HEARTBURN is a pain in the chest just below the breastbone, when acid leaks out of the stomach and comes up towards the throat (acid reflux).
It’s usually worse just after eating, or when bending over or lying down. When it happens continuously its known as Gastro Oesophageal Reflux Disease (GORD).
Symptoms can range from being quite mild to very severe. The main symptoms are the heartburn and a sour taste in the mouth due to acid, but there can also be bloating and nausea, cough or hiccups, and bad breath.
The most common reason for GORD is the muscle at the bottom of the oesophagus being too lax and not tightening properly. Other causes can be excess weight, having a hiatus hernia (part of the stomach gets pushed above the diaphragm) or a condition called gastoparesis (when the stomach takes too long to empty itself of acid).
GORD can affect all ages, and although more common in men, it affects a significant proportion of women. Pregnancy is a risk factor for it. Ongoing GORD can lead to complications such as ulcers, bleeding and mouth problems.
Diagnosing GORD is usually just done through questioning by your GP. Further referral is only required if there is difficulty swallowing or no relief from ongoing treatment. At that point, you may be referred and an endoscopy may take place, where a camera is placed down your throat to identify any physical damage or to rule out a more serious diagnosis. They may also conduct a test to check the strength of the muscle between your stomach and oesophagus, to see that it’s tightening properly. There are lots of things that you can do yourself to help with acid reflux symptoms.
- Keep a food diary and see if certain things are worsening symptoms. Often the culprits show up as caffeine, alcohol, spicy or very fatty foods. Eating smaller and more frequent meals can help to ease symptoms, rather than triggering larger releases of acid in response to a big meal.
– night-time reflux can be particularly problematic, as you’re lying flat and making it much easier for acid to travel back towards throat.
Try raising the head of the bed by about 15cm by placing something under the two top legs of the bed (make sure it’s steady!).
Extra pillows are not advised as they put the head and neck out of alignment with the rest of the body, and place extra pressure on the abdomen.
– Excess weight can put pressure on the stomach and cause the acid to be pushed up more easily.
Exercising will have numerous health benefits regardless of acid reflux, and may contribute to reducing any excess weight and pressure on the tummy too.
– smoking is known to irritate the digestive system, and cessation of smoking usually improves the symptoms of GORD.
– tighter clothes restrict the flow of food downwards, and can contribute to the passage of acid upwards. Loose, comfortable clothing is better for the prevention of acid reflux.
– chat to your pharmacist to see if any medications you might be taking could be contributing to the acid. Some very common medicines like ibuprofen or aspirin can irritate the stomach, and extra protection may be needed.
– levels of which are higher than normal across the board at the moment. We feel our emotions in our stomach, and our digestion is physically impacted by stress hormones. Carving out time to destress in whatever way works best for you can positively impact your acid reflux.
Mild or short-term symptoms of acid reflux can be helped with medications over the counter.
Antacids neutralise the acid so that it doesn’t cause the usual pain or irritation. Alginates act like a raft on the top of the stomach to prevent the acid from rising upwards. H2 antagonists and proton pump inhibitors are also available at low doses in some cases.
Always check the suitability of any medication to your symptoms and other medical conditions before taking them.
While short term acid reflux can often be treated with over-the-counter medications, you should be seeing your GP if symptoms persist for more than three weeks, are not being relieved by these over the counter medications, or if any other symptoms such as food lodging in your throat, weight loss or being sick are present.
Acid reflux can become such a regular part of people’s lives that they stop even questioning why it’s there. But there is lots can be done to relieve symptoms, and investigation into long-term presence of it is important to prevent complications. If unsure, ask. Your pharmacist or doctor will be delighted to help.
Dr Michelle O’Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company. Her research lies in the area of mental health education, and through her company InTuition she delivers health promotion workshops to corporate and academic organisations nationally. See www.intuition.ie and @intuitionhealthandwellness