Heartburn and acid reflux are two of the most common digestive problems people experience, often used interchangeably but with distinct differences. Dr Reshma Rakshit, a consultant gastroenterologist, explains how these conditions affect many UK adults, their causes, symptoms, and the best ways to manage them.
What are heartburn and acid reflux?
Heartburn is the uncomfortable, burning sensation felt in the chest, typically after eating. This discomfort usually starts in the lower chest and can rise upwards, sometimes reaching the throat. The sensation is often described as a painful or burning feeling that can be mistaken for a heart-related issue, though it’s related to digestion.
Acid reflux, on the other hand, occurs when stomach acid or food rises back up into the oesophagus (gullet). This regurgitation can cause a sour taste in the mouth and discomfort in the chest or throat. It’s this movement of stomach contents back up into the gullet that can lead to heartburn.
Symptoms of heartburn and acid reflux
Along with the burning sensation in the chest, heartburn and acid reflux can bring other symptoms, including:
- A sore throat or hoarse voice
- A persistent cough
- Increased symptoms after eating large meals
- Symptoms worsening when lying down or bending over, such as during gardening or housework
- Feeling food stuck in the throat
- Nausea or vomiting, especially after a meal
Many people find their symptoms worsen at night, particularly if they’ve had a late or heavy meal.
What causes heartburn and acid reflux?
Dr Rakshit points out that the body’s digestive system is designed to keep stomach contents, including acid, where they belong. However, when certain risk factors come into play, these contents can rise back into the gullet, which is not equipped to handle the acidic environment, leading to discomfort.
Common risk factors for heartburn and acid reflux include:
- Excess weight: Carrying extra weight, particularly around the midsection, increases pressure on the stomach, making acid reflux more likely.
- Eating late: Going to bed on a full stomach doesn’t give your body enough time to digest food properly, leading to an increased chance of reflux.
- Large or heavy meals: These can overfill the stomach, causing acid to spill upwards.
- Carbonated drinks: Fizzy drinks can cause bloating, which puts more pressure on the stomach and increases the chance of reflux.
When to see a doctor
While heartburn and acid reflux are common, there are times when it’s important to seek medical attention. If symptoms persist despite over-the-counter medications or lifestyle changes, or if you experience more severe issues such as unintentional weight loss, difficulty swallowing, or vomiting, it’s time to consult your doctor. These could be signs of more serious conditions.
Additionally, Dr Rakshit stresses that if you notice blood in your vomit or stools, you should seek emergency medical attention immediately.
Diagnosis and treatment options
If your GP or specialist suspects you have ongoing issues with heartburn or acid reflux, they’ll likely start by taking a detailed medical history. In some cases, further investigation may be necessary, such as an endoscopy. This is a straightforward procedure where a small camera is used to examine your oesophagus and stomach to check for abnormalities, such as a hiatus hernia (where part of the stomach moves up into the chest), which can contribute to reflux.
Lifestyle changes to manage heartburn and acid reflux
For many people, simple lifestyle adjustments can significantly reduce the frequency and severity of heartburn and acid reflux. Dr Rakshit recommends several changes that can help:
- Lose weight: Reducing excess weight, especially around the abdomen, can relieve pressure on the stomach.
- Avoid late-night eating: Give your body two to three hours to digest before going to bed.
- Eat smaller portions: This reduces the strain on your stomach and prevents excess acid production.
- Sleep with your head elevated: While propping up your head with pillows often doesn’t work, raising the head of your bed or using a wedge pillow can help keep stomach acid down.
Dietary considerations and medication
In addition to lifestyle changes, certain foods and drinks can trigger or worsen reflux symptoms. Consulting a dietitian can help identify foods that may be contributing to your discomfort. If lifestyle changes aren’t enough, medications such as proton pump inhibitors (PPIs), which reduce stomach acid production, can be prescribed. These are often short-term treatments, but in some cases, people may need them for longer periods under medical supervision.
Is surgery ever needed?
In rare cases where lifestyle changes and medication are not effective, surgery might be an option. This is typically reserved for people with severe symptoms, often related to a hiatus hernia.
Take control of your symptoms
If you’re struggling with heartburn and acid reflux, don’t hesitate to seek advice from your GP or a gastroenterologist. With the right combination of lifestyle changes and, if necessary, medication, these conditions can often be well-managed, allowing you to enjoy life without discomfort.
Dr Reshma Rakshit is a highly regarded Consultant Gastroenterologist with expertise in managing a wide range of gastrointestinal conditions, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders. She currently practises at leading healthcare institutions across London and Essex. With a compassionate approach and dedication to patient care, Dr Rakshit is committed to helping individuals understand their symptoms and improve their quality of life through personalised treatment plans.
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