Heartburn can be a symptom of other conditions, including stomach ulcers, hiatal hernia, and pregnancy. A person must consult a doctor to receive the correct diagnosis and treatment.

An older woman sitting at the sofa holding her chest due to heartburnShare on Pinterest
AsiaVision/Getty Images

Heartburn is a common symptom of acid reflux — when stomach acid flows back into the esophagus — causing a burning sensation. However, other possible causes may also result in heartburn as a symptom.

This article looks at the other conditions that may also cause heartburn, related symptoms and treatments, and signs it could be more serious.

Stomach ulcers are sores or ulcers that develop in the lining of the stomach or small intestine.

Symptoms

The most common symptom of stomach ulcers is a burning pain in the abdomen.

People may also experience other symptoms, such as:

  • indigestion (dyspepsia)
  • heartburn (people may mistake this for indigestion, or they may occur at the same time)
  • nausea

Some stomach ulcers are painless, and people may only notice them when a complication has developed, such as bleeding.

Treatment

The treatment depends on the cause of the ulcer. Most stomach ulcers will heal in 1–2 months.

Doctors may prescribe a proton pump inhibitor (PPI) to reduce the stomach’s acid, preventing heartburn. If the ulcer resulted from an infection, they might also receive a course of antibiotics.

Stomach ulcers may recur after treatment, but this tends to be less likely if a person receives suitable treatment for the cause of the ulcer.

A hiatal hernia is when the stomach pushes through a weakness in the wall of another body part. This tends to occur where the food pipe narrows — the diaphragm.

This condition is common in people over 50.

Symptoms

Some people can have a hiatal hernia without knowing as it may not cause any symptoms, while others may experience:

Treatment

A hiatal hernia does not require treatment if it is not causing any issues.

Other recommendations include dietary and lifestyle changes such as quitting smoking (if you smoke), and over-the-counter (OTC) or prescription medications for GERD to relieve heartburn.

In some cases, if the above treatments have not worked, doctors may recommend laparoscopic surgery.

According to the Office on Women’s Health (OWH), heartburn is a common effect of pregnancy. These symptoms result from hormonal changes and the baby pressing against the stomach.

Read more about heartburn during pregnancy.

Treatment for heartburn

OTC treatments that contain calcium carbonate may help with pregnancy-related heartburn. With severe heartburn, a doctor may prescribe sucralfate (Carafate), an H2-receptor agonist, or a PPI.

A person should always confirm with a doctor or pharmacist that the medication is suitable during pregnancy.

Medical professionals may also recommend the following:

  • eating less fatty foods
  • reducing caffeine intake
  • eating smaller, more frequent meals
  • sleeping with the head elevated

Doctors define reflux esophagitis as the inflammation of the esophagus lining.

The most common symptoms of reflux esophagitis include the following:

  • heartburn
  • a sense of a lump in the throat
  • increased saliva

Common risk factors for developing this condition include:

  • being over 50
  • having body mass index above 30
  • smoking
  • having anxiety or depression
  • having decreased physical activity
  • taking certain medications, such as:
    • nitrates
    • calcium channel blockers
    • anticholinergic agents

Reflux esophagitis also frequently occurs during any pregnancy trimester. Pregnant people tend not to have heartburn before their pregnancy, and reflux and heartburn usually resolve after giving birth.

Treatment

There are various strategies and treatments that people can use to manage their symptoms:

  • Elevate the head of the bed.
  • Avoid meals 2–3 hours before sleep.
  • Make dietary changes, such as avoiding:
    • chocolate
    • caffeine
    • alcohol
    • spicy food
  • Take a PPI, which is safe during pregnancy if prescribed by a doctor (but they should discuss the possible side effects).

Anxiety can affect both mental and physical health.

2019 research found that anxiety and depression rates were significantly higher in people with GERD. A 2015 study also showed that among people with GERD, heartburn was more severe in those with higher anxiety levels.

Read more about acid reflux and anxiety.

Treatments

If anxiety, heartburn, or both occur together, a person should consult a doctor to help treat the symptoms. Sometimes, one may aggravate the other, so a person must work to prevent them.

People will benefit from dietary changes in terms of eating schedules, types of foods consumed, and prescribed medications for GERD.

Doctors may also recommend ways to reduce anxiety, such as:

Gastroparesis causes food to pass through the stomach slower than it should.

Symptoms

Symptoms may start after eating and may include:

  • feeling full sooner than usual
  • nausea and vomiting
  • abdominal pain
  • heartburn
  • bloating

Treatment

This is a long-term condition that people can manage with diet changes and medications.

Doctors may recommend:

  • eating 4–6 smaller meals per day
  • reducing the amount of insoluble fiber in the diet
  • having a liquid diet
  • taking medications that help food move through your stomach faster, such as metoclopramide or domperidone
  • pain relievers
  • anti-sickness medications

Barrett’s esophagus is where the food pipe lining cells have started to grow abnormally — dysplasia.

People with Barrett’s esophagus have a higher risk of developing adenocarcinoma of the esophagus. This cancer can also cause heartburn as a symptom. However, most people with Barrett’s esophagus do not get esophageal cancer.

Symptoms

Many people with Barrett’s esophagus do not have any symptoms. Doctors may find the changes when they have tests for something else.

Long-term indigestion and heartburn are the most common symptoms. They may also have difficulty swallowing food.

A person should consult a doctor if these symptoms persist as this could signify complications and damage to the esophagus.

Treatment

Treatments aim to reduce the amount of acid to control symptoms and reduce the risk of abnormal cells developing into cancer. Other treatments remove or treat the damaged areas.

Do any other conditions feel like heartburn?

Biliary colic is right upper quadrant abdominal pain radiating to the right shoulder with symptoms typically worsening after a fatty meal.

Do heart attacks feel the same as heartburn?

Some heartburn symptoms and a heart attack could overlap, such as chest pain (angina). As a result, some people having a heart attack may mistake this symptom for heartburn and vice versa.

A person should consult immediate medical attention if they experience heartburn pain alongside:

  • pressure, squeezing, fullness, or pain in the center of the chest
  • pain or discomfort in one or both arms, the back, neck, jaw, or stomach
  • shortness of breath with or without chest discomfort
  • breaking out in a cold sweat
  • nausea
  • lightheadedness

Learn more about the differences between heartburn and a heart attack here.

Although heartburn is common with GERD, it can also be a symptom of stomach ulcers, hiatal hernia, and esophagitis. Pregnancy may also cause heartburn.

A person must consult a doctor for the correct diagnosis and treatment for their symptoms.