What Causes Heartburn?

A Checklist
Your daily habits may be triggering your heartburn.

While most heartburn sufferers may recognize the symptoms of the condition, few
are aware of how it starts. The root cause of heartburn stems from a weakened lower
esophageal sphincter (LES), or when the LES relaxes abnormally.1

The LES is a circular band of muscle at the bottom of your esophagus, and it acts like a
'valve' as it enters the stomach. Normally when you swallow, your LES relaxes to let
food and liquid flow into your stomach, and then it closes again. For some people,
though, the LES may open too often or not close tight enough. When this happens,
the acid in your stomach can flow back up into your esophagus. Since your esophagus
doesn't have the same protective lining that your stomach does, the acid can irritate
its more sensitive tissues, triggering heartburn and discomfort.
Foods That May Trigger Heartburn

Although the actual cause of heartburn is physical, people generally view their heart-
burn triggers as the root cause. Though scientifically that’s not the case, it’s still worth
noting which behaviors can trigger the experience of heartburn. Food, for instance, is
a common heartburn trigger.2

Check out this list of common offenders to see if any could be triggering your heart-
burn:

Tomatoes, tomato sauce, and ketchup

Oranges, grapefruit, and other citrus fruits and juices
Garlic
Vinegar
Onions
Chocolate
Coffee, tea, or other caffeinated products
Alcohol
Peppermint
Fried & fatty foods
Carbonated drinks
Mustard, pepper, and other spices3

Habits That May Trigger Heartburn

Many people realize that their behaviors around mealtime, or the activities they take
part in, also can cause heartburn.4 Here are some habits that could be triggering your
heartburn symptoms:

Eating large meals or eating too fast

Laying down right after eating
Eating close to bedtime
 Drinking alcohol or smoking
Pressure on the stomach from frequent bending over or tight clothes
Stress and/or anxiety
Exercising soon after eating5

Medications That May Trigger Heartburn

There are some medications that can cause heartburn, because they may relax the
LES. You may want to talk to your pharmacist or doctor about your heartburn if you're
taking any of the following:

Medications for asthma or allergies

Prescription blood pressure or angina pills
Medication for a urinary tract infection
Muscle relaxants
Prescription pain killers
Antidepressants6

Physical Changes & Conditions That May Trigger Heartburn

It's true that your meals, habits, or even medication could be triggering your heart-
burn. But the fact is that heartburn is a real condition with biological causes. Here are
some physical reasons you could be suffering from heartburn:

Pregnancy
Acid Reflux
GERD or Acid Reflux Disease
Weak esophageal muscles
Stomach emptying muscles
Obesity
Anxiety or depression
Hiatal hernia
Peptic ulcer6

What Behaviors Can Trigger Heartburn?

From your eating habits to your clothing choices, here are the most common culprits.

Everyone has rituals—from enjoying their morning coffee to snacking in the midst of a
busy day—and most are harmless. There are, however, a few daily habits that could be
contributing to your heartburn.
Eating Habits
If you’ve ever had a large meal or eaten too fast, there’s a good chance you experi-
enced heartburn afterwards. This occurs because you added too much food, too
quickly, so your stomach had to work overtime to process it.

It's healthier to have three small meals a day that are supplemented by healthy snacks
whenever you feel hunger coming on. You won't get too full, which will prevent your
stomach from overproducing the acid that causes heartburn.1

It’s also important to eat slowly. Remember to put your fork and knife down between
bites, and to chew your food 20 times before swallowing.2 Lastly, avoid eating too
close to your bedtime.3
General Habits

Your general behaviors also can cause heartburn. After eating, avoid lying down flat,
so as not to put pressure on the stomach and increase your chances for reflux. Wait
two to three hours after eating before going to bed.

It’s also important to avoid working out after a meal, so the contents of your stomach
aren’t bouncing around during an exercise routine. After you’ve eaten, wait 30 mi-
nutes to one hour before exercising.
Clothing Choices

Wearing clothing or belts that are too tight around the abdomen can put constant
pressure on your stomach. When pressure builds, acid has no place to go but up and
out. An easy fix, without costing you a dime, is to loosen your belt a notch or two.

