Heartburn

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Common Causes

Almost everyone has occasional heartburn. If you have frequent, ongoing heartburn, you may have gastroesophageal reflux disease (GERD). Reflux is when food or liquid travels from the stomach back up into the esophagus (the tube from the mouth to the stomach). This partially digested material is usually acidic and can irritate the esophagus, often causing heartburn and other symptoms.

Normally, when you swallow, the muscular walls of the esophagus move in waves to push the food down into the stomach. Right after the food enters your stomach, a band of muscle at the end of your esophagus (called the lower esophageal sphincter or LES) closes off the esophagus. If this muscle fails to close tightly enough, the stomach contents can back up into the esophagus, causing heartburn and other symptoms.

Heartburn can also be a side effect of certain drugs, including:

• Calcium channel blockers for high blood pressure (e.g., amlodipine, diltiazem, felodipine, nifedipine, and verapamil)
• Bisphosphonates for osteoporosis (e.g., alendronate and risedronate)
• Progestin hormones used for abnormal menstrual bleeding or for contraception (e.g., norethindrone and medroxyprogesterone)
• Anticholinergics (e.g., scopolamine for sea sickness)
• Aspirin or nonsteroidal anti-inflammatory drugs NSAIDs like ibuprofen
• Certain bronchodilators for asthma (e.g., theophylline)
• Tricyclic antidepressants (e.g., amitriptyline and nortriptyline)
• Dopamine for Parkinson's disease
• Sedatives for insomnia or anxiety
• Beta blockers for high blood pressure or heart disease (e.g., atenolol, labetalol, metoprolol, nadolol, pindolol, and propranolol)

NEVER change or stop medication you take regularly without talking to your doctor and getting instructions on how to do so. If you take an occasional aspirin or NSAID for headache or mild pain, try acetaminophen (Tylenol) instead.