Heartburn occurs when acid from the stomach backflows into the oesophagus, causing irritation and inflammation. It’s quite normal from time to time. Everyone gets a bit of heartburn after a big, fatty meal or spicy food. The question is: how do you know if your heartburn is serious?

Most people assume heartburn is always diet related. That’s not true. Heartburn has several different causes. It’s also not a single symptom. If persistent, it can progress to conditions like gastroesophageal reflux disease (GERD).

That’s why it’s so important to investigate constant heartburn. But what counts as constant heartburn? When is heartburn serious? And what should you do about it? Find out below.

What Counts as “Constant” Heartburn?

Heartburn becomes constant when it occurs more than 2-3 times per week. Even if you’re only getting heartburn once or twice a week, if that’s every week without fail, then it might be worth investigating.

The big factor is that it’s prolonged, with symptoms lasting for weeks or months.

People with consistent heartburn often ignore it. They treat the problem with antacids and forget that it’s an issue, especially if they have nighttime symptoms. Even if the reflux is relatively mild, if it’s persistent and frequent, it’s important to get checked.

When Heartburn Stops Being “Just Heartburn”

Heartburn is painful. But it’s often dismissed as just a part of everyday life. It’s just something we all have to deal with from time to time.

The difference is when occasional reflux becomes chronic reflux. Usually, with intermittent reflux, your oesophagus has time to recover between episodes. But persistent inflammation of the oesophagus due to repeated acid attacks can cause long-term damage.

Ignoring these symptoms allows this progression. It’s what turns heartburn into GERD.

8 Warning Signs Your Heartburn Could Be Serious

1. Heartburn That Happens Almost Daily

If your heartburn is a daily occurrence, even if mild, it could be serious. It’s a common early sign of GERD. This symptom suggests chronic acid exposure and should never be dismissed as normal.

2. Symptoms That Wake You Up

Nighttime reflux is often worse due to a large evening meal and lying flat. In bed, it’s easier for the acid to backflow into the oesophagus. If heartburn wakes you from sleep, it indicates relatively severe symptoms. Plus, it leads to poor sleep and fatigue, which exacerbates the situation.

3. Difficulty Swallowing or Food Sticking (Dysphagia)

Difficulty swallowing is a red flag symptom. It may be caused by a narrowing of the oesophagus or weakened muscles after prolonged acid exposure.

Don’t ignore it. This needs investigating.

4. Persistent Chest or Upper Back Pain

Chest pain is common with heartburn. It occurs due to oesophageal irritation and can sometimes be experienced in the back (especially between the shoulder blades).

It’s important to rule out cardiac causes first though. Persistent chest or upper back pain is often confused with muscular pain.

5. Chronic Cough, Hoarseness, or Throat Clearing

Cough is one of the most missed signs of reflux. Acid irritates the throat, causing a cough, hoarseness, and throat clearing. If you don’t get heartburn, it can be a sign of “silent reflux.”

Often misdiagnosed as asthma or allergies.

6. Unintentional Weight Loss or Loss of Appetite

Painful eating (odynophagia) tends to lead to food avoidance or a preference for easy-to-eat but low-calorie foods like soup. This can lead to unintentional weight loss.

7. Black Stools or Vomiting Blood

Black stools or vomiting blood are red flag symptoms and require immediate medical attention. They are often a sign of internal bleeding and can signal oesophageal ulceration. Never ignore this symptom.

8. Heartburn That No Longer Responds to Medication

If your heartburn no longer responds to medication, it might be because of the disease progressing or a structural problem. Most people are prescribed proton pump inhibitors (PPIs) or H2 blockers for acid reflux. If one medication is causing problems, you can switch. However, further testing might be required to diagnose the underlying issue.

Why Early Investigation Matters

When heartburn is caught early, it’s often highly reversible (even if the symptoms are severe). It’s only with repeated, prolonged acid attacks that permanent changes to the oesophagus occur.

Early investigation is therefore crucial. It prevents the worst complications and can even reduce the need for long-term acid-suppressing medication (which brings its own side effects).

The Functional Gut Clinic offers specialist testing to build a clear picture of what’s happening inside your digestive system. We offer 24-hour reflux monitoring and detailed assessments of oesophageal function.

Take a little time to explore your symptoms and move one step closer to a clear diagnosis and lasting relief.