How You Can Reduce Heartburn

Although you may not always be able to prevent heartburn, there are several things
you can do to reduce your chances of triggering it.

Looking for heartburn relief? It might be time to switch up your routine. Here are
some changes that may help:
Change your sleeping position
Sleeping on your left side and with your upper body elevated by a 6-to-10-inch wedge-
shaped pillow may help reduce your heartburn.
Relax

Start by taking deep breathes. If you’re feeling stressed at the office, take a break—
go outside to get some air and walk around the block. You may be surprised what the
change of pace can do. Yoga and meditation also can be great stress relievers.
Eat healthier

Consider including foods that are low in fat and high in protein, and make sure that
you stop eating before you’re full.
Rethink your workout

Exercises like sit-ups and crunches can increase pressure on your stomach, pushing
acid into the esophagus to trigger heartburn pain.1 Other activities like running cause
you to bounce, increasing your risk of getting heartburn. You may want to try calmer
activities like walking. Consider speaking with a personal trainer to see what’s less
likely to trigger heartburn.
Maintain a healthy weight

Extra pounds can put pressure on your stomach, causing acid to back up into your
esophagus.1
Eat smaller meals

Instead of three big meals, try eating smaller ones with snacks in between. This will
help reduce acid production in your stomach, and lower your chances for heartburn.2
Avoid certain foods

While spicy foods are the most commonly reported food that triggers heartburn, they
can vary from person to person. Carbonated drinks, high-fat foods, caffeine, citrus
fruits, and even chocolate can cause heartburn.1
Quit smoking

Smoking is a well-known trigger for heartburn. The nicotine and other chemicals in cig-
arettes can relax the lower esophageal sphincter as they enter the body. Quitting, or
at least cutting back, can help with your heartburn symptoms and improve your over-
all health.3
Gastroesophageal reflux disease (GERD)

Symptoms & causes

Diagnosis & treatment
Doctors & departments
Care at Mayo Clinic

Print
Overview

How GERD occurs in the esophagus

How heartburn and GERD occur

Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows
back into the tube connecting your mouth and stomach (esophagus). This backwash
(acid reflux) can irritate the lining of your esophagus.

Many people experience acid reflux from time to time. GERD is mild acid reflux that
occurs at least twice a week, or moderate to severe acid reflux that occurs at least
once a week.

Most people can manage the discomfort of GERD with lifestyle changes and over-the-
counter medications. But some people with GERD may need stronger medications or
surgery to ease symptoms.
Symptoms

Common signs and symptoms of GERD include:

A burning sensation in your chest (heartburn), usually after eating, which might be
worse at night
Chest pain
Difficulty swallowing
Regurgitation of food or sour liquid
Sensation of a lump in your throat

If you have nighttime acid reflux, you might also experience:

 Chronic cough
Laryngitis
New or worsening asthma
Disrupted sleep

When to see a doctor

Seek immediate medical care if you have chest pain, especially if you also have short-
ness of breath, or jaw or arm pain. These may be signs and symptoms of a heart attack.

Make an appointment with your doctor if you:

Experience severe or frequent GERD symptoms

Take over-the-counter medications for heartburn more than twice a week

Request an Appointment at Mayo Clinic

Causes

GERD is caused by frequent acid reflux.

When you swallow, a circular band of muscle around the bottom of your esophagus
(lower esophageal sphincter) relaxes to allow food and liquid to flow into your stom-
ach. Then the sphincter closes again.

If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into
your esophagus. This constant backwash of acid irritates the lining of your esophagus,
often causing it to become inflamed.
Risk factors

Conditions that can increase your risk of GERD include:

Obesity
Bulging of the top of the stomach up into the diaphragm (hiatal hernia)
Pregnancy
Connective tissue disorders, such as scleroderma
Delayed stomach emptying

Factors that can aggravate acid reflux include:

Smoking
Eating large meals or eating late at night
Eating certain foods (triggers) such as fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Taking certain medications, such as aspirin

Complications
Over time, chronic inflammation in your esophagus can cause:

Narrowing of the esophagus (esophageal stricture). Damage to the lower esopha-

gus from stomach acid causes scar tissue to form. The scar tissue narrows the food
pathway, leading to problems with swallowing.
An open sore in the esophagus (esophageal ulcer). Stomach acid can wear away tis-
sue in the esophagus, causing an open sore to form. An esophageal ulcer can bleed,
cause pain and make swallowing difficult.
Precancerous changes to the esophagus (Barrett's esophagus). Damage from acid
can cause changes in the tissue lining the lower esophagus. These changes are associ-
ated with an increased risk of esophageal cancer.

