Most people in the UK will experience the discomfort of indigestion and its related symptoms at some point in their lives, according to the National Health Service. A particularly common complaint is heartburn, which can become more frequent after periods of overindulgence, such as during the festive season.
Understanding Heartburn and Acid Reflux
Heartburn is characterised by a distinct burning sensation felt in the chest. This is caused by stomach acid travelling back up towards the throat, a process known as acid reflux. When this happens repeatedly, it may be diagnosed as gastro-oesophageal reflux disease, often abbreviated to GORD.
The primary signs of acid reflux are heartburn itself and an unpleasant, sour taste in the mouth resulting from the stomach acid. However, you might also experience a range of other symptoms, including:
- A recurrent cough or hiccups
- A hoarse voice
- Bad breath
- Bloating and feelings of nausea
Symptoms frequently worsen after eating, when lying down flat, or when bending over.
Common Causes and Triggers
While heartburn often occurs without an obvious reason, many factors can trigger or exacerbate it. Key triggers highlighted by the NHS include specific foods and drinks like coffee, tomatoes, alcohol, chocolate, and fatty or spicy foods.
Lifestyle and health factors also play a significant role. Being overweight, smoking, and experiencing high levels of stress or anxiety can contribute. Physiological changes during pregnancy, including increases in hormones like progesterone and oestrogen, are also common culprits.
Certain medicines, particularly anti-inflammatory painkillers like ibuprofen, can cause issues. Underlying medical conditions such as a hiatus hernia, a stomach ulcer, or a bacterial stomach infection may also be responsible for persistent symptoms.
Managing Symptoms: Self-Help and Pharmacy Advice
There are several effective ways to ease heartburn yourself. The NHS recommends eating smaller, more frequent meals and trying to lose weight if you are overweight. Finding ways to relax can also help manage symptoms.
It is equally important to know what to avoid. Key advice includes:
- Avoiding food and drink that trigger your symptoms.
- Not eating within three to four hours before going to bed.
- Avoiding clothes that are tight around your waist.
- Not smoking and limiting alcohol intake.
- Never stopping prescribed medicine without first consulting a doctor.
A simple but effective physical remedy is to raise the head of your bed by 10 to 20cm using bricks or wooden blocks. This helps keep your chest and head above your waist, which can prevent stomach acid from rising. Crucially, do not use extra pillows for this purpose, as they can increase pressure on your abdomen and worsen symptoms.
Your local pharmacist can be a great first port of call. They may recommend medicines such as antacids or alginates to ease discomfort. It is best to take these with food or shortly after eating, as this is when heartburn is most likely to strike, and they may work for longer. Remember, these treatments help in the short term but do not cure the underlying problem and should not be taken regularly over long periods.
When to Seek Further Medical Help
You should book an appointment to see a GP if lifestyle changes and pharmacy medicines are not controlling your heartburn, if you have symptoms most days, or if you develop other worrying signs. These include food feeling stuck in your throat, frequent vomiting, or unexplained weight loss.
If your symptoms are getting worse at any time, contact a GP, visit 111.nhs.uk, or call 111 for advice.
A GP may prescribe a stronger medicine known as a proton pump inhibitor (PPI), such as omeprazole or lansoprazole, which reduces stomach acid production. A typical course lasts for four to eight weeks, depending on the severity of the reflux.
If medication proves ineffective or symptoms are severe, a GP can refer you to a specialist for further investigation. This could involve tests like a gastroscopy, checks for stomach bacteria (treatable with antibiotics and PPIs), or, in some cases, surgery on the stomach or oesophagus to prevent acid reflux.
