Description, causes, prevention, treatment and medicines

What is heartburn?

Heartburn is a form of dyspepsia or indigestion. It is caused by oesophageal reflux. Oesophageal reflux occurs when some of the acidic contents of the stomach splash up into the oesophagus (gullet).

Heartburn is the main symptom of gastro-oesophageal reflux and is described as a burning feeling behind the breastbone that usually rises towards the throat. Heartburn often occurs after eating or lying down. Occasionally there may also be a bitter or sour taste in the mouth when the acidic stomach contents rise as far as the mouth (regurgitation).

Heartburn is one of the most common digestive symptoms. Most people will experience heartburn occasionally and it is no cause for alarm. If heartburn occurs often or interferes with your daily activities then doctors call it gastro-oesophageal reflux disease (GORD, or GERD in the US). Over time GORD can lead to complications such as narrowing of the oesophagus.

What causes heartburn?

Heartburn is usually caused by a defect in the sphincter (muscle) that surrounds the bottom of the oesophagus, where it joins the stomach. The sphincter should be a one-way door only allowing food down into the stomach, but if it does not close properly then stomach contents can go back up into the oesophagus.

What can you do?

The following tips may help.

  • Try to avoid bending over or lying down after a meal to help prevent stomach contents being pushed upwards.
  • Avoid foods that you know upset your stomach. A bland diet is not necessary, but fatty or spicy foods, coffee, chocolate, carbonated drinks and alcohol can cause indigestion.
  • Discuss with your doctor any medicines you are taking that may make reflux worse. Examples include aspirin, other non-steroidal anti-inflammatory drugs (NSAIDs) and some medicines used for osteoporosis.
  • Avoid wearing tight clothing and belts.
  • Sleep with the head of your bed raised 10-20 centimetres.
  • Give up smoking.
  • Lose weight if you are overweight or obese.
  • Use antacids only for relief of occasional symptoms, unless prescribed by your doctor.
  • Talk to your pharmacist about taking one of the medicines used to treat gastro-oesophageal reflux disease (GORD). H2-antagonists (e.g. Zantac Relief, Pepzan) and proton pump inhibitors (e.g. Maxor Heartburn Relief, Pariet 10, Somac Heartburn Relief, Suvacid Heartburn Relief, Salpraz Heartburn Relief) are available over the counter from your pharmacist and can be used to treat mild, intermittent symptoms of gastro-oesophageal reflux in the short term.

When should you see a doctor?

If the pain is more than just occasional, or if you are using an antacid more than twice a week, you should visit your doctor to confirm a diagnosis.

Sometimes heartburn happens during pregnancy, but this will usually go away after the baby is born.

Heartburn can be very similar to the sensations people feel when having a heart attack. If the pain radiates through to your back or down your arm, if you are short of breath or if you are in any doubt, get medical help immediately.

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