Hi, Thank you for asking Symptoms of heartburn may get worse after you eat a large meal or when you are lying down. In general, the symptoms of heartburn can be treated successfully at home. First, I advise you to take same steps, in order to change your lifestyle: 1. Please DO NOT smoke, take caffeine or alcohol 2. Please DO NOT take spicy foods 3. DO NOT take certain medications such as Aspirin, Ibuprofen 4. DO NOT lie down immediately afte eating. Second: If you experience frequent heartburn (more than twice a week) or heartburn that does not improve with treatment, you SHOULD contact a gastroenterologist, as this could be a sign of a more serious condition. So, your heartburn may be associated with other gastrointestinal conditions, such as ulcers ( I strongly doubt as you told me that you split out blood) or gastroesophageal reflux disease (GERD). To determine if your heartburn is a symptom of GERD, I recommend you to do some other tests, such as: 1. X-ray, to view the shape and condition of your esophagus and stomach. 2. Endoscopy, to check for abnormalities in your esophagus. A tissue sample (biopsy) may be taken for analysis. 3. Ambulatory acid probe tests, to identify when, and for how long, stomach acid backs up into your esophagus. An acid monitor that is placed in your esophagus connects to a small computer that you wear around your waist or on a strap over your shoulder. 4. Esophageal motility testing, to measure movement and pressure in your esophagus. As soon as you make your tests, please write to me again to tell your results! Hope this was helpful Dr. Ermira BIU