Heartburn is caused when the contents of the stomach, especially acid, is forced back up through the valve at the top of the stomach, causing pain in the gullet.
It is a burning discomfort in the upper part of the stomach and upwards behind the breastbone. Sometimes it can be felt up to the throat, with an acid taste in the mouth. It is mainly brought on by a large meal and worsens when bending or lying down. Heartburn is more common in the overweight and is very common in pregnant women (approx. 50%). Some people who clear the throat by swallowing (a nervous habit) so fill their stomach with air, the resulting belch can be associated with heartburn. The problem is most common in those who are pregnant, overweight or over 55 years of age. Heartburn is not a childhood condition. The pain may be severe and sudden, like a heart attack.

 

  • When did you first notice the symptoms of heartburn?
  • Do you know what foods cause this heartburn? If you can identify the trigger foods then try to avoid eating these.
  • Have you tried any indigestion remedies to treat your condition? If so were they effective?
  • Are you taking any other medication?

 

Treatment:

 

In normal adult’s patients, we recommend one of the treatments containing alginates, such as GAVISCON. GAVISCON acts as a barrier raft at the top of the stomach thus blocking the reflux of stomach contents into the oesophagus. These preparations are available as liquid or tablets. The liquid formulation acts fastest and most effectively, and should be bought for home use. The tablets, however are more convenient and should be bought for this reason, to carry around, or to bring on holiday.

Alginates are derived from seaweed. When an alginate enters the stomach it floats just like a raft of seaweed, preventing acid going up to the oesophagus (the tube from the mouth to the stomach) by acting like a lid on the stomach. The sodium bicarbonate also contained in such preparations acts as an antacid, so these preparations have a dual action – one prevents the acid going up the tube, the other breaks down the acid itself, reducing the amount of acid in the oesophagus and hence the pain of heartburn.

A new product named Pantup/Pantoloc is now available over the counter. This medication was only available on prescription until recently and is an extremely effective product for heartburn, although it may take a day or two to take effect. This medication may not be suitable for everybody, so the pharmacist may have to ask you a few questions before selling it.

MOTILIUM is another useful product for heartburn, especially when associated with overindulgence, large meals or bloating. Although this product has no antacid action, it helps food move through the stomach into the intestines and so can help prevent it refluxing into the oesophagus where it can cause the familiar burning sensation of heartburn.

 

Practical Points:

 

  • Overweight patients are more susceptible to heartburn therefore some weight-loss will probably reduce the frequency of heartburn. Most people will find that symptoms ease when they reach their ideal weight. If you choose to diet it is helpful to have a weekly weight check so drop in to the pharmacy for an accurate reading..
  • Small meals should be eaten frequently rather than large meals so that the stomach is never over-full.
  • The last meal of the day should be eaten a few hours before bedtime, as heartburn is worst when lying down.
  • Other things that may worsen heartburn include smoking, alcohol, caffeine, chocolate and fatty foods.
  • Posture may also be a problem – heartburn is worse when bending, stooping even slumping in an armchair. Squat rather than bending and raise your head in the bed with pillows.

 

Tight constricting clothes should be avoided as they worsen the problem