Diagnosis

Endoscopy
Endoscopy

Your doctor might be able to diagnose GERD based on a physical examination and his-
tory of your signs and symptoms.

To confirm a diagnosis of GERD, or to check for complications, your doctor might rec-
ommend:

Upper endoscopy. Your doctor inserts a thin, flexible tube equipped with a light and
camera (endoscope) down your throat, to examine the inside of your esophagus and
stomach. Test results can often be normal when reflux is present, but an endoscopy
may detect inflammation of the esophagus (esophagitis) or other complications. An
endoscopy can also be used to collect a sample of tissue (biopsy) to be tested for com-
plications such as Barrett's esophagus.
Ambulatory acid (pH) probe test. A monitor is placed in your esophagus to identify
when, and for how long, stomach acid regurgitates there. The monitor connects to a
small computer that you wear around your waist or with a strap over your shoulder.
The monitor might be a thin, flexible tube (catheter) that's threaded through your
nose into your esophagus, or a clip that's placed in your esophagus during an endos-
copy and that gets passed into your stool after about two days.
Esophageal manometry. This test measures the rhythmic muscle contractions in
your esophagus when you swallow. Esophageal manometry also measures the coordi-
nation and force exerted by the muscles of your esophagus.
X-ray of your upper digestive system. X-rays are taken after you drink a chalky liquid
that coats and fills the inside lining of your digestive tract. The coating allows your
doctor to see a silhouette of your esophagus, stomach and upper intestine. You may
also be asked to swallow a barium pill that can help diagnose a narrowing of the
esophagus that may interfere with swallowing.

Treatment

Nissen fundoplication
GERD surgery

The ring of beads between the esophagus and stomach

Substitute for esophageal sphincter

Your doctor is likely to recommend that you first try lifestyle modifications and over-
the-counter medications. If you don't experience relief within a few weeks, your doc-
tor might recommend prescription medication or surgery.
Over-the-counter medications

The options include:

Antacids that neutralize stomach acid. Antacids, such as Mylanta, Rolaids and Tums,
may provide quick relief. But antacids alone won't heal an inflamed esophagus dam-
aged by stomach acid. Overuse of some antacids can cause side effects, such as diar-
rhea or sometimes kidney problems.
Medications to reduce acid production. These medications — known as H-2-receptor
blockers — include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid
AR) and ranitidine (Zantac). H-2-receptor blockers don't act as quickly as antacids, but
they provide longer relief and may decrease acid production from the stomach for up
to 12 hours. Stronger versions are available by prescription.
Medications that block acid production and heal the esophagus. These medications
— known as proton pump inhibitors — are stronger acid blockers than H-2-receptor
blockers and allow time for damaged esophageal tissue to heal. Over-the-counter pro-
ton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec
OTC, Zegerid OTC).

Prescription medications

Prescription-strength treatments for GERD include:

Prescription-strength H-2-receptor blockers. These include prescription-strength fa-

motidine (Pepcid), nizatidine and ranitidine (Zantac). These medications are generally
well-tolerated but long-term use may be associated with a slight increase in risk of vi-
tamin B-12 deficiency and bone fractures.
Prescription-strength proton pump inhibitors. These include esomeprazole
(Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Pro-
tonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant). Although generally well-
tolerated, these medications might cause diarrhea, headache, nausea and vitamin B-12
deficiency. Chronic use might increase the risk of hip fracture.
 Medication to strengthen the lower esophageal sphincter. Baclofen may ease GERD
by decreasing the frequency of relaxations of the lower esophageal sphincter. Side ef-
fects might include fatigue or nausea.

