What is the difference between heartburn and acid indigestion

Confused about the difference between heartburn and acid reflux? Manan Shah, M.D., a Piedmont gastroenterologist, sets the record straight, plus shares three things you can do to reduce heartburn without medication.

"Heartburn is a condition in which you feel burning behind your chest and it can be a symptom of reflux," says Dr. Shah. "Reflux is the medical term given to the stomach contents coming up into your esophagus. Heartburn is one of the common symptoms."

How common is heartburn in the United States?

Approximately 20 percent of the population has frequent heartburn symptoms – that's one in five people. If you're one of them, it's important to get your symptoms under control. Not only will doing so improve your quality of life, but you'll also reduce your risk of esophageal cancer and esophageal stricture, a narrowing in the esophagus caused by untreated inflammation.

What can you do about heartburn?

Dr. Shah says the following are research-proven methods for lessening heartburn symptoms:

• Lose weight if you are overweight or obese.

• Get a better night's sleep. Elevate the head of the bed 6 to 8 inches with a cinderblock or wedge from a surgical supply store and let gravity work in your favor. Stomach acid won't come up as high in the esophagus, which should lessen your symptoms, particularly at night.

• Consider your diet. Each person's needs are different. Certain foods may trigger heartburn in some people, but not in others. If you're susceptible to heartburn, limit your intake of the following foods to see if your symptoms improve:

  • Spicy foods

  • Carbonated beverages

  • Caffeine

  • Chocolate

  • Fatty foods

"The bottom line is reflux is a condition that does affect patients and really can cause symptoms that affect quality of life," says Dr. Shah. "Medicines aren't the only options. There are a lot of things we can do with our lifestyle, the way we eat and the way we sleep to help improve our symptoms. And there are patients where diet and lifestyle don't improve their symptoms. That's where medicines and even surgery play a role."   

Get more Living Better healthy lifestyle tips.

Need to make an appointment with a Piedmont physician? Save time, book online.

Indigestion is a feeling of discomfort or pain in the upper abdomen and chest, often accompanied by bloating, burping, nausea, or feeling too full after eating. It is, in other words, an umbrella term for a group of gastrointestinal symptoms.

Certain foods can trigger indigestion symptoms, such as fried, fatty, or spicy foods and chocolate.

Informally, indigestion is known as upset stomach; formally, it's known as dyspepsia.

This article explains the difference between indigestion and heartburn, describes indigestion symptoms and causes, and outlines indigestion treatments.

Indigestion vs. Heartburn and GERD

It's common for people to confuse indigestion with heartburn and gastroesophageal reflux disease (GERD). But these are separate conditions. Although they may have similar triggers and often are treated similarly, indigestion is different from heartburn. Heartburn is a symptom usually associated with GERD. Indigestion is a group of symptoms, one of which may be heartburn.

You feel heartburn when stomach acid comes up through the lower esophageal sphincter (LES) that links your esophagus to your stomach. This causes a burning sensation in the chest or throat. When you taste acid in the back of your mouth, it may be called acid indigestion.

Gastroesophageal reflux (GER) is when your stomach contents come back up into the esophagus; GERD is classified as a sustained or chronic state of GER, and it's often paired with regurgitation. This is when gastric acid, sometimes combined with undigested food, flows back up to the esophagus and into the mouth.

How Reflux Happens

Heartburn is a symptom of acid reflux. It involves a weakness in a valve, called the lower esophageal sphincter (LES), at the bottom of the esophagus. Usually, the LES is closed. But after it opens to allow food to pass through, sometimes it doesn't close all the way. This is when food, acid, and digestive juices can creep back up into the esophagus. This process is known as acid reflux.

Indigestion Symptoms

Many symptoms can fit under the "indigestion umbrella." It can cause:

• Bloating
• Burping
• Discomfort or pain in the upper abdomen
• Feeling full quickly while eating
• Flatulence (gas)
• Growling or gurgling noises in the stomach
• Heartburn
• Loss of appetite
• Nausea
  

Lying down within two hours of eating can bring on a wave of indigestion symptoms. So put greater distance between your last meal of the day and bedtime.

When to See a Healthcare Provider

Indigestion can be a sign of a more serious condition, such as an ulcer, or, occasionally, cancer. If you experience the following symptoms in addition to indigestion, see your healthcare provider as soon as possible:

• Black, tarry stools
• Bloody vomit
• Difficulty or pain when swallowing
• Family history of gastric (stomach) cancer
• Frequent vomiting
• Heartburn more than twice a week
• Indigestion symptoms that last longer than two weeks
• Pain in the jaw, neck, chest, or arm
• Severe stomach pain
• Shortness of breath
• Sweating
• Unexplained weight loss
  

Causes

Indigestion is a common problem that can be triggered by many things, including what and how you eat and drink. The most frequent triggers are:

Conditions such as:

• Cholecystitis (inflammation of the gallbladder)
• Chronic or acute gastritis (inflammation of the stomach)
• Gastric ulcer
• GERD
• Helicobacter pylori(H. pylori), bacteria that can infect the mucus layer of the stomach and cause gastritis and ulcers
• Irritable bowel syndrome
• Stress

Medications you take, such as:

• Antibiotics
• Nonsteroidal anti-inflammatory drugs (NSAIDs)

Activities within your control, such as:

• Drinking too much alcohol
• Drinking too much caffeine
• Eating fatty or spicy foods
• Eating too fast
• Smoking

Watch What You Drink

You can also unwittingly invite indigestion if you drink too much alcohol, coffee, or beverages containing caffeine. How much is "too much" can vary from person to person.

