If heartburn persists

It may start as a burning feeling in the center of your chest. Then, you may get a sour taste in your mouth. Soon, you're wishing you hadn't eaten that greasy hamburger.

Almost everyone gets heartburn from time to time. But when it's a frequent problem, you may have gastroesophageal reflux disease (GERD). As many as 19 million Americans suffer from GERD. Some people may be bothered by it daily.

GERD is caused by stomach acid that backs up into the esophagus, the tube that carries food from the mouth to the stomach, and irritating the esophagus.

A muscle between the stomach and the esophagus—the lower esophageal sphincter (LES)—plays a major role. When working properly, the LES opens to allow food into the stomach, then closes to prevent stomach acid from washing back up. However, in some people, the LES stays relaxed or is weakened, so doesn't close properly.

When this happens, stomach acid is able to flow back up, causing heartburn. Some people have a hiatal hernia which can also lead to heartburn. Normally the stomach lies completely below the diaphragm, a muscle which separates the chest from the abdominal cavity. A hiatal hernia is when part of the stomach projects into the chest.

Factors that contribute to heartburn either directly or by relaxing the LES include obesity, pregnancy, smoking; alcohol, foods and drinks high in acid such as citrus and tomato products, caffeine and a high fat diet, especially fried foods.

Certain behaviors such as eating very large meals, wearing clothing that is tight at the waist or bending over or lying down too soon after eating can also contribute. See a doctor if you have heartburn symptom concerns or over-the-counter remedies don't relieve chronic problems.

GERD can damage the lining of the esophagus which may lead to esophagitis (an inflammation of the esophagus). Chronic inflammation may lead to more serious problems such as scarring, ulcers or a precancerous condition of the esophagus called Barretts esophagus.