Heart Burn

• One in three people suffer heartburn caused by acid reflux
• Over £126 million is spent on indigestion remedies in the UK each year
• Only a quarter of people with gastro-oesophageal reflux disease visit a GP
• 2-3% of children aged 3-9 years-old suffer with heartburn

Heart burn is typically caused by Gastro-Oesophageal Reflux Disease (GORD) and occurs when stomach acid leaks into the tube running from the throat to the stomach (known as the oesophagus). The condition is also known as 'acid reflux' and is a chronic health problem which will affect someone for life.

In most cases of GORD, there is no apparent explanation for the condition but the main cause is a weakened muscle at the bottom of the oesophagus. Known as the lower oesophageal sphincter, this muscle opens to allow food into the stomach and then closes to prevent stomach acid leaking back up. People with GORD have a weakened muscle which allows acid to pass into the oesophagus and cause heart burn.

GORD can also be caused by excessive pressure on the stomach or when the stomach takes longer than normal to dispose of stomach acid. There are certain risk factors which increase the likelihood of developing GORD such as:

• Smoking
• Drinking alcohol
• Drinking caffeine
• Eating chocolate
• Medications (such as benzodiazepines or anticholinergics)
• Being pregnant

All these factors can relax or weaken the lower oesophageal sphincter. Other factors that increase the chance of developing GORD include:

• A diet high in fat – digesting a fatty meal causes the stomach to take longer in disposing of stomach acid
• Being overweight/obese
• A hiatus hernia – this is a condition which causes part of the stomach to push up through the diaphragm
• Stress

In one-off cases of heart burn the condition can be relieved by over-the-counter remedies but persistent heart burn is a sign of GORD and requires a diagnosis by your GP. Testing isn't always necessary but your GP may suggest a referral for an endoscopy to rule out any serious underlying conditions such as stomach cancer.

An endoscopy involves a thin, flