Heartburn is a form of indigestion

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.

Simple treatment

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.

You might also be interested in:

• Barrett's oesophagus.
  
• Chest pain.
  
• Digestive system.
  
• Stomach ulcer.
  

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Last reviewed: November 2011

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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.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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