Is it normal to have heartburn every day?
Experiencing heartburn occasionally is normal and very common. Many people have heartburn at some point in their lives, however the symptoms are usually mild, and they do not generally interfere with day-to-day life.
However, having heartburn every day or on most days may signal another health problem or a chronic condition called gastro-oesophageal reflux disease (GERD). In most cases, GERD can be managed with simple lifestyle changes or medication.
If you’re regularly getting heartburn, it’s best to consult your doctor.
How long does heartburn last?
A heartburn episode can last anywhere between several minutes to a few hours. Some people may even have heartburn all day.
Some may get heartburn on occasion, others may have it once a week or more, while there can be people that experience heartburn daily.
Below, we explain when heartburn is mild, moderate or severe and when you should see a doctor.
When is Heartburn Mild?
Heartburn is an uncomfortable or painful burning sensation in the middle of your chest, which can travel up and down your neck.
Heartburn is generally considered to be mild if it doesn’t interfere with your quality of life and well-being and/or you don’t get it very often.
Some people may experience heartburn on occasion, particularly after a large meal. The sensation is caused by acid reflux — when stomach acid and food contents float back up the oesophagus and towards the throat.
Common triggers for mild heartburn can include:
- Spicy foods
- Fatty foods
- Eating a very large meal
- Eating too close to bedtime
When is Heartburn Moderate or Severe?
The progression from mild to moderate or even severe heartburn is not clear-cut. Whether your heartburn symptoms classify as moderate or severe can depend on several factors combined, such as:
- How frequently you get heartburn
- How much your heartburn symptoms interfere with your daily life
- Whether your symptoms respond to simple lifestyle changes or over-the-counter medication
For example, having heartburn twice a week or more can be a sign of chronic heartburn or GERD. But, the extent to which symptoms interfere with daily life is key for an accurate diagnosis.
People with persistent heartburn may find that their symptoms greatly affect their work and daily activities. Some people may also experience heartburn in the middle of the night, which can interfere with their sleep. In severe cases, people may struggle to eat and drink.
See your doctor if you experience heartburn on most days.
Could it be GERD?
Getting frequent heartburn (on most days or more than half the days) may be a sign of chronic acid reflux, or GERD.
Getting heartburn constantly may be due to GERD, but constant heartburn doesn’t automatically mean you have GERD.
GERD is a complex condition, and receiving an accurate diagnosis will depend on many factors, like the severity of your symptoms or the health of your oesophagus.
The main symptoms of GERD are:
- Recurring heartburn and acid reflux
- Inflammation of the oesophagus, which happens as a result of stomach acid refluxing constantly
In addition, some people may experience:
- Bloating
- A feeling of fullness
- Nausea
Over time, if left untreated, GERD can lead to more symptoms, such as:
- A hoarse voice
- Inflammation of the vocal cords (laryngitis)
- A sore throat
- A cough that won’t go away
The Different Stages of GERD
The different stages of GERD are not very sharply defined, and experts may have slightly differing views on what constitutes mild, moderate, or severe GERD.
Importantly, if a person has severe symptoms, this won’t necessarily mean their oesophagus is severely damaged or even damaged at all.
Mild GERD
Mild GERD, or stage I, is sometimes defined as having symptoms for 3 days a week or less.
According to other experts, GERD is mild when the lining of the oesophagus is not inflamed, eroded, or damaged by the refluxed acid.
Moderate GERD
Having GERD symptoms (like heartburn) for more than 3 days a week has been described as moderate GERD or stage II GERD.
Erosive oesophagitis, or the inflammation of the stomach lining, is sometimes considered a moderate, intermediary stage of GERD.
Severe GERD
Some experts define daily heartburn as severe GERD or stage III GERD.
When the oesophagus is severely damaged by reflux, this can also mean severe GERD. Barrett’s oesophagus, a complication of GERD, is often considered to be the most severe form of GERD.
What Is Barrett's Oesophagus?
Barrett’s oesophagus is a condition where the cells that normally line the oesophagus transform to resemble cells that line the intestines.
This can occur in constant heartburn because the cells in your oesophagus are constantly exposed to the stomach acid that’s being refluxed.
Barrett’s oesophagus slightly raises a person’s risk of oesophageal cancer.
Other Complications from GERD
It’s important to note that most people don’t go on to develop complications from GERD, particularly if they get treatment early on.
But, over time, constant heartburn and GERD can lead to oesophageal damage and several complications, such as:
- Dental and gum problems. Constant exposure to stomach acid can affect the teeth’s enamel and inflame the gums, leading to gum disease.
- Asthma, wheezing, or other lung problems that affect the airways and cause trouble breathing
- Scar tissue in the oesophagus that forms when the lining becomes inflamed or eroded; this can cause the narrowing of the oesophagus and difficulty swallowing
- Sores and bleeding from erosive oesophagitis (when the oesophagus is inflamed)
What Causes Constant Heartburn and GERD?
Persistent heartburn can be caused by many things, such as:
- Pregnancy, which increases abdominal pressure and may also trigger hormonal changes, all of which can contribute to GERD and heartburn
- Obesity
- Regularly consuming fatty foods or having poor eating habits
Other times, constant heartburn can be caused by another condition, such as:
- A hiatal hernia
- A bacterial infection in the stomach
- A stomach ulcer
Other risk factors for GERD and constant heartburn include:
- Being overweight or having more abdominal fat
- Smoking
- Having a family history of GERD
- Consuming alcohol
- Doing demanding, sedentary jobs or night shifts
- Not getting enough physical activity
- Stress
- Insufficient sleep
How Is Constant Heartburn Diagnosed?
As we’ve mentioned above, diagnosing constant heartburn or GERD is a nuanced process.
Your doctor may ask you in-depth questions to understand how severe your symptoms are; they may also wish to perform some tests, such as:
- A PPI test, where you take proton-pump inhibitors for 8 weeks to see how you respond to treatment. This is a very common way to diagnose GERD.
- pH monitoring, a procedure where your doctor will monitor how much acid you have in your oesophagus and how long it stays there.
- An endoscopy, where a specialist looks inside your oesophagus to see if it has any lesions or inflammation using an endoscope — a thin device with a small camera at the end of it.
How to Treat Constant Heartburn
Constant heartburn can be managed and treated with lifestyle changes, dietary adjustments, over-the-counter medications, or a combination.
Helpful lifestyle changes include:
- exercising more (but avoiding excessive exercise)
- keeping a healthy weight
- not smoking or quitting smoking
To avoid nighttime heartburn, try sleeping on your left side or sleeping in a raised position on a wedge.
You can also try the following dietary adjustments to keep constant heartburn at bay:
- Avoid trigger foods and drinks
- Eat smaller meals more frequently
- Don’t eat 2–3 hours before bedtime
Also, many over-the-counter medications can help relieve your heartburn, such as antacids, alginates, H2 blockers and PPIs — the latter being the most common treatment for GERD and its complications.
Lastly, in some severe cases, surgical procedures can also help alleviate very advanced GERD. To learn more, read our article, Is GERD a curable condition?
Conclusion
Most of us will have heartburn at some point in our lives, but getting constant heartburn or regular heartburn should be checked out, as it may be a sign of GERD. With the right treatment and a timely diagnosis, you can manage GERD, regain your quality of life, and keep complications at bay.
To learn more about how to alleviate frequent heartburn, read our articles, Remedies for acid reflux, and What medication can I take for GERD?
