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Heartburn-like pain is a common symptom of gastroesophageal reflux disease (GERD). But several other conditions can cause a burning feeling in your chest. Heart disease Angina, or chest pain caused by lack of blood flow to the heart, can feel a lot like heartburn. "The major key is if you're getting heartburn when you're doing strenuous or moderate activity," says Ryan Madanick, MD, a gastroenterologist and assistant professor of medicine at the University of North Carolina School of Medicine, in Chapel Hill. Gallstones Although gallstones don't always cause symptoms, a stone blocking your bile duct can hurt, usually in the middle or upper-right side of the abdomen. Pain may be cramping, dull, or sharp, and often strikes minutes after you eat. If you're experiencing stomach pain after meals that doesn't improve after you take an over-the-counter acid-suppressing medication, gallstones should be suspected. Stomach ulcer Ulcers can cause a gnawing, burning sensation, usually felt in the upper abdomen. The pain can find its way up to the chest, Dr. Madanick says. Acid-suppressing medications may relieve ulcer pain. But ulcers are usually caused by Helicobacter pylori, a type of bacteria that inflames the stomach lining, so you will need to take antibiotics to clear the infection. Certain anti-inflammatory drugs (such as aspirin, ibuprofen, and naproxen), and osteoporosis drugs called bisphosphonates, can also cause stomach ulcers. Hiatal hernia A hiatal hernia occurs when a portion of the upper stomach pokes through the diaphragm into the chest cavity, rather than staying in the abdominal cavity where it belongs. This can push food and stomach acid up into the esophagus, causing heartburn. Other signs of hiatal hernia include chest pain, belching, and nausea. If you have heartburn due to hiatal hernia, your doctor will typically prescribe acid-suppressing drugs, and recommend lifestyle changes like eating smaller meals, avoiding alcohol, and not eating right before bed. In rare cases, surgical repair may be warranted. Anxiety Although anxiety won't cause GERD, it can cause heartburn and make GERD symptoms worse, Dr. Madanick says. A person can have both anxiety-related heartburn and GERD-related heartburn. "One of the signs that it's not just reflux is that treating the reflux problem doesn't make it any better," he says. Reducing anxiety and stress through, for example, exercise, relaxation, and therapy, can also ease heartburn.