Surgery and other procedures

GERD can usually be controlled with medication. But if medications don't help or you
wish to avoid long-term medication use, your doctor might recommend:

Fundoplication. The surgeon wraps the top of your stomach around the lower
esophageal sphincter, to tighten the muscle and prevent reflux. Fundoplication is usu-
ally done with a minimally invasive (laparoscopic) procedure. The wrapping of the top
part of the stomach can be partial or complete.
LINX device. A ring of tiny magnetic beads is wrapped around the junction of the
stomach and esophagus. The magnetic attraction between the beads is strong enough
to keep the junction closed to refluxing acid, but weak enough to allow food to pass
through. The Linx device can be implanted using minimally invasive surgery.

Request an Appointment at Mayo Clinic

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a
means to prevent, detect, treat or manage this disease.
Lifestyle and home remedies

Lifestyle changes may help reduce the frequency of acid reflux. Try to:

Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing
up your stomach and causing acid to reflux into your esophagus.
Stop smoking. Smoking decreases the lower esophageal sphincter's ability to func-
tion properly.
Elevate the head of your bed. If you regularly experience heartburn while trying to
sleep, place wood or cement blocks under the feet of your bed so that the head end is
raised by 6 to 9 inches. If you can't elevate your bed, you can insert a wedge between
your mattress and box spring to elevate your body from the waist up. Raising your
head with additional pillows isn't effective.
Don't lie down after a meal. Wait at least three hours after eating before lying down
or going to bed.
Eat food slowly and chew thoroughly. Put down your fork after every bite and pick it
up again once you have chewed and swallowed that bite.
Avoid foods and drinks that trigger reflux. Common triggers include fatty or fried
foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
Avoid tight-fitting clothing. Clothes that fit tightly around your waist put pressure
on your abdomen and the lower esophageal sphincter.

Alternative medicine
No alternative medicine therapies have been proved to treat GERD or reverse damage
to the esophagus. Some complementary and alternative therapies may provide some
relief, when combined with your doctor's care.

Talk to your doctor about what alternative GERD treatments may be safe for you. The
options might include:

Herbal remedies. Licorice and chamomile are sometimes used to ease GERD. Herbal
remedies can have serious side effects and might interfere with medications. Ask your
doctor about a safe dosage before beginning any herbal remedy.
Relaxation therapies. Techniques to calm stress and anxiety may reduce signs and
symptoms of GERD. Ask your doctor about relaxation techniques, such as progressive
muscle relaxation or guided imagery.

Preparing for your appointment

You may be referred to a doctor who specializes in the digestive system (gastroenter-
ologist).
What you can do

Be aware of any pre-appointment restrictions, such as restricting your diet before

your appointment.
Write down your symptoms, including any that may seem unrelated to the reason
why you scheduled the appointment.
Write down any triggers to your symptoms, such as specific foods.
Make a list of all your medications, vitamins and supplements.
Write down your key medical information, including other conditions.
Write down key personal information, including any recent changes or stressors in
your life.
Write down questions to ask your doctor.
Ask a relative or friend to accompany you, to help you remember what the doctor
says.

Questions to ask your doctor

What's the most likely cause of my symptoms?

What tests do I need? Is there any special preparation for them?
Is my condition likely temporary or chronic?
What treatments are available?
Are there any restrictions I need to follow?
I have other health problems. How can I best manage these conditions together?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to
ask questions during your appointment anytime you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them
may leave time to go over points you want to spend more time on. You may be asked:

When did you begin experiencing symptoms? How severe are they?
Have your symptoms been continuous or occasional?
What, if anything, seems to improve or worsen your symptoms?
Do your symptoms wake you up at night?
Are your symptoms worse after meals or lying down?
Does food or sour material ever come up in the back of your throat?
Do you have difficulty swallowing food, or have you had to change your diet to avoid
difficulty swallowing?
Have you gained or lost weight?

Nonulcer stomach pain

Symptoms & causes

Diagnosis & treatment
Doctors & departments
Care at Mayo Clinic

Print
Overview

Nonulcer stomach pain is a term for recurring signs and symptoms of indigestion that
have no obvious cause. Nonulcer stomach pain is also called functional dyspepsia (dis-
PEP-see-uh) or nonulcer dyspepsia.

