Heartburn or reflux happens when the contents of the stomach back up into the oesophagus, causing a burning sensation. Most healthy people experience heartburn from time to time. Pregnant women can also experience heartburn. Overweight people can suffer from constant heartburn, which often leads to complications. Antacid is a suitable treatment for healthy people, but severe heartburn requires medical attention.
Once food is chewed and swallowed, it is pushed by muscular waves down the oesophagus and through a sphincter (or muscle ring) into the stomach. Sometimes, even in healthy individuals, the contents of the stomach squeeze up through the sphincter and back into the oesophagus. This is called 'reflux' and feels like a burning sensation behind the breastbone.
Overindulgence is often to blame
Occasional heartburn can be caused by:
- Eating a large meal
- Eating a large meal and then doing some kind of physical activity, like lifting or bending
- Too much coffee or alcohol
- Anxiety, which can make the stomach 'churn'
- Advanced pregnancy, when the womb pushes up against the stomach.
Treatment for heartburn
The oesophagus uses muscular contractions (called 'peristalsis') to squeeze swallowed food down into the stomach. However, food inside the stomach is only kept there by the force of gravity, so don't lie down after a big meal. Usually, taking an antacid and waiting is all the treatment needed for heartburn in healthy people.
Heartburn in overweight people
Persistent heartburn can be caused by obesity. The extra fat inside the abdominal wall reduces the amount of room for the stomach and small intestines. Any extra pressure on the stomach, such as stooping, forces the stomach contents up into the oesophagus. Weight loss may reduce the symptoms.
Gastro-oesophageal reflux disease
Frequent heartburn also called gastro-oesophageal reflux disease can also be caused by:
- A hiatus hernia – part of the stomach is pushed up through the diaphragm and stays there.
- Dietary factors – dietary fats, chocolate, alcohol and coffee may provoke heartburn because of their effect on the sphincter.
- Cigarettes – giving up smoking reduces the frequency of symptoms.
Complications of gastro-oesophageal reflux disease
Chronic exposure of the oesophagus to gastric juices can lead to:
- Oesophagitis – inflammation of the oesophagus.
- Ulceration – with bleeding, scarring and stricture ( narrowing) of the oesophagus.
- Barrett’s oesophagus – a premalignant condition of the lower lining of the oesophagus.
Risk reduction of gastro-oesophageal reflux disease
A person can reduce their risks by:
- Losing weight if necessary
- Trying not to increase abdominal pressure through bending or lifting
- Raising the head of their bed to avoid reflux while sleeping
- Making dietary changes and giving up smoking
- Seeking advice from their doctor.
Where to get help
- Your doctor
- Your pharmacist.
Things to remember
- Heartburn is caused by stomach contents backing up into the oesophagus.
- Eating a large meal or drinking too much coffee or alcohol are common causes.
- Overweight people with constant heartburn can have complications.
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Last reviewed: March 2012
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