Heartburn After Surgery: Causes, Treatment, and When to Seek Help
Learn why heartburn is common after surgery, how to manage symptoms, and which signs mean you should call your doctor.
Experiencing heartburn, or acid reflux, is a surprisingly common occurrence following surgery—even for procedures unrelated to the digestive system. Understanding why this happens, how to manage symptoms, and when to seek medical advice can make your recovery more comfortable and safer. This comprehensive guide breaks down the causes of post-surgical heartburn, effective treatments, risk factors, and important warning signs.
Is Heartburn Common After Surgery?
Many people notice heartburn or a burning sensation in the chest during the hours and days after an operation. This can occur regardless of whether the procedure involved your digestive tract. While heartburn is often temporary and resolves within a day, it can cause discomfort and, rarely, serious complications.
- Common surgical side effects include thirst, discomfort at the incision site, restlessness, and, for some, burning chest pain due to acid reflux.
- General anesthesia and surgery-related factors are major triggers for post-operative heartburn.
- Heartburn after surgery is usually uncomfortable but not dangerous.
- Persistent or severe symptoms should be reported to your healthcare team.
What Causes Heartburn After Surgery?
Heartburn, or acid reflux, happens when stomach acid flows back into your esophagus, irritating its lining. This can be especially common right after surgery, and several factors may contribute:
- General Anesthesia: The medications used during surgery relax the muscles in your body—including the lower esophageal sphincter (LES), a muscle ring that normally prevents acid from rising up. This relaxation makes it easier for acid to move from the stomach into the esophagus.
- Surgical Stress: Surgery can trigger the body’s stress response, sometimes leading to increased acid production in the stomach.
- Reduced Motility: Certain pain medications and anesthesia can slow down digestion and impair the movement of food and fluids, increasing the likelihood of reflux.
- Trauma to the Stomach: Surgeries directly involving the stomach (e.g., sleeve gastrectomy or other bariatric procedures) may increase acid production or cause pressure changes, further increasing reflux risk.
- Vomiting and Nausea: Nausea and vomiting are common after anesthesia and can physically force stomach contents upward, triggering reflux episodes.
Research shows that up to 9% of patients undergoing heart valve surgery experience acid reflux in the first 12 hours of recovery.1
Other Risk Factors for Heartburn Following Surgery
- Obesity: Extra abdominal pressure can make reflux more likely after any type of surgery.
- Smoking: Smoking impairs muscle function, including the LES, increasing heartburn risk.
- Certain Medications: Drugs for asthma, antihistamines, sedatives, painkillers, and antidepressants can all relax the LES.
- Dietary Triggers: Spicy foods, fatty foods, alcohol, caffeine, chocolate, carbonated drinks, tomatoes, onions, and eating large meals or eating late can exacerbate reflux.
What Does Post-Surgical Heartburn Feel Like?
Common signs and symptoms of acid reflux or heartburn after surgery include:
- Burning sensation behind the breastbone or in the upper chest
- Unpleasant sour or bitter taste in the mouth or throat
- Chest pressure or discomfort, often worse when lying down
- Mild nausea, sometimes accompanied by belching
- Throat irritation or frequent need to clear the throat
These symptoms usually peak within the first several hours after surgery and diminish with time.
When Is Heartburn After Surgery a Concern?
Heartburn is typically a mild, temporary problem after surgery. However, you should contact your doctor or nurse immediately if you experience any of the following:
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- Severe or persistent chest pain unrelieved by antacids
- Shortness of breath, wheezing, or difficulty breathing
- Vomiting up blood or material that looks like coffee grounds
- Swallowing difficulty or pain with swallowing
- High fever or chills
- Pain, redness, or swelling around the surgical site
- Coughing up green/yellow mucus
These could be signs of a more serious complication such as aspiration pneumonia (when acid or food is inhaled into the lungs), infection, or a surgical issue requiring prompt attention.
Treatment for Heartburn After Surgery
Most cases of heartburn following surgery resolve within a few hours to days. However, there are several ways to safely relieve symptoms during recovery:
- Drink Small Sips of Water: This can help clear acid from the esophagus.
- Antacid Medications: If your doctor approves, antacids (such as calcium carbonate or magnesium hydroxide) may offer quick symptom relief.
- Acid-Reducing Drugs: In some cases, proton pump inhibitors (PPIs) or H2 blockers may be prescribed to further reduce acid production.
- Adjust Your Position: Sitting upright or elevating the head of your bed may help prevent acid from rising while you rest.
- Eat Small, Bland Meals: Stick to simple foods in small amounts to avoid triggering reflux, and avoid eating right before lying down.
- Manage Nausea: If you are experiencing significant nausea after anesthesia, your medical team may prescribe anti-nausea medication.
Lifestyle Measures to Prevent Heartburn After Surgery
- Do not smoke after your surgery.
- Avoid caffeinated, alcoholic, spicy, or fatty foods until your doctor advises otherwise.
- Dress in loose-fitting clothes to reduce abdominal pressure.
Possible Complications
If heartburn becomes a persistent problem after surgery, it may lead to complications including:
- Esophagitis: Inflammation and irritation of the esophagus lining
- Strictures: Scar tissue causing narrowing and difficulty swallowing
- Barrett’s Esophagus: Premalignant changes in esophagus cells (rare, from long-term acid reflux)
- Aspiration Pneumonia: Inhalation of stomach contents into the lungs
Frequently Asked Questions
Q: Is heartburn after surgery normal?
A: Yes, mild heartburn is a common, usually temporary side effect of general anesthesia and surgery, often resolving within 12 to 24 hours.
Q: What makes heartburn worse after surgery?
A: Risk factors include anesthesia, certain medications, slow digestion, stomach trauma from abdominal surgery, obesity, smoking, certain foods, and lying down too soon after eating.
Q: How long does post-surgical heartburn last?
A: Typically, symptoms last for a few hours up to a day or two. Persistent symptoms may require evaluation and treatment.
Q: Can I take my regular acid reflux medicine after surgery?
A: Always consult your surgeon or medical team before resuming any medications. Many acid-reducing drugs are safe post-op, but some may interact with other medicines you’re prescribed.
Takeaway
Heartburn and acid reflux after surgery are common. These symptoms usually improve with time and basic self-care. Drinking small amounts of water, using approved medications, and adjusting your posture may help. Alert your healthcare team if symptoms are severe, long-lasting, or accompanied by red flag symptoms like difficulty breathing or persistent vomiting. With proper management, most cases of post-op heartburn resolve quickly, allowing you to focus on full recovery.
References
- https://www.healthline.com/health/heart/heartburn-after-surgery
- https://www.medicalnewstoday.com/articles/146619
- https://www.healthline.com/health/gerd/surgery
- https://www.healthline.com/health/video/heartburn-acid-reflux-remedies
- https://www.healthline.com/health/video/beverages
- https://rmggastroenterology.com/blog/benefits-of-probiotics-for-acid-reflux/
- https://www.webmd.com
- https://www.tums.com/about-heartburn/causes/what-is-gerd-symptoms-treatment-diet-medication/
- https://www.nhs.uk/conditions/
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