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Heartburn

Heartburn is a burning feeling behind the breastbone. Almost everyone gets it now and then. Heartburn two or more times a week may be GERD and is worth seeing a doctor about. Chest pain that could be a heart attack needs 911.

Chest pain? Call 911 if it could be a heart attack. Don’t assume chest pain is heartburn until a doctor has checked for a heart cause (ACG). Heart attack signs include (CDC):

  • Chest pain or discomfort — pressure, squeezing, fullness or pain in the center or left of the chest that lasts more than a few minutes, or goes away and comes back.
  • Pain or discomfort spreading to one or both arms or shoulders, or to the jaw, neck or back.
  • Shortness of breath, with or before the chest discomfort.
  • Feeling weak, light-headed or faint, or breaking into a cold sweat. Women are more likely to also have unusual tiredness, nausea or vomiting.

See a doctor promptly if heartburn comes with any of these (NIDDK, ACG):

  • Trouble swallowing, pain when swallowing, or food that feels stuck behind the chest.
  • Vomiting blood or vomit that looks like coffee grounds, or black, tarry or bloody stools.
  • Weight loss you can’t explain, loss of appetite, or vomiting that keeps happening.

Pregnant? Heartburn that doesn’t go away with heartburn medicines can be a sign of pre-eclampsia — get urgent medical help (NHS).

This guide is about occasional heartburn. For frequent heartburn or GERD, our Acid Reflux & GERD guide covers testing, prescription treatment, surgery, costs and complementary care in depth.

What is heartburn?

Heartburn is a painful, burning feeling in the middle of the chest, behind the breastbone, rising from its lower tip toward the throat (NIDDK). It happens when stomach contents flow back up into the esophagus — gastroesophageal reflux (GER), which doctors also call acid indigestion, acid reflux or simply heartburn (NIDDK).

Strictly, heartburn is a symptom, acid reflux is what causes it, and GERD is the disease (ACG).

Occasional heartburn or GERD?

Almost everyone has heartburn at some point, especially after a heavy meal (ACG), and having GER once in a while is common (NIDDK). Infrequent heartburn is not the same as GERD, and it can often be controlled with lifestyle changes and proper use of over-the-counter medicines (ACG).

GERD is defined as frequent symptoms — two or more times a week — or reflux that damages the esophagus (ACG). See a doctor if:

Long-standing, untreated heartburn is linked with Barrett’s esophagus and esophageal cancer (ACG). Most people are diagnosed from symptoms alone; tests are for possible complications or symptoms that don’t improve (NIDDK).

Heartburn or heart attack?

Reflux can cause chest pain much like heart pain. The ACG’s advice is plain: if you have chest pain, don’t assume it is your esophagus until a doctor has checked for a heart cause (ACG). Some signs point toward the heart — pain that spreads to the arm, jaw, neck or back, shortness of breath, a cold sweat or feeling faint (CDC) — but no one should try to tell the two apart at home. The sooner a heart attack is treated, the less damage to the heart muscle; call 911 (CDC). Gallstone attacks can also cause chest pain that feels like a heart attack (ACG).

Common triggers

Heartburn often has no obvious reason (NHS), but common triggers include:

  • Food and drink: acidic foods such as citrus and tomatoes, alcohol, chocolate, coffee and other caffeine, high-fat foods, mint and spicy foods (NIDDK).
  • How and when you eat: large meals and eating close to bedtime; symptoms are often worse after eating, lying down or bending over (NHS).
  • Body and habits: extra weight, smoking or secondhand smoke, and pregnancy (NIDDK); stress and anxiety; tight waistbands (NHS).
  • Medicines such as NSAID painkillers, benzodiazepines, calcium channel blockers, certain asthma medicines and tricyclic antidepressants (NIDDK). Never stop a prescribed medicine without talking to your doctor first (NHS).

