Although often used interchangeably, heartburn and indigestion are different conditions. Indigestion is a general term that describes discomfort or pain in your upper abdomen.
On the other hand, heartburn refers to a burning sensation in the chest, right behind the breastbone. Both conditions are especially common in pregnancy due to hormonal changes and the baby pressing against the stomach.
What Is Heartburn?
For starters, heartburn has nothing to do with the heart. It is a common condition, which creates a burning pain in the chest. The pain often gets worse after eating, in the evening, or when lying down or bending over.
Heartburn is caused by acid reflux, which is when stomach acid flows back into the esophagus. Acid reflux that occurs more than twice a week is known as gastroesophageal reflux disease (GERD). Heartburn may be a symptom of indigestion.
What Is Indigestion?
Indigestion, otherwise known as dyspepsia, can be described as a persistent or recurrent discomfort in your upper abdomen.
It is not a condition of its own, but rather some symptoms you experience, such as bloating, abdominal pain, or feeling full too quickly after you start eating. Indigestion can be a symptom of an underlying disease, such as GERD, gallbladder disease, or ulcers.
Difference between Indigestion, Heartburn, and GERD
People with indigestion, i.e., discomfort in the upper abdomen, may sometimes also experience heartburn. Heartburn is a burning sensation in your chest that occurs when stomach acid backs up into your esophagus. This backwash is known as acid reflux.
Now, gastroesophageal reflux disease (GERD) is mild acid reflux that occurs at least twice a week or moderate to severe acid reflux that occurs at least once a week.
If left untreated, GERD can lead to serious health problems such as Barrett’s esophagus, a condition associated with an increased risk of esophageal cancer.
So to recap:
- Indigestion is upper abdominal discomfort.
- Heartburn is a burning pain behind the breastbone.
- Heartburn occurs as a result of acid reflux, i.e., the backward flow of stomach acid into the food pipe.
- GERD is recurrent acid reflux.
- Heartburn may be a symptom of indigestion and GERD.
What Causes Indigestion and Heartburn?
Most people experience indigestion at some point. In most cases, it is linked to lifestyle choices and can be triggered by what you eat and drink. However, it may also be a result of other digestive conditions.
Causes of indigestion include:
- Eating too fast
- Eating fatty or spicy foods
- Excessive alcohol consumption
- Drinking too much caffeine
- Stress and anxiety
- Certain antibiotics and painkillers (e.g., NSAIDs)
- Underlying diseases or conditions like ulcers, stomach cancer, inflammation of the stomach lining (gastritis), chronic or acute pancreatitis, intestinal blockage, gallstones, thyroid disease, and pregnancy
Getting heartburn from time to time is normal and is rarely a significant cause for concern. Heartburn occurs when contents from your stomach flow back up into the esophagus, which is the tube that carries food from your mouth to your stomach.
Usually, when you swallow, a ring of muscles around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow the passage of food and liquids into your stomach.
After which, it closes. However, if the lower esophageal sphincter isn’t functioning normally or becomes weakened, stomach acid can leak back into the food pipe (acid reflux). The acid irritates your esophagus, causing you to feel a burning sensation in your chest.
Risk factors for heartburn
Heartburn can be triggered or made worse by:
- Certain foods and drinks, such as spicy foods, fried or fatty foods, chocolate, onions, citrus products, coffee, alcohol, and carbonated beverages
- Hiatus hernia, i.e., when part of your stomach pushes through the diaphragm and into your chest
- Some medications such as aspirin and ibuprofen
- Obesity or overweight
If you have indigestion (dyspepsia), you may have one or more of the following symptoms:
- Burning pain in the chest (heartburn)
- Bloating (feeling full)
- Mild to severe abdominal pain
- Belching and farting
- Nausea and vomiting
- Bitter taste in your mouth
Note: You may feel these symptoms occasionally or as often as daily.
The symptoms of heartburn include:
- Burning sensation in the chest, often after you eat
- Pain that gets worse when you bend over or lie down
- Bitter or acidic taste in your mouth
There’s usually no need to see a doctor about indigestion or heartburn. You can ease your symptoms with simple lifestyle changes, such as:
- Eating small frequent meals so that your stomach does not have to work as hard or as long.
- Try to maintain a healthy weight since excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to flow back into your food pipe.
- Keep fit through regular exercise as it helps shed off the extra weight and promotes better digestion. However, do not work out on a full stomach. Instead, exercise before a meal or at least 1 hour after eating.
- Avoid foods that trigger your heartburn or indigestion, such as spicy and fatty foods.
- Cut down on alcohol, caffeine, carbonated beverages, and smoking.
- Manage stress such as relaxation techniques (e.g., deep breathing, meditation, yoga), getting plenty of sleep, and doing things you enjoy.
- Avoid lying down right after eating, instead wait at least three hours. Sleep with your head elevated (at least 6 inches) above your feet. You can achieve this by raising the head of your bed using plastic or wooden bed risers or a therapeutic bed wedge pillow. Doing so will help allow digestive juices to flow into the intestines rather than to the esophagus.
Additionally, various over the counter medications can help relieve indigestion and heartburn. These include:
- Proton pump inhibitors (PPIs), such as lansoprazole (Prevacid 24HR) and omeprazole (Nexium 24 HR).
- H-2-receptor antagonists (H2RAs)
- Antacids. Although they provide quick relief, they can’t heal an esophagus damaged by stomach acid.
When to see a doctor
Make an appointment with your doctor if:
- Discomfort persists for more than two weeks.
- You get heartburns that exceed twice a week.
- Symptoms persist even after using OTC medications.
- You have appetite loss or lost weight unintentionally.
- You have difficulty swallowing.
- You experience severe chest pain or pressure, especially if accompanied by shortness of breath and pain in the arm, neck, or jaw.
- Mayo Clinic Staff. Indigestion (dyspepsia). Updated April 2016.
- National Institute of Diabetes and Digestive and Kidney Diseases. Indigestion. Updated May 2020.
- Verywellhealth. Indigestion and Heartburn Differences. Updated February 2020.
- National Institute of Diabetes and Digestive and Kidney Diseases. Heartburn and Acid reflux (GER & GERD). Updated November 2015.