Heartburn is a common digestive symptom, which occurs when stomach acid backs up, or refluxes, into the oesophagus, the tube that carries food from your mouth to your stomach.
It causes a painful burning feeling in your chest or upper abdomen, and may spread to your neck or throat, or even arms.
Early pregnancy, certain foods (especially large meals), a hiatal hernia, alcohol and side effects of some medication can trigger heartburn. It is also a symptom of indigestion, which can be brought on by stress or anxiety.
If you have symptoms more than twice a week, you may have Gastroesophageal Reflux Disease (GORD), chronic acid reflux that can lead to complications, such as oesophagitis (inflammation of the oesophagus), bleeding and narrowing of the oesophagus, and rarely oesophageal cancer.
What are its symptoms?
Heartburn symptoms include:
- A sour taste in your mouth that creeps up the throat
- A burning sensation in the chest after eating
- Pain that worsens when lying down or bending over.
If symptoms are more severe, you will need to see your doctor. These include:
- Heartburn occurs more than twice a week
- Heartburn persists despite use of over-the-counter medications
- You have difficulty swallowing
- You have persistent nausea or vomiting
- You experience weight loss because of poor appetite or difficulty swallowing.
How is it diagnosed?
A doctor will start a heartburn diagnosis with a detailed health history, questioning you about your symptoms, as well as other factors, such as whether or not you smoke. Then they will conduct a routine physical examination. If the symptoms are very troublesome, and the doctor suspects something more serious than mild heartburn, he or she might recommend a gastroscopy or upper endoscopy (commonly known as “swallowing the camera”).
What are your treatment options?
Occasional heartburn is very common. Most people can manage the discomfort with simple remedies, these include certain lifestyle changes and over-the-counter medication, like antacids.
Lifestyle changes include:
- Eat smaller, more frequent meals
- Avoid eating before bedtime
- Avoid alcohol, aspirin, ibuprofen and caffeine
- Stop smoking
- Elevate the head of your bed (or use two or three pillows) to allow gravity to keep acid in the stomach and avoid reflux.
There is a wide variety of over-the-counter medication to choose from. Antacids can be taken after meals, at bedtime, or when needed, to bind excess acid in the stomach and to coat the oesophagus.
Histamine H2 antagonists block the action of histamine (a chemical that stimulates stomach cells to produce acid) on the acid-producing cells of the stomach. This decreases acid production, and thereby heartburn symptoms.
Some H2 blockers and proton pump inhibitors are available without a prescription, but there may be interactions with some prescription medications. Check with your doctor or pharmacist for advice about their safe use.
Can it be prevented?
Adjusting your diet is effective when it comes to prevention as certain foods and drink can aggravate heartburn. These include:
- Alcohol, which relaxes the lower oesophageal sphincter
- Coffee and orange juice, plus other acidic juices, which can worsen or trigger heartburn
- Fatty foods, fried foods, and some acidic foods (oranges, grapefruits, tomatoes) as well as spicy foods.
You can also take some over-the-counter medications before you eat to prevent heartburn. Leading a healthy lifestyle and avoiding alcohol and tobacco can also help to prevent heartburn symptoms.