When heartburn is something else

Heartburn can come from a stomach ulcer, a bacterial infection in the stomach or a hiatus hernia (NHS); heartburn and indigestion are common ulcer symptoms (NHS). Our Digestion guide covers indigestion, ulcers and H. pylori, and our Gallbladder guide covers gallstone pain. One more warning sign: in a narrowed esophagus (stricture), heartburn can actually ease while food starts to stick (ACG) — so less heartburn with new trouble swallowing is a reason to see a doctor, not a sign of getting better.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Lifestyle changes and over-the-counter antacids, alginates, H2 blockers or a 14-day OTC PPI course for occasional heartburn. A doctor visit for heartburn two or more times a week, symptoms that don’t improve, or warning signs. Over-the-counter heartburn medicines are typically about $4–$25 a package and usually aren’t covered by insurance. A primary care visit is about $50–$200+ without insurance. H2 blockers typically start working in one to three hours; OTC PPIs can take one to four days for full effect. Heartburn that keeps coming back needs a diagnosis — see the Acid Reflux & GERD guide.
Chiropractic No role in treating heartburn. Chest pain must be checked by a doctor before it is treated as a muscle or joint problem. Not a treatment for heartburn, so no cost is listed. We found only case reports, no controlled trials, of it relieving heartburn. See the Acid Reflux guide for the GERD research.
Acupuncture Fine needles, usually added to medical care. Studied mainly in GERD and in heartburn that persists on a PPI. About $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90. Medicare covers acupuncture only for chronic low back pain. Small studies are encouraging, but the evidence is very low quality, and reviewers don’t recommend acupuncture alone in place of a PPI.
Herbal medicine We found no good evidence that any herb treats heartburn. Peppermint and ginger can cause heartburn; licorice that contains glycyrrhizin carries serious risks. Cost estimate being researched. Herbal remedies are not a substitute for checking frequent heartburn or warning signs. Tell your doctor or pharmacist about everything you take, especially in pregnancy.
Massage therapy No direct role in treating heartburn. Some people use it to relax; stress can make heartburn worse, but evidence that massage eases it is limited. Not a treatment for heartburn, so no cost is listed. See the Acid Reflux guide for typical session prices. Book sessions away from big meals and avoid lying flat if reflux bothers you. Don’t use massage to put off seeing a doctor.
MBHA Wellness Coach Smaller meals, an earlier last meal, a raised head of the bed, a healthy weight, quitting smoking, less alcohol, looser waistbands, ways to relax, and a food-and-symptom diary. Cost estimate being researched. These changes may be enough for occasional heartburn. They support, never replace, medical care, and frequent heartburn still needs a doctor.

Approach 1 of 6

Conventional medicine (AMA)

For occasional heartburn, doctors start with lifestyle changes and over-the-counter medicines (ACG): losing weight if needed, raising your head during sleep, quitting smoking and changing eating habits (NIDDK). See Choosing an over-the-counter heartburn medicine below. If symptoms won’t go away with over-the-counter medicines, talk with your doctor, who may prescribe a stronger medicine (NIDDK). Prescription treatment and surgery are covered in our Acid Reflux & GERD guide.

What it costs

Over-the-counter medicines for occasional reflux typically cost about $4–$25, depending on quantity and brand, and insurers don’t usually pay for them. A primary care visit is typically a $10–$50 copay with insurance, or $50–$200 or more without (CostHelper). Prices on that page are older estimates.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no established role in treating heartburn. In one study of 54 adults with GERD, pressure in the valve at the bottom of the esophagus rose during cervical traction and a trunk stabilization maneuver (Bitnar et al., 2021) — but the study measured pressure during the techniques, not whether heartburn improved.

Chest pain comes first. Some chest pain does come from muscles and joints. A Danish trial recruited people with chest pain of musculoskeletal origin through an emergency cardiology department; at one year, chiropractic care and self-management did equally well (Stochkendahl et al., 2012). As with any chest pain, get heart causes checked by a doctor first (ACG) rather than treating new chest pain as a back or rib problem.

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Most acupuncture research is on GERD rather than occasional heartburn.

  • Heartburn that persists on a PPI: in a trial of 30 people, adding acupuncture twice a week for 4 weeks reduced daytime and night-time heartburn, while doubling the PPI dose did not (Dickman et al., 2007). It was a small study.
  • GERD: a 2025 review of 12 studies found that manual acupuncture improved symptom scores, but the evidence was rated very low quality, overall improvement was lower than with PPIs, and the authors did not recommend acupuncture alone as the main treatment (Yin et al., 2025).

Safety and cost: relatively few complications have been reported, but nonsterile needles and improper treatment have caused serious harm; most states license acupuncturists (NCCIH). A first private visit is about $125–$230, follow-ups about $90–$185, and community clinics about $50–$90 (The Pricer, 2026). Medicare covers acupuncture only for chronic low back pain (Medicare.gov).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

We found no good evidence that any herb treats heartburn, and some popular remedies can make it worse.

