Is it Heartburn or Something Else?

Everyone has paid the price for overindulging in their guilty food pleasures at one time or another. That burning or painful sensation in your chest and sour taste in your throat are telltale signs that heartburn is rearing its ugly post-mealtime head.

But sometimes what you think is heartburn might be another condition altogether. Here’s how to tell if what you are experiencing is heartburn or something else.

Conditions That Can Feel Like Heartburn

Heartburn is caused by acid reflux — stomach acid being pushed up from the stomach into the esophagus. This happens when your body cannot properly digest and break down food, usually due to factors like eating a heavy, large meal, consuming fatty or acidic foods, or eating too fast.

Occasional heartburn is nothing to worry about. However, if you find that you’re experiencing heartburn-like symptoms regularly, that should not go unchecked. Visit your doctor for a complete evaluation, as it could be one of the following, more serious conditions:

GERD (gastroesophageal reflux disease): GERD develops when heartburn (acid reflux) occurs constantly. In GERD sufferers, stomach acid is continually pushed up into the esophageal area, which can eventually lead to painful ulcers and sores in along the lining of the esophagus. GERD is most commonly seen in those who are smokers, obese or sedentary.
Peptic Ulcers: Peptic ulcers, or stomach ulcers, are painful sores that develop from the overproduction of acid in the stomach. The excess acid begins to break down the protective lining of the stomach, leaving parts of it exposed and raw — making digestion extremely painful. Ulcer symptoms can feel like heartburn, but usually also include nausea or vomiting, bloating and a burning sensation in the chest in between meals — not necessarily right afterward.
Heart Disease: Heaviness in the chest is the main symptom of heart disease. But for some people, this “heaviness” can also feel like burning, pinching or esophageal pressure — all symptoms of heartburn. However, with heart disease, you will usually feel the heartburn-like symptoms while doing moderate-to-strenuous activity, rather than after eating.
Anxiety: Although anxiety is a mental health condition, it has numerous physical side effects. Many people with anxiety have visited the hospital at one point or another, mistaking a panic attack for a heart attack. Moderate-to-severe anxiety can cause episodes of shortness of breath, racing heartbeat, dizziness and nausea, tingling in the extremities, throat tightness, and chest heaviness and pain. If your heartburn episodes tend to coincide with periods of high stress and worry, anxiety could be the culprit.
Gallstones: If your heartburn symptoms include sudden, rapidly intensifying pain in the upper right portion of your abdomen, or just below your breastbone, you could be suffering from gallstones. Even the tiniest stones can block the bile ducts in your stomach, leading to sharp, severe pain moments after you’ve finished your meal.
Heart Attack: A person who is having a heart attack does not always experience crushing chest pain that makes them fall to their knees. For women especially, symptoms of a heart attack are often subtle. These symptoms can certainly mimic the chest-burning, feeling of fullness, and indigestion associated with heartburn. But heart attacks are also accompanied by distinct pain in the arms, neck, or jaw, cold sweats, nausea or vomiting, and extreme weakness or anxiety — none of which are heartburn symptoms.
Esophageal Cancer: Esophageal cancer is rare in the U.S., comprising only about 1% of the cancers diagnosed. Its symptoms, however, are very similar to heartburn. They can include burning in the chest, indigestion, and difficulty swallowing food. But other esophageal cancer signs may also be unexplained weight loss, choking on food, nausea or vomiting blood, and loss of appetite. Your doctor can test for this type of cancer using an endoscopy or through surgery to collect tissue samples.