Less often, a hiatal hernia can cause indigestion. This occurs when part of the stomach slides upward through the diaphragm and into the chest cavity. Besides indigestion, a hiatal hernia can cause pain and heartburn.

Mild indigestion caused by food or drink often goes away after an hour or two. Indigestion caused by a medical condition may linger until it's treated professionally.

Diagnosis

To diagnose indigestion, your healthcare provider will start with your medical history and a physical exam and review your lifestyle and the medications you take. From there, they may recommend:

• Endoscopy: This procedure employs a thin, flexible scope, which has a small camera and light attached, to evaluate the inside of the body. It is used mostly for indigestion when symptoms are severe.
• Imaging tests: This may include X-ray, computerized tomography, or ultrasound.
• H. pylori testing: Detecting the bacteria may involve blood, stool, or breath testing.

Indigestion Treatment

Changes to how you live your life may help relieve heartburn and indigestion. Over-the-counter and prescription drugs can also help.

Lifestyle Changes

Lifestyle modifications can go a long way toward relieving indigestion symptoms:

• Eat smaller, more frequent meals and avoid late-night snacks. Large meals expand your stomach and increase upward pressure against the esophageal sphincter.
• Limit your intake of foods and beverages that trigger your symptoms. Keeping a journal can help you identify and avoid those foods that make heartburn worse.
• Loosen your belt and other clothing around your waist. Tight-fitting clothing will squeeze the stomach, forcing food up against the lower esophageal sphincter, causing food to reflux into the esophagus. This goes for slenderizing undergarments as well as belts.
• Exercise regularly but not immediately after eating. Wait about three hours to give your food time to digest.
• Stay upright for about two hours after you eat. Gravity helps prevent stomach juices from backing up into the esophagus. It also assists the flow of food and digestive juices from the stomach to the intestines.
• Elevate your head a few inches during sleep. Lying down flat presses the stomach's contents against the lower esophageal sphincter. When your head is higher than your stomach, gravity helps reduce this pressure. To elevate your head, place blocks under the legs at the head of your bed or use an extra pillow to prop yourself up.
• Don't smoke. The habit stimulates the production of stomach acid.
• Cut back on alcohol or don't drink at all. If you still want to drink alcoholic beverages, dilute them with water or club soda, limit the amount you drink at one time, and avoid mixers you know may trigger symptoms.
• Relax. Learn relaxation exercises to alleviate stress, which can make stress-related indigestion less likely.
  
• Maintain a healthy weight. Excess fat on your abdomen pushes on your stomach.

Medications

These drugs may help relieve indigestion:

• OTC heartburn medications:Some people have found relief from indigestion symptoms by taking antacids like Tums, Maalox, and Milk of Magnesia.
• Histamine receptor antagonists: This group of medicines for treating indigestion and heartburn is known as H2-receptor antagonists, or H2 blockers. Included are Tagamet HB (cimetidine) and Pepcid AC (famotidine).
• Proton pump inhibitors: PPIs are a group of OTC medications that prevent the release of acid in the stomach and intestines. They include Nexium, Prevacid, and Prilosec.
• Prokinetics: These drugs help your stomach empty faster. They include Urecholine (bethanechol) and Reglan (metoclopramide).
• Antibiotics: If your healthcare provider detects an H. pylori infection, they will likely prescribe a combination of antibiotics, PPIs, and bismuth (which kills ulcer bacteria).
• Tricyclic antidepressants:Drugs such as nortriptyline and amitriptyline may help relax the lower esophageal sphincter and reduce indigestion symptoms

Indigestion treatments can often help mild cases go away. Indigestion caused by a medical condition may linger until it's treated professionally.

Does Water Help With Indigestion?

Medical advice is mixed on whether drinking water can relieve indigestion, perhaps because people respond to it differently. Some people swear that adding 1 teaspoon of baking soda (sodium bicarbonate) to 1 cup of tepid water helps reduce the bloated, acidic feeling of indigestion. If you're tempted to try water (with or without baking soda), take only a few sips at a time, and do so slowly.

Summary

Indigestion is a feeling of discomfort or pain in the upper abdomen and chest, often accompanied by bloating, burping, nausea, or feeling too full after eating. Indigestion can also cause growling or gurgling noises in the stomach, a loss of appetite, and nausea.

Indigestion is a common problem that can be triggered by many things, from what you eat and drink to an underlying health condition. Lifestyle modifications can sometimes do the most to relieve indigestion symptoms. These changes range from eating smaller, more frequent meals to avoiding alcohol. If these don't provide enough relief, OTC and prescription drugs may help.

A Word From Verywell

People with indigestion often receive a list of foods from their healthcare provider—some labeled "easy to digest" and others labeled "hard to digest"—after doing a food inventory of what they regularly eat. Just prepare yourself: You may not like (or agree with) what you see under the second column.

It will take time for you to work your way down the list to figure out which foods may be triggering your indigestion. But eliminating one food item at a time is an effective way to isolate what may be troubling your stomach. If removing it from your regular diet doesn't make you feel any better after a week or so, move on to the next one. It can be a time-consuming process, but it's worth it.

Be sure to report your experiences to your healthcare provider, who may be able to make some inferences or connections about your health and eating habits that only they can see.

Heartburn Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Download PDF

Thank you, {{form.email}}, for signing up.

There was an error. Please try again.

Is heartburn the same as acid indigestion?

What does acid indigestion feel like?

How do you know if it's indigestion?

Is heartburn or acid reflux worse?