Heartburn, reflux and indigestion:

What is heartburn ?

Heartburn, reflux and indigestion are very common symptoms and are usually due to the regurgitation of acid from the stomach to the oesophagus (gullet), known as gastro-oesophageal reflux disease. The most typical symptom, heartburn is often described as burning behind the chest bone commonly after food. Other symptoms of reflux include belching, flatulence and chest pain. Occassionally, dry cough, sore throat, wheezing and hoarse voice may be due to acid reflux.

Why does reflux occur ?

The stomach is normally very acidic and acts as a barrier to infections reaching the intestine. A circular muscle normally prevents this acid from refluxing up into the oesophagus. When this anti-reflux mechanism fails, acid freely refluxes into the oesophagus causing inflammation (Oesophagitis) and all the symptoms described.

How is reflux investigated ?

Normally the diagnosis is very clear from the symptoms and no tests are needed. If the diagnosis is unclear, then tests including gastroscopy and measurement of the oesophageal muscles and acid are required. Reasons for urgent investigation of reflux symptoms would include difficulty in swallowing, loss of appetite and weight loss.

How is reflux treated?

We always suggest lifestyle changes in addition to other treatments. These include diet, particularly reducing fat, eating early in the evening, and reducing any other triggers such as alcohol, smoking and caffeine. Antacids such as Gaviscon neutralize and create a barrier against the acid.  Other drugs used to treat acid reflux include ranitidine and omeprazole. When symptoms are very severe and do not respond to medicines, anti-reflux surgery may be beneficial.