Heartburn is a form of indigestion, felt as a burning discomfort in the tube leading from the mouth to the stomach (the oesophagus/gullet). The name comes from the fact that the sensation occurs in the chest above the heart.
Heartburn is often a symptom of a condition called gastro-oesophageal reflux disease (GORD) where stomach acid leaks into the oesophagus causing the burning sensation and then comes back up into the mouth where it tastes sour.
- Burning chest pain
- Sour taste if stomach acid comes back up
- Pain and difficulty swallowing
What causes Heartburn?
Most cases of GORD are due to problems with the valve (sphincter) at the bottom of the oesophagus. The sphincter muscle opens to let food into the stomach and then closes to prevent acid leaking back into the oesophagus but if it becomes weakened it doesn’t close properly. Acid then leaks into the gullet causing an unpleasant burning sensation.
How is Heartburn treated?
There are a large number of over-the-counter medicines that relieve heartburn.
Alginates, taken in a suspension, form a thick layer of non-acidic gel that floats on the stomach contents and restricts reflux (the acid coming back up). If reflux does occur, the gel has a soothing effect on the lining of the oesophagus.
Antacids such as aluminium hydroxide, calcium carbonate or magnesium hydroxide are another option. These work by neutralising the gastric acid making it less painful.
If these treatments don’t work medicines called H2-receptor antagonists, such as cimetidine, famotidine, nizatidine and ranitidine, may help. These reduce the amount of stomach acid that your stomach produces. These are more tightly regulated so your pharmacist will need to check these are right for you.
Another option are prescribed proton pump inhibitors (PPIs), such as esomeprazole, omeprazole, lansoprazole, pantoprazole and rabeprazole which also reduce acid production.
If the pain is intense, in the centre of the chest, spreading to the arms and lower jaw - seek urgent help - this could indicate a heart attack rather than heartburn.
Eat small portions at regular interviews, go for a short walk after meals and avoid eating late at night to lessen the risk of heartburn. Avoid foods that have previously caused heartburn.
Limit alcohol levels and drink white wine over red or beers. Drinking water with meals can also help dilute gastric acid.