Serious conditions that mimic heartburn

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Heartburn like pain is a common symptom of gastroesophageal reflux disease (gerd). But several other conditions can cause a burning feeling in your chest.

Most of the time, your doctor will be able to identify whether you have heartburn or gerd by conducting tests.

Here are nine other conditions that can cause heartburn-like pain.

Heart disease
Angina, or chest pain caused by lack of blood flow to the heart, can feel a lot like heartburn.

The major key is if youre getting heartburn when youre doing strenuous or moderate activity, says Ryan Madanick, MD, a gastroenterologist and assistant professor of medicine at the University of North Carolina School of Medicine, in Chapel Hill.

If youre 50 or older and getting heartburn especially if you havent had this kind of pain before it can raise suspicion of angina. Suspicions can also be raised if youre younger, but have heart risk factors such as hypertension, diabetes, or a family history of heart disease.

Gallstones
Although gallstones dont always cause symptoms, a stone blocking your bile duct can hurt, usually in the middle or upper-right side of the abdomen.
Pain may be cramping, dull, or sharp, and often strikes minutes after you eat.

Stomach ulcer
Ulcers can cause a gnawing, burning sensation, usually felt in the upper abdomen. The pain can find its way up to the chest, Dr Madanick says.
Acid-suppressing medications may relieve ulcer pain.

But ulcers are usually caused by Helicobacter pylori, a type of bacteria that inflames the stomach lining, so you will need to take antibiotics to clear the infection.

Hiatal hernia
A hiatal hernia occurs when a portion of the upper stomach pokes through the diaphragm into the chest cavity, rather than staying in the abdominal cavity where it belongs.

This can push food and stomach acid up into the oesophagus, causing heartburn. Other signs of hiatal hernia include chest pain, belching and nausea.

If you have heartburn due to hiatal hernia, your doctor will typically prescribe acid-suppressing drugs and recommend lifestyle changes like eating smaller meals, avoiding alcohol and not eating right before bed. In rare cases, surgical repair may be warranted.

Oesophageal cancer
Oesophageal cancer is rare, but its incidence is rising rapidly in the United States, Dr Madanick says.

If you have heartburn, it might be a sign of esophageal cancer, but its highly unlikely, he says. Your doctor may decide to order an upper endoscopy to examine your oesophagus if youve got long-standing heartburn, especially if you smoke or drink heavily, both of which are risk factors for oesophageal cancer.

Gastroparesis
Poor control of diabetes can lead to nerve damage, which can affect the workings of your digestive tract. This is called gastroparesis and it dramatically slows the movement of food through the stomach and can cause heartburn.

Treatment can include dietary changes such as eating smaller meals, avoiding fat and fibre, medications and, for people with very severe symptoms, inserting a feeding tube or an implanted device that emits electrical pulses mimicking stomach contractions.

Oesophagitis
Oesophagitis, or inflammation of the oesophagus, can result from frequent acid reflux. This condition can in turn lead to more heartburn, as well as difficulty swallowing.

The oesophagus can also become inflamed from taking certain painkillers and osteoporosis medications, particularly if the pills are taken without water, allowing them to remain in the oesophagus.

A third type of oesophagitis, called oeosinophilic oesophagitis, occurs when white blood cells known as oeosinophils invade the oesophagus. The condition is often allergy-related, so treatment requires identifying and avoiding the offending foods. Doctors may also prescribe steroid medications to ease inflammation.

Pleuritis or costochondritis
Inflammation of the lining of the lungs and chest cavity, known as pleuritis or pleurisy, can cause heartburn-like chest pain. Pleuritis should be suspected if the pain or burning gets worse when you take deep breaths or move around, Dr Madanick says.

Pleuritis is most commonly caused by a viral or bacterial infection and resolves when the infection does.

Costochondritis an inflammation of the cartilage anchoring ribs to the breastbone can cause sharp pain along the breastbone or sternum. It can be related to injury or infection, and typically is treated with anti-inflammatory medicines, pain relievers, and rest.

Anxiety
Although anxiety wont cause gerd, it can cause heartburn and make gerd symptoms worse, Dr Madanick says.

A person can have both anxiety-related heartburn and gerd-related heartburn. One of the signs that its not just reflux is that treating the reflux problem doesnt make it any better, he says.

Reducing anxiety and stress through, for example, exercise, relaxation and therapy, can also ease heartburn.

When it comes to acid reflux, there are certain foods that are almost universally problematic. The best strategy is to avoid them, but they often make up over half of many peoples diets.