  • Peppermint: peppermint oil can cause heartburn (NCCIH), and the ACG lists peppermint among trigger foods (ACG).
  • Ginger: often taken for nausea, ginger can itself cause heartburn and belly discomfort (NCCIH).
  • Licorice: it’s unclear whether licorice alone affects digestive symptoms. Its glycyrrhizin can cause serious effects such as irregular heartbeat, especially in large amounts, over long periods, or in people with high blood pressure or heart or kidney conditions. Deglycyrrhizinated licorice (DGL) might be safe for up to 4 months, and large amounts of licorice are unsafe in pregnancy (NCCIH).

Ask your doctor or pharmacist before combining herbs with medicines, especially in pregnancy.

Approach 5 of 6

Massage therapy

Our PubMed search found no studies of massage for occasional heartburn in adults; the small, preliminary GERD study on diaphragm work is described in our Acid Reflux guide. Stress and anxiety can make heartburn worse (NHS), but evidence that massage eases anxiety is limited and comes mostly from other conditions (NCCIH). Because reflux is often worse after eating, lying down or bending over (NHS), book sessions away from big meals and ask to have your head raised. Rare serious side effects of massage have been reported, and it shouldn’t be used to put off seeing a health care provider (NCCIH).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you try these changes one at a time and keep the ones that work:

Heartburn two or more times a week still needs a doctor (ACG).

Another approach

Choosing an over-the-counter heartburn medicine

There are three main classes of over-the-counter (OTC) heartburn medicine (FDA), plus alginates. Follow the label, and ask a doctor or pharmacist first if you take prescription medicines, since acid reducers can interact with them (FDA).

  • Antacids (such as Tums, Rolaids or Mylanta) neutralize stomach acid (FDA) and help mild symptoms, but shouldn’t be used every day or for severe symptoms without talking to your doctor; side effects include diarrhea or constipation (NIDDK).
  • Check for aspirin. Some heartburn and upset-stomach products contain aspirin, which can cause stomach or intestinal bleeding — especially if you are 60 or older, have had ulcers or bleeding problems, take blood thinners, steroids or other NSAIDs, or have three or more drinks a day. The FDA suggests choosing an aspirin-free product (FDA).
  • Alginates (such as Gaviscon) help stop stomach acid coming back up into the esophagus (ACG, NHS). The NHS suggests taking antacids or alginates with or soon after food, and says they help in the short term but won’t cure the problem and shouldn’t be taken regularly for long periods (NHS).
  • H2 blockers (such as famotidine or cimetidine) reduce the acid the stomach makes. They relieve and prevent heartburn, typically start working in one to three hours, and last several hours (FDA). Cimetidine can raise blood levels of some seizure, blood-thinning and heart-rhythm medicines; famotidine doesn’t have this problem (ACG). Ranitidine (Zantac) was withdrawn from the U.S. market in 2020 over an impurity (FDA).
  • OTC proton pump inhibitors (such as omeprazole, esomeprazole or lansoprazole) are for frequent heartburn — two or more days a week. They aren’t for immediate relief and may take one to four days for full effect. The FDA says OTC PPIs are intended only for a 14-day course, up to three times a year (FDA). Side effects are uncommon and include headache, diarrhea and upset stomach; PPIs may raise the chance of C. diff infection (NIDDK).

If you keep needing them, see a doctor: frequent heartburn may be a sign of a more serious condition (ACG, FDA).

Another approach

Heartburn in pregnancy

Heartburn is common in pregnancy, caused by hormonal changes and the growing baby pressing on the stomach. It can start at any point but is more common from 12 weeks on, and more likely later in pregnancy, in a second or later pregnancy, or if you had indigestion before (NHS).

  • Try first: small, frequent meals; nothing within 3 hours of bed; sitting up straight while and after you eat; less caffeine and rich, spicy or fatty food; propping up your head and shoulders; and sleeping on your left side (NHS).
  • Medicines: antacids and alginates can help, but tell the pharmacist you’re pregnant, as some antacids aren’t suitable. Don’t take antacids within 2 hours of iron or folic acid, which they can stop your body absorbing. If these don’t help, your doctor or midwife may prescribe something else (NHS).
  • See your doctor or midwife if changes don’t work, or for trouble swallowing, a hoarse voice, a cough that won’t go away, weight loss, or belly pain or swelling (NHS).

Get urgent help for heartburn that doesn’t go away with heartburn medicines, especially with a severe headache, vision problems, pain below the ribs, sudden swelling of the face, hands or feet, or vomiting. These can be signs of pre-eclampsia, most likely from 20 weeks on and sometimes in the weeks after birth (NHS).

Member stories

Living with Heartburn? Share your experience

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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