Heartburn differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differentiating Heartburn from other Diseases

• Angina / ischemia
• Ascites
• Asthma
• Barrett's esophagus
• Cardiotomy
• Caustic agent ingestion with resultant mucosal injury
• Chagas disease
• Cholelithiasis
• Clothes (elevated internal stomach pressure)
• Constipation
• Coronary artery disease
• Coughing
• CREST syndrome (Calcinosis Raynaud's phenomenon Esophagus Sclerodactyly Telangiectasias)
• Direct irritation of esophagus:
  • Aspirin
  • Cigarette smoke
  • Citrus fruits, juice
  • Ibuprofen
  • Spicy foods
  • Tomatoes
  • Tomato sauce
• Diabetes
• Drugs:
  • Albuterol
  • Anticholinergics
  • Caffeine
  • Calcium channel blockers
  • Cigarette smoking
  • Nitrates
  • Progesterone
  • Theophylline

• Esophageal atresia or fistula
• Esophageal carcinoma
• Esophageal diverticulum
• Esophageal varices
• Foods:
  • Alcohol
  • Chocolate
  • Coffee
  • Fatty foods
  • Peppermint
  • Soft drinks with caffeine
  • Tea

• Fundectomy (postoperative)
• Gastrectomy (postoperative)
• Gastritis
• Gastroesophageal reflux disease (GERD)
• Hiatal hernia
• Infectious esophagitis
• Lifting
• Mallory-Weiss tear
• Motility disorders
• Muscle strain
• Myasthenia gravis
• Myocardial infarction
• Obesity
• Peptic ulcer disease
• Pericardial disease
• Pregnancy
• Primary reflux esophagitis
• Pulmonary embolism
• Raynaud's phenomenon
• Scleroderma
• Strictures, webs or rings
• Vagotomy (postoperative)