Symptoms of Serious conditions

1. Angina Angina, or chest pain caused by lack of blood flow to the heart, can feel a lot like heartburn. "The major key is if you're getting heartburn when you're doing strenuous or moderate activity," says Dr. Ryan Madanick, a gastroenterologist and assistant professor of medicine at the University of North Carolina School of Medicine, in Chapel Hill. If you're 50 or older and getting heartburn—especially if you haven't had this kind of pain before—it can raise suspicion of angina. Suspicions can also be raised if you're younger but have heart risk factors such as hypertension, diabetes, or a family history of heart disease. 2. Gallstones Although gallstones don't always cause symptoms, a stone blocking your bile duct can hurt, usually in the middle or upper-right side of the abdomen. Pain may be cramping, dull, or sharp, and often strikes minutes after you eat. If you're experiencing stomach pain after meals that doesn't improve after you take an over-the-counter acid-suppressing medication, gallstones should be suspected, says Dr. Joel Richter, a gastroenterologist and chairman of the department of medicine at Temple University School of Medicine, in Philadelphia. 3. Stomach Ulcer Ulcers can cause a gnawing, burning sensation, usually felt in the upper abdomen. The pain can find its way up to the chest, Madanick says. Acid-suppressing medications may relieve ulcer pain. But ulcers are usually caused by Helicobacter pylori, a type of bacteria that inflames the stomach lining, so you will need to take antibiotics to clear the infection. Certain anti-inflammatory drugs (such as aspirin, ibuprofen, and naproxen), and osteoporosis drugs called bisphosphonates, can also cause stomach ulcers. 4. Hiatal Hernia A hiatal hernia occurs when a portion of the upper stomach pokes through the diaphragm into the chest cavity, rather than staying in the abdominal cavity where it belongs. This can push food and stomach acid up into the esophagus, causing heartburn. Other signs of hiatal hernia include chest pain, belching, and nausea. If you have heartburn due to hiatal hernia, your doctor will typically prescribe acid-suppressing drugs, and recommend lifestyle changes like eating smaller meals, avoiding alcohol, and not eating right before bed. In rare cases, surgical repair may be warranted. 5. Esophageal Cancer Esophageal cancer is rare, but its incidence is rising rapidly in the United States, Madanick says. "If you have heartburn, it might be a sign of esophageal cancer, but it's highly unlikely," he says. Your doctor may decide to order an upper endoscopy to examine your esophagus if you've got long-standing heartburn, especially if you smoke or drink heavily, both of which are risk factors for esophageal cancer. This test involves passing a tube with a light and a camera at one end down your throat into your esophagus. During the test, your doctor can look for abnormal areas as well as collect tissue samples to test for cancer.