Nonulcer stomach pain is common and can be long lasting. The condition can cause
signs and symptoms that resemble those of an ulcer, such as pain or discomfort in
your upper abdomen, often accompanied by bloating, belching and nausea.
Symptoms

Signs and symptoms of nonulcer stomach pain may include:

A burning sensation or discomfort in your upper abdomen or lower chest, some-

times relieved by food or antacids
Bloating
Belching
An early feeling of fullness when eating
Nausea
When to see a doctor

Make an appointment with your doctor if you experience persistent signs and symp-
toms that worry you.

Seek immediate medical attention if you experience:

Bloody vomit
Dark, tarry stools
Shortness of breath
Pain that radiates to your jaw, neck or arm
Unexplained weight loss

Causes

It's not clear what causes nonulcer stomach pain. Doctors consider it a functional dis-
order, which means it's not found to be caused by a specific disease or diagnosable
disorder.
Risk factors

Factors that can increase the risk of nonulcer stomach pain include:

Female sex
Older age
Use of certain over-the-counter pain relievers, such as aspirin and ibuprofen (Advil,
Motrin IB, others), which can cause stomach problems
Smoking
Anxiety or depression
History of childhood physical or sexual abuse

Diagnosis

Endoscopy
Endoscopy

Your doctor will likely review your signs and symptoms and perform a physical exami-
nation. A number of diagnostic tests may help your doctor determine the cause of
your discomfort and rule out other disorders causing similar symptoms. These may in-
clude:

Blood tests. Blood tests may help rule out other diseases that can cause signs and
symptoms similar to those of nonulcer stomach pain.
Tests for a bacterium. Your doctor may recommend a test to look for a bacterium
called Helicobacter pylori (H. pylori) that can cause stomach problems. H. pylori test-
ing may use your blood, stool or breath.
Using a scope to examine your digestive system. A thin, flexible, lighted instrument
(endoscope) is passed down your throat so that your doctor can view your esophagus,
stomach and the first part of your small intestine (duodenum). This will also allow the
doctor to collect small pieces of tissue from your duodenum to look for inflammation.

Treatment

Nonulcer stomach pain that is long lasting and isn't controlled by lifestyle changes
may require treatment. What treatment you receive depends on your signs and symp-
toms. Treatment may combine medications with behavior therapy.
Medications

Medications that may help in managing the signs and symptoms of nonulcer stomach
pain include:

Over-the-counter gas remedies. Drugs that contain the ingredient simethicone may
provide some relief by reducing intestinal gas. Examples of gas-relieving remedies in-
clude Mylanta and Gas-X.
Medications to reduce acid production. Called H-2-receptor blockers, these medica-
tions are available over-the-counter and include cimetidine (Tagamet HB), famotidine
(Pepcid AC), nizatidine (Axid AR) and ranitidine (Zantac 75). Stronger versions of these
medications are available in prescription form.

Medications that block acid 'pumps.' Proton pump inhibitors shut down the acid
"pumps" within acid-secreting stomach cells. Proton pump inhibitors reduce acid by
blocking the action of these tiny pumps.

Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24HR),

omeprazole (Prilosec OTC) and esopremazole (Nexium). Other proton pump inhibitors
also are available by prescription.
Medication to strengthen the esophageal sphincter. Prokinetic agents help your
stomach empty more rapidly and may help tighten the valve between your stomach
and esophagus, reducing the likelihood of upper abdominal discomfort.
Medication to increase the rate of stomach emptying. Doctors may prescribe the
medication metoclopramide (Reglan) if they find that emptying of your stomach is de-
layed, but this drug doesn't work for everyone and may have significant side effects.
Low-dose antidepressants. Tricyclic antidepressants and drugs known as selective
serotonin reuptake inhibitors (SSRIs), taken in low doses, may help inhibit the activity
of neurons that control intestinal pain.
Antibiotics. If tests indicate that a common ulcer-causing bacterium called H. pylori
is present in your stomach, your doctor may recommend antibiotics.

