Telling The Difference Between Indigestion and Heartburn

By Zina Semenovskaya, MD
Medically reviewed checkmarkMedically reviewed
January 12, 2022

You’ve just enjoyed a fantastic meal and now feel uncomfortably full.

Maybe you ate too fast, or opted for the spiciest option on the menu.

Situations like these can all trigger heartburn and indigestion – a burning sensation in your chest accompanied by acid regurgitation and an upset stomach. 

Unfortunately, since the two conditions present themselves with similar symptoms, it can be hard to differentiate between the two.

A closer look at the location of your symptoms can help determine which you are suffering from, as well as the best course of treatment.

What is Indigestion?

Indigestion, also known as dyspepsia, is a common condition experienced by a lot of us at least once in our lives, and is a broad term for a range of digestive issues.

It is a gastrointestinal problem typically brought on by food and can be recurring when you are not sure what the triggers are. 

You may get indigestion from eating too fast, eating too much, or specific food triggers such as caffeine, spicy foods, acidic foods, or alcohol.

Indigestion is our body’s way of reminding us to slow down, chew our food, respect when we are full, and listen to our gut response to certain foods. 

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What is Heartburn?

Given its name, you may expect heartburn to have something to do with your heart.

While the symptoms are similar to a heart attack or heart disease, heartburn is very different. It is an irritation of the esophagus caused by stomach acid and is a type of indigestion.

Heartburn symptoms can vary, but are most commonly described as a burning pain and tightness in the upper chest and mid-chest behind your breastbone.

Indigestion tends to worsen when lying down immediately after eating, or after eating certain spicy or otherwise irritating foods.

Symptoms

Symptoms of indigestion and heartburn are, for the most part, interchangeable since heartburn is a symptom of indigestion.

However, there are subtle differences between the two medical conditions which can tell you which one you may be experiencing. 

Indigestion

Indigestion has many symptoms that you may experience at once.

Heartburn is one of them. You may also have any of the following:

  • Pain, discomfort, or a burning sensation in your upper abdomen
  • Feeling full very early while eating 
  • Feeling uncomfortably full after eating
  • Bloating
  • Burping (this can include burping up food or liquid)
  • Gas
  • Nausea
  • An upset stomach that growls or gurgles

Heartburn

Think you may have heartburn? Aside from chest pain after eating a meal or at night, you may be experiencing other symptoms that indicate heartburn such as: 

  • Pain that worsens when lying down or bending over
  • Difficulty swallowing
  • Hiccups 
  • Cough
  • Acidic taste in the mouth
  • Nausea 
  • Vomiting 

Causes and Triggers

While certain food triggers and the way in which we consume food can bring on an onset of indigestion or heartburn, there are also a myriad of underlying health conditions that can cause it.

Learning about these causes and triggers can help you avoid bloating, burping, belching, and painful tightness in your chest and throat.

Indigestion

Some of the causes of indigestion include:

  • Eating: eating too fast, eating too much during a meal, eating spicy, acidic, greasy foods
  • Drinking: drinking too many alcoholic beverages, too many carbonated drinks, too much coffee or too many drinks containing caffeine
  • Medicines: certain antibiotics such as tetracycline, doxycycline, and clindamycin as well as Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs can trigger indigestion and heartburn.
  • Stress: as well as affecting your central nervous system, stress can impact your digestive system and increase the amount of acid in your stomach.
  • Ulcers: having ulcers in your stomach may cause you to have indigestion.

Heartburn

A weak or relaxed lower esophageal sphincter can cause stomach acid to creep up into your esophagus which then results in heartburn.

If this is a common reoccurrence, you may be experiencing a chronic medical condition known as GERD, gastrointestinal reflux disease. 

Much the same as indigestion, heartburn is caused by food triggers, smoking, stress, certain medicines, and drinking caffeine, alcohol, and carbonated drinks.

Treatment

Most indigestion and heartburn can be treated with over-the-counter medications, home remedies, and lifestyle changes.

Antacids are the first choice for those suffering from ongoing indigestion and heartburn. Your pharmacist may also recommend any of the following over-the-counter medications:

  • Proton pump inhibitors (PPIs): PPIs such as Prevacid, Nexium, and Prilosec can reduce stomach acid. 
  • H-2-receptor blockers: This includes Zantac 360, Pepcid, Tagamet, and Axid. Take these to reduce stomach acid.
  • Prokinetics: Prokinetic medications can be taken if your stomach empties slowly to improve the motility of the stomach and esophagus. Metoclopramide is one such common prescription medication.
  • Antidepressants or anti-anxiety medications: Taking these can help if your indigestion is a result of stress, anxiety, or depression. They can work to decrease your reaction to pain and thus alleviate discomfort caused by indigestion.
  • Antibiotics: If H. pylori bacteria is causing your indigestion, you can take antibiotics to help.

Prevention and Risks

The prevention methods for indigestion and heartburn are the same.

If you struggle with heartburn or have bouts of indigestion, consider doing the following:

  • Eat smaller meals throughout the day
  • Avoid the food triggers that bring on symptoms (this may mean eliminating caffeine and spicy foods from your diet)
  • Chew your food slowly to help promote digestion
  • Eliminate fried, fatty, and excessively greasy foods from your diet 
  • Don’t eat a large meal within a few hours before bedtime
  • Don’t lay down after a large meal
  • Avoid drinking alcohol and smoking
  • Maintain a healthy weight
  • Raise your head when you sleep by using large pillows
  • Avoid tight-fitting clothing, which can cause pressure on both your abdomen and lower esophageal sphincter.

Aside from certain medications which can trigger heartburn or indigestion, there are lifestyle choices that can put you at greater risk such as:

  • Anxiety or depression: if you have anxiety or depression, you may experience an upset stomach quite regularly. This can lead to indigestion and trigger heartburn.
  • Obesity: being overweight or obese can push on your abdomen or lower esophageal sphincter.
  • Pregnancy: hormonal changes and the baby pressing on your stomach can cause indigestion and heartburn.
  • Smoking or secondhand smoke exposure: the nicotine from tobacco can relax the lower esophageal sphincter allowing stomach acid and juices which break down food in the stomach to creep up the esophagus and cause heartburn.

Having recurring heartburn or indigestion can create more serious health conditions.

If left untreated, otherwise mild and maybe tolerable symptoms could turn into esophagitis, aspiration pneumonia, ulcers, esophageal strictures, laryngitis, and a potentially precancerous condition called Barrett’s esophagus.

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When to See a Doctor

Are you struggling with ongoing symptoms of heartburn and indigestion that are not going away with over-the-counter medications and home remedies?

It’s time to see a doctor.

Your health care provider will examine you to determine if you have a more serious condition and recommend a treatment plan for you.

They may do a physical examination of your abdomen along with imaging, including an endoscopy if you are over 60 years old or have particularly severe or otherwise concerning symptoms.

Your doctor may also conduct a blood or stool test to determine if your indigestion is a sign of a bacterial infection.

If you experience severe chest pain, pressure, difficulty swallowing, nausea, vomiting, and recurring heartburn, especially pain in the arm or jaw, you should seek medical advice immediately.

Since most indigestion can be cured with over-the-counter medicine, recurring symptoms or strong symptoms will need medical attention.

How K Health Can Help

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Frequently Asked Questions

Who is at highest risk for indigestion?
Individuals who are obese or pregnant are at greater risk of indigestion due to the increased pressure on your stomach and esophagus. People with certain chronic medical conditions, such as diabetes, are also at high risk due to the diabetes effect of slowing down digestion.
Will indigestion go away on its own?
For the most part, indigestion will go away on its own after a few hours. Avoid lying down and take over-the-counter medicines or home remedies to alleviate your symptoms.
Can heartburn lead to more dire issues if left untreated?
Yes, if you experience heartburn regularly, it may develop into more serious health concerns such as esophagitis, aspiration pneumonia, ulcers, strictures, and a potentially precancerous condition called Barrett's esophagus.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.