Heartburn

What is Heartburn ?

Heartburn is a burning sensation in the throat or chest, and occurs when the acid in your stomach flows back up into your oesophagus, the tube that connects your mouth with your stomach.

At its entrance to the stomach is a tight muscle, or sphincter, which normally acts as a one-way valve when swallowing food. When this sphincter lets stomach acid pass back up, the problem is known as acid reflux.

Stomach acids irritate the oesophagus and cause heartburn, as well as leaving a bitter or sour taste in your mouth.

Heartburn often occurs after overeating, when bending over, or when lying down. Most people have occasional bouts of heartburn. More frequent heartburn, occurring a couple of times per week or more, may be a symptom of a more serious condition.

Before heartburn causes permanent damage, it is best to see a gastroenterologist. The gastroenterologists at PIMS utilise the latest diagnostic and treatment options to assist in finding relief from your uncomfortable heartburn

When should I seek medical care for heartburn?

You should always see your GP or attend an emergency department in the first instance with any type of chest pain, as cardiac causes need to be ruled out.

If your heartburn is frequent or persistent, the lining of the oesophagus can be damaged, and so you should consult with a PIMS gastroenterologist.

Treatment is especially urgent in some cases of heartburn, particularly if it associated with:

• Severe pain
• Bloody vomiting or dark or bloody bowel movements
• Dizziness or fainting
• Problems swallowing (also known as dysphagia)
• Dehydration
• Unexplained weight loss

How is heartburn investigated and treated?

Usually, you will be advised to make some changes to your diet and lifestyle, or try some simple medications, to see if these improve or fix the problem.

If these options don’t work, you may need an upper GI endoscopy (gastroscopy) in order to directly view your oesophagus and stomach. You also might undergo an upper GI imaging series, where you’ll drink a specific liquid which can be seen by X-rays.

A capsule the size of a peanut may sometimes be used to measure the amount of acid in your system. The strength of the sphincter between your oesophagus and stomach may also be tested.

Can heartburn be caused by serious problems?

In some cases, yes. Continuous heartburn may be due to gastroesophageal reflux disease (or GORD) or Barrett’s oesophagus. Some hernias can create heartburn, as can gastritis, and other gastrointestinal conditions. Peptic ulcer disease, including those caused by Helicobacter pylori, often produce heartburn as a symptom, too.

How can I treat heartburn?

Mild or occasional cases of heartburn can often be relieved by simple means as avoiding large meals, too much caffeine, as well as minimising fatty or fried foods.

Limiting spicy foods, citrus or tomato products can also help, as well as the avoidance of tight clothing, or activities such as heavy lifting or straining (especially after eating).

A low fat, high protein diet often helps. if you are overweight, then losing weight can frequently improve things. Quitting smoking and limiting your alcohol use are beneficial too. Don’t lie down for three hours after eating, as this encourages acid to flow back into the oesophagus.

Antacids can reduce the amount of acid your stomach makes and they can produce fast, temporary relief from heartburn. If antacids and lifestyle changes are unsuccessful in relieving your heartburn, your gastroenterologist may prescribe stronger medications.