Behavior therapy

Working with a counselor or therapist may help relieve signs and symptoms that aren't
helped by medications. A counselor or therapist can teach you relaxation techniques
that may help you cope with your signs and symptoms. You may also learn ways to re-
duce stress in your life to prevent nonulcer stomach pain from recurring.
Request an Appointment at Mayo Clinic
Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a
means to prevent, detect, treat or manage this disease.
Lifestyle and home remedies

Your doctor may recommend lifestyle changes to help you control your nonulcer stom-
ach pain.
Make changes to your diet

Changes to your diet and how you eat might help control your signs and symptoms.
Consider trying to:

Eat smaller, more-frequent meals. Having an empty stomach can sometimes pro-
duce nonulcer stomach pain. Nothing but acid in your stomach may make you feel sick.
Try eating a small snack, such as a cracker or a piece of fruit.

Avoid skipping meals. Avoid large meals and overeating. Eat smaller meals more fre-
quently.
Avoid trigger foods. Some foods may trigger nonulcer stomach pain, such as fatty
and spicy foods, carbonated beverages, caffeine, and alcohol.
Chew your food slowly and thoroughly. Allow time for leisurely meals.

Reduce stress in your daily life

Stress-reduction techniques may help you control your signs and symptoms. To reduce
stress, spend time doing things that you enjoy, such as hobbies or sports. Relaxation
therapy or yoga also may help.
Alternative medicine

People with nonulcer stomach pain often turn to complementary and alternative med-
icine to help them cope. No complementary or alternative treatments are proved to
cure nonulcer stomach pain. But when used along with your doctor's care, comple-
mentary and alternative treatments may provide relief from your signs and symptoms.

If you're interested in complementary and alternative treatments, talk to your doctor

about:

Herbal supplements. Herbal remedies that may be of some benefit for nonulcer
stomach pain include a combination of angelica, peppermint leaf, clown's mustard
plant, German chamomile, caraway, licorice, milk thistle, celandine and lemon balm.
These supplements may relieve some of the symptoms of nonulcer stomach pain, such
as fullness and gastrointestinal spasms.

Artichoke leaf extract may reduce other symptoms of nonulcer stomach pain, includ-
ing vomiting, nausea and abdominal pain.
Relaxation techniques. Activities that help you relax may help you control and cope
with your signs and symptoms. Consider trying meditation, yoga or other activities
that may help reduce your stress levels.

Preparing for your appointment

Make an appointment with your family doctor or a general practitioner if you have
signs or symptoms that worry you. If nonulcer stomach pain is suspected, your doctor
may refer you to a specialist in digestive diseases (gastroenterologist).
What you can do

Take these steps to prepare for your appointment:

Be aware of any pre-appointment restrictions. At the time you make the appoint-
ment, ask if there's anything you need to do in advance, such as restrict your diet.
Write down any symptoms you're experiencing, including any that may seem unre-
lated to the reason for which you scheduled the appointment.
Write down key personal information, including any major stresses or recent life
changes.
Make a list of all medications, as well as any vitamins or supplements you take.
Consider taking a family member or friend along. Sometimes it can be difficult to re-
member all the information provided during an appointment. Someone who accompa-
nies you may remember something that you missed or forgot.
Write down questions to ask your doctor.

Questions to ask your doctor

Your time with your doctor is limited, so preparing a list of questions can help you
make the most of your visit. List your questions from most important to least impor-
tant in case time runs out.

For nonulcer stomach pain, some basic questions to ask include:

What is likely causing my stomach discomfort?

What are other possible causes for my stomach discomfort?
What kinds of tests do I need?
Is my stomach discomfort likely temporary or chronic?
What are my treatment options?
What are the alternatives to the primary approach that you're suggesting?
I have other health conditions. How can I best manage them together?
Are there any restrictions that I need to follow?
Should I see a specialist? What will that cost, and will my insurance cover it?
 Is there a generic version of the medicine you're prescribing me?
Are there brochures or other printed material that I can take with me? What web-
sites do you recommend?
What will determine whether I should plan for a follow-up visit?

In addition to the questions you've prepared, don't hesitate to ask your doctor other
questions that occur to you during your appointment.
What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them
may allow more time to cover other points you want to address. Your doctor may ask:

When did you first begin experiencing symptoms?

Have your symptoms been continuous or occasional?
How severe are your symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?
Have you lost weight?