About this symptom
Heartburn usually feels like burning behind the breastbone and may rise towards the throat. Acid regurgitation is the sensation of stomach contents moving upwards, sometimes leaving a sour taste. Both can occur after a large meal or on lying down.
How the symptom or condition presents
Episodes may be triggered by late meals, bending over or individual foods. Some people also notice a cough or hoarse voice, but those symptoms are not specific for reflux. Record their frequency, night-time occurrence and any previous response to treatment.
Important differences and warning signs
An isolated episode does not establish gastro-oesophageal reflux disease (GERD), and chest discomfort must not automatically be attributed to acid. Difficulty or pain on swallowing, unintended weight loss, repeated vomiting or signs of bleeding require clinical assessment.
Evaluation and individual care
Evaluation is based on the symptom pattern and alarm features. Endoscopy or further oesophageal investigations are reserved for appropriate indications. Management may include avoiding lying down soon after eating, identifying personal triggers and medicines prescribed to reduce acidity when suitable.
Related information: Gastro-oesophageal reflux disease; Upper abdominal pain.
Signs and symptoms
- Burning behind the breastbone, often after meals.
- Sour taste or fluid returning towards the throat.
- Symptoms on lying down, sometimes with a cough or hoarseness.
Diagnosis and tests
A clinician reviews typical symptoms, duration, medicines, possible cardiac causes and alarm features. Gastroscopy or another oesophageal test may be appropriate if symptoms persist, swallowing is affected or an unusual course is suspected.
Care and treatment approaches
Do not lie down immediately after eating; discuss meal timing, specific triggers and weight management if relevant. Acid-suppressing medicines may be prescribed when indicated. Ongoing or worsening symptoms need reassessment rather than indefinite self-medication.
When to seek urgent care
Call 103 or 112 for sudden pressure in the chest with breathlessness, sweating or weakness. Vomiting blood, black stools or inability to swallow also require urgent medical help.
Frequently asked questions
Why is heartburn worse when I lie down?
Lying flat can make it easier for stomach contents to reflux into the oesophagus. This pattern alone does not confirm a particular diagnosis.
Do all people with heartburn need a gastroscopy?
No. The need depends on alarm symptoms, age, clinical history and response to appropriate initial management.
Is every episode of heartburn a sign of GERD?
No. Occasional reflux symptoms are common. Recurrent troublesome symptoms or complications warrant evaluation for GERD and alternative causes.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
