Heartburn

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What is Heartburn?
Heartburn is a burning feeling rising from the stomach or lower chest up towards the neck. It is caused by acid from the stomach backing up into the gullet (oesophagus or swallowing pipe). See also Dyspepsia, Gastroesophageal Reflux Disease (GERD) and oesophagitis.

How do you get Heartburn?
Normally, a ‘valve’ at the lower end of the swallowing pipe (the lower oesophageal sphincter) opens when you swallow and closes when food has passed. In some people, this does not work properly and does not close off when it should, usually after a meal.

• Heartburn can be infrequent or can occur regularly in patients with conditions such as acid reflux disease.

• In patients with acid reflux disease, heartburn usually gets worse after they eat, or when they lie down or bend over.

How serious is Heartburn?
Heartburn symptoms produce a lot of discomfort and can affect feelings of well-being when they appear regularly. Heartburn may signal other problems such as oesophagitis (inflammation of the oesophagus) or GERD, which can be more serious. Patients may then require stronger medicines to control symptoms if heartburn persists, so it is important to seek a doctor’s advice.

How long does Heartburn last?
The symptoms of heartburn can be frequent and may last several weeks, months or longer if left untreated. Because they may appear now and again they may be experienced for a long time before a decision is taken to seek medical advice. They can also re-occur after treatment.

How is Heartburn treated?
Medications commonly used in the treatment of heartburn include:

• Acid suppressants, such as histamine H2-antagonists (blockers). Histamine is a chemical released in the body under many different conditions. In the stomach it can release more acid, so blocking histamine’s action reduces acid production.

• Proton-pump inhibitors also work on the cells in the stomach wall, which make acid, to reduce the amount of acid produced and released into the stomach chamber.

• Other medicines (called pro-kinetic agents) increase the movement of the stomach. They work by increasing the pressure of the lower oesophageal sphincter (the point where the oesophagus joins the stomach) and promote emptying of the stomach.

• Antacids are medicines that are commonly used to treat acid-related symptoms, like heartburn or indigestion, and work by neutralising acid in the stomach. However, they are not usually recommended to treat the frequent heartburn suffered by people with GERD.