Ever get a sharp, burning sensation in your upper chest? That's one of the typical heartburn symptoms most people recognise. It's caused by the presence of stomach acid in the oesophagus and throat. But stomach ulcers can cause a similar pain, leading to confusion.

Despite both being digestive conditions (and with similar symptoms), heartburn and ulcers have different causes. Heartburn primarily involves the upper gastrointestinal (GI) tract, including the oesophagus and throat, whereas ulcers are sore in the stomach lining and small intestine.

Let's take a closer look at these two conditions, including the key differences between ulcers and heartburn.

What Is an Ulcer?

An ulcer is a medical term for an open sore or wound. Peptic ulcers (or stomach ulcers) occur in the stomach lining or upper small intestine.

Usually, the stomach lining is protected by a layer of mucus that shields it from the strong gastric acids. However, if the lining is weakened, it can cause damage, leading to a painful, bleeding sore.

Common causes of peptic ulcers include Helicobacter pylori (H. pylori) infection, a bacterium that weakens the stomach's protective lining, long-term use of NSAIDs (like ibuprofen, aspirin, or naproxen) or excess stomach acid (from stress, smoking, or alcohol).

Symptoms of a Stomach Ulcer

Stomach ulcers are extremely uncomfortable.

Symptoms include:

• Dull or burning pain in the upper abdomen

• Pain that improves or worsens after eating

• Bloating or feeling full quickly

• Nausea or occasional vomiting

• Dark, tarry stools (a sign of bleeding)

• Loss of appetite or unintentional weight loss

What Is Heartburn?

Heartburn is a burning sensation behind the breastbone and or into the throat caused by acid reflux from the stomach into the oesophagus and throat. It's extremely common, affecting around 20% of people.

Persistent heartburn is a sign of gastro-oesophageal reflux disease (GERD). It occurs because the lower oesophageal sphincter (LOS) between the stomach and oesophagus weakens.

Normally, it acts like a valve, allowing food to enter but not leave the stomach. However, factors like smoking, hiatus hernias, certain medications, alcohol, and large meals can cause food and acid to move backwards.

If acid reflux persists, it inflames and irritates the oesophageal lining. Long-term, this can cause permanent damage, such as strictures and in rare cases even cancer.

Symptoms of Heartburn

Heartburn is a familiar symptom. It’s often associated with these symptoms:

• Burning feeling in the chest or throat

• Sour or acidic taste in the mouth

• Discomfort after eating or when lying down

• Regurgitation of food or liquid

• Persistent cough or hoarseness (in chronic cases)

The Key Differences Between an Ulcer and Heartburn

Ulcers and heartburn both involve the digestive tract and cause abdominal pain or discomfort. You may even notice indigestion and nausea. But that's where the similarities end.

Here's an overview of the key differences between ulcers and heartburn:

Treatments for Ulcers and Heartburn

Ulcers and heartburn might have several core differences, but the fundamental treatments are quite similar. The objective is to reduce acid production, allowing the ulcer and irritation to heal.

Ulcers

Peptic ulcer treatment comes in two parts:

1. Reduce acid production via proton pump inhibitors (PPIs) or H2 blockers.

2. Eliminate H. pylori infection via antibiotics. Your doctor may also prescribe a medication called bismuth subsalicylate to coat and protect the stomach lining.

If the cause is excessive NSAID use, you'll need to stop taking the medication for a while or significantly reduce your dose.

Heartburn

The first line treatment for heartburn is lifestyle modification. Most people develop heartburn due to dietary and lifestyle habits. Eating smaller meals, avoiding spicy or fatty foods, limiting alcohol and caffeine, stopping smoking, and keeping the head elevated during sleep can make a substantial difference.

If that doesn't work, PPIs and H2 blockers can provide long-term relief. During an acute attack, antacids can neutralise the acid, providing immediate relief.

Get Your Heartburn Symptoms Assessed

If you've been dealing with persistent heartburn, it's time to get checked. The Functional Gut Clinic offers a range of testing options to determine the underlying cause of your symptoms. And they'll provide a roadmap to recovery, so you can reduce or eliminate your symptoms entirely.

Learn about heartburn diagnostic testing→