Burning Chest Pain: Not Your Heart, But Acid Reflux

27 March 2026

Article by: Dr Lim Sim Yee - Consultant Gastroenterologist & Hepatologist

Have you ever woken up in the middle of the night with a sudden, sharp, burning sensation in your throat, one so uncomfortable that you had to reach for a cold drink just to calm it down? Or maybe you've felt a sour, acidic liquid rise into your throat right after a big meal, or even after skipping breakfast altogether. Or perhaps you've experienced a burning sensation in your chest, with discomfort intense enough to leave you reaching for more cold beverages, hoping the discomfort will pass?

When such symptoms occur, many would assume that they may be suffering from a serious illness, such as a heart-related condition. However, this is often not the case. These are classic acid reflux or gastroesophageal reflux disease (GERD) symptoms, and they're far more common than most people realise.

With busy lifestyles, late nights and irregular meal times, more people today are prone to acid reflux. So, what exactly is acid reflux, and how does it develop? Read on to learn more.

Acid Reflux: A Chronic Condition

When people talk about acid reflux, many assume it simply means acid churning uncomfortably in the stomach. In reality, it is more than that. The irritation caused by acid reflux can travel from the stomach up into the oesophagus, and in some cases, even reach the vocal cords. Sufferers will often experience a burning sensation. In severe cases, the condition can even damage the lining of the oesophagus.

Gastroesophageal reflux disease (GERD), is a chronic digestive disorder, occuring when stomach acid or gastric contents flow back from the stomach into the oesophagus.

Heartburn Isn't the Same as Acid Reflux

Many people assume heartburn and acid reflux are one and the same. This isn't entirely accurate. Heartburn is just one of several symptoms of acid reflux. In Southeast Asia, patients rarely use the term "heartburn" at all, instead describing their symptoms as bloating, "wind," or general stomach pain.

The lining of the oesophagus is delicate. When acid reflux occurs, stomach acid irritates it, producing that familiar burning sensation in the chest. In more severe cases, swallowing can become difficult.

Beyond heartburn, sufferers may also experience acid regurgitation, which tends to strike when lying down at night. Some are even woken by a choking sensation, resulting in disrupted sleep.

Other common symptoms include nausea, a bitter or sour taste in the mouth, chronic cough, hoarseness, and difficulty swallowing.

Factors That Contribute to Acid Reflux

It's easy to assume acid reflux is simply caused by excessive stomach acid. But is that really the case?

Between the oesophagus and the stomach sits a valve called the lower oesophageal sphincter (LES). Once food has passed through, this valve closes to keep stomach contents from flowing back up. In people with acid reflux, however, this valve weakens or relaxes abnormally, allowing acid to escape upward.

While stomach acid is the direct cause of the discomfort, several underlying factors can contribute to the condition, including:

• Hiatal hernia
• Obesity
• Pregnancy
• Certain medications, such as asthma drugs or painkillers that relax the LES
• Smoking and alcohol consumption
• Frequent late-night eating
• Staying up late
• Lying down immediately after meals
• Poor dietary habits, such as consuming high-fat, high-sugar, high-salt or spicy, or caffeine-containing foods (e.g., tomatoes or chocolate), overeating or irregular meals
• High stress levels

Keep Your Diet Light

Sufferers can ease their symptoms by adjusting their diet and lifestyle. It's important to identify and avoid the specific foods that trigger or worsen symptoms. However, these triggers vary from person to person, so there's no single acid reflux diet that works for everyone.

Staying hydrated also helps, as water dilutes stomach acid and can reduce symptoms.

As a general rule, sufferers should stick to a diet that is low in salt, sugar, oil and fat, and maintain this habit until symptoms improve.

Helpful dietary habits include:

• Avoid hard-to-digest foods
• Limit fried, strongly flavoured, spicy or acidic foods
• Eat smaller, more frequent meals, and avoid overeating
• Skipping late-night meals and avoiding food within three hours of bedtime

Don't Underestimate Warm Water 

Acid reflux can strike at any time. When it does, is medication your first instinct?

If symptoms stem from a temporary acid spike, antacids can offer quick relief by neutralising stomach acid. That said, these medications often contain compounds like aluminium and calcium, so they're not recommended for long-term use. If symptoms occur frequently, it's worth consulting a doctor.

Beyond medication, a few simple habits can also help relieve symptoms:

• Drinking warm water: Helps dilute stomach acid, ease irritation, and support digestion
• Adjust your sleeping position: Elevate your head, sleep on the left side, or stay in a semi-upright position to reduce reflux
• Wear loose clothing: Tight clothing can put pressure on the stomach and worsen symptoms
• Watch your diet: Avoid spicy, acidic, high-sugar, high-salt, and fried foods, as well as glutinous rice products, processed foods, caffeinated or carbonated drinks, and alcohol

Severe Acid Reflux Can Increase Your Cancer Risk

Although acid reflux is common, it can become a serious problem if left untreated. Over time, acid exposure can damage the oesophagus, leading to inflammation, ulcers or bleeding.

Chronic inflammation can also cause the oesophagus to narrow, making swallowing difficult. In some cases, long-term acid reflux can progress into Barrett's oesophagus, a condition where the cells lining the oesophagus change, raising the sufferer's risk of oesophageal cancer.

Acid reflux can also worsen asthma symptoms.