When should I go to the emergency room for heartburn?

If you have heartburn, call 911 or go to the hospital emergency room for:

  • Burning feeling that comes with a squeezing or crushing feeling in your chest
  • Bloody vomit (throw up), or vomit that is black like coffee grounds
  • Black or bloody stools
Dr. Joseph W. Beets, MD

Heartburn is a common problem. Most people experience heartburn symptoms at some point, often related to eating a heavy meal. Occasional heartburn symptoms that respond to an over-the-counter antacid likely don’t warrant any particular assessment or intervention.

People who experience frequent or recurring problems with heartburn, or symptoms that don’t respond to available remedies, warrant further attention. Typically, an outpatient referral to a gastroenterologist by a patient’s regular physician is appropriate.

Unrelenting “heartburn” symptoms that persist despite available remedies may warrant an emergency room visit.

Sometimes, symptoms can be very severe. Symptoms may manifest as chest pain and, sometimes, an inability to swallow. These are situations that may warrant emergency room assessment. 

  • Chest pain is a major concern. The biggest issue is that other disease processes can masquerade as “heartburn.” Heart disease, particularly ischemia, may present as chest pain or angina. Many people have a sense of fullness in the chest that can be mistaken for “heartburn.” Because heart disease and other disease processes can have devastating consequences if not recognized and treated quickly, chest pain should always be taken seriously. It should prompt an emergency room assessment.
  • The inability to swallow is another problem that should prompt an emergency room visit. Sometimes swallowing can be difficult or slow. Foods may hang up transiently, and then pass. These problems should be brought to the attention of a patient’s physician, and this should prompt referral to a gastroenterologist. If a person realizes that they cannot swallow anything without spitting back up, then they should go to the emergency. Sometimes food sticks in the chest. Other food, drink, and even saliva may be unable to pass. This is an emergency situation and, again, should prompt a trip to the emergency room.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.