healthcare provider may advise the following to prevent and treat heartburn during pregnancy:

• Avoiding oily or spicy foods
• Eating five or six smaller meals throughout the day rather than three large ones
• Eating yogurt to help reduce acid
• Not lying down after eating
• Taking OTC antacids
• Taking prescribed medications like histamine blockers, such as Pepcid (famotidine), and PPIs
  

Stomach Ulcer

Stomach ulcers, or peptic ulcers, are sores that appear on your stomach lining.

Stomach ulcers may cause symptoms like:

• A dull burning pain in your stomach
• A loss of appetite
• Belching
• Heartburn
• Nausea
• Weight loss

Those symptoms may arise on an empty stomach, such as between meals or while sleeping. Others may temporarily manage stomach ulcer symptoms with antacids and may go away when eating.

Some causes of stomach ulcers include:

• Bacterial infections: H. pylori, a bacteria, can infect your digestive system and damage your stomach's mucus lining. Often, the bacteria are found in contaminated food and water. Too much damage to the stomach lining may cause an ulcer.
• Prolonged non-steroidal anti-inflammatory drug (NSAID) use: NSAIDs are pain relievers, such as Advil (ibuprofen), Bayer (aspirin), and Aleve (naproxen). NSAIDs may damage your stomach lining if you take them daily or for long periods. 
• Tumors: Ulcers may occur if you have Zollinger-Ellison syndrome, a rare condition that forms cancerous tumors in your pancreas and stomach. The cancer cells release gastrin, a highly acidic hormone. Gastrin may damage your stomach tissues, causing ulcers. 

Stomach ulcers can lead to severe complications. Reach out to a healthcare provider if you feel light-headed or have muscle weakness, and notice blood in your stool or vomit.

Treatment options for stomach ulcers depend on the cause. A healthcare provider may prescribe antibiotics, histamine blockers, or PPIs to protect the stomach lining.

Conditions That Cause Heartburn-Like Pain

Severe health conditions like gallstones or heart disease can mimic heartburn. Consider seeking immediate medical attention if you have heartburn-like pain with the following additional symptoms.

Gallstones

Gallstones are hard stones of cholesterol in the gallbladder, a pear-shaped organ behind the liver that stores bile. You may develop gallstones if there's too much cholesterol in your bile or your gallbladder does not empty.

Most of the time, gallstones do not cause symptoms. Gallstones may cause heartburn-like symptoms if they block your bile duct.

Common gallstone symptoms include:

• Dark-colored urine
• Fever
• Heartburn and indigestion after eating
• Jaundice, or the yellowing of the skin and eyes
• Nausea and vomiting
• Sudden stomach and chest pain that worsens when lying down

Gallstone complications can be severe. Contact a healthcare provider if you have abdominal pain that does not resolve with medication or symptoms that last several hours.

Heart Disease

Heart disease is an umbrella term for several diseases that affect the heart. One of the most common types of heart disease is coronary artery disease (CAD), which blocks blood flow to your heart.

Heart disease can lead to severe complications:

• Angina: This chest pain happens when there's limited blood flow to your heart. Angina symptoms include fullness in your stomach, severe pain in your chest, and tightness in your upper body.
• Cardiac arrhythmia: You may notice a change in your heartbeat rhythm if something blocks blood flow to your heart. Cardiac arrhythmia symptoms include chest pounding, fainting, sharp chest pains, and shortness of breath.
• Heart attack: A myocardial infarction, the clinical name for a heart attack, occurs when there is a complete blockage of blood to the heart muscle. The pain or discomfort is similar to angina-a pressure, burning, or squeezing sensation but more severe and lasting longer. Heartburn pain that is severe and lasts longer than 10 to 15 minutes may be due to a heart attack. Other heart attack warning signs may include difficulty breathing, dizziness, fatigue, pain and numbness in the limbs, and nausea.

Seek immediate medical attention if you or a loved one has sudden heartburn symptoms. A healthcare provider can check for severe heart concerns and initiate appropriate therapy to prevent heart failure.

Other Possible Conditions

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

• Achalasia: This rare disease makes it hard for your esophagus to move food into your stomach. As a result, you may develop chest pain and regurgitation.
• Eosinophilic esophagitis (EoE): Eosinophils, a type of white blood cell, build up in your esophagus and cause inflammation. You may get food caught in your through or have pain and trouble swallowing.
• Esophageal diverticula: This rare disease causes pouches in your esophagus to point outward. Food fills up the pouches, which may develop regurgitation.
• Esophageal cancer: In its early stages, esophageal cancer does not cause symptoms. You may later develop GERD-like symptoms like a hoarse voice and difficulty or painful swallowing.
• Rumination syndrome: People with this disorder purposefully regurgitate and rechew their food.
• Stomach cancer: This type of cancer is difficult to detect since it causes GERD-like symptoms like indigestion. Later, stomach cancer may cause blood in your stool, jaundice, and unexplained weight loss.

Eating Habits That Cause Heartburn

Certain eating habits may trigger heartburn symptoms. For example, fatty, greasy, and spicy foods are more likely to cause heartburn than others.

Other drinks and foods that may cause heartburn include:

• Alcohol
• Caffeine
• Chocolate
• Fizzy drinks
• Highly acidic foods (e.g., oranges and tomatoes)
• Peppermint and spearmint

Drinking or eating too fast can trigger heartburn symptoms. Try eating more frequent and smaller meals spread evenly throughout the day instead of three large meals. 

Do not eat at least three hours before bedtime. Lying down after eating may cause your stomach contents to place pressure on the lower esophageal sphincter.

Heartburn Symptoms in Women

Generally, heartburn symptoms present similarly in all genders. 

Some evidence suggests that women report heartburn and regurgitation more often than men. A study published in 2016 hypothesized that women may be more likely to notice heartburn symptoms than men.

In contrast, women may have different heart attack warning symptoms that resemble heartburn than men.

For example, heart attack symptoms in women may include:

• Back and jaw pain
• Nausea
• Shortness of breath
• Vomiting

When To See a Healthcare Provider

Reach out to a healthcare provider if you have heartburn symptoms more than two times per week. Let them know if your symptoms do not resolve with lifestyle changes and medicine.

Other reasons to consult a healthcare provider may include:

• Chronic cough or wheezing
• Trouble swallowing
• Unexplained weight loss
• Worsening symptoms after using medicines like antacids and histamine blockers

Seek medical attention right away if you have sudden severe symptoms, such as:

• Blood in your vomit
• Black or maroon stool
• Burning feeling, crushing, or squeezing pressure in your chest in your chest

Your symptoms may be everyday heartburn. You may still consider seeing a healthcare provider so they can rule out health conditions. They will likely ask about your health history, perform imaging or lab tests, and talk to you about treatment options. 

A Quick Review

Heartburn may indicate health conditions like a hiatal hernia, GERD, or stomach ulcers. Sometimes pain that is perceived as heartburn is from more serious conditions such as gallstones or coronary artery disease.

Lifestyle changes, medicines, and surgeries are among the treatment options for those cases. See a healthcare provider for a diagnosis and other treatment if your heartburn persists or is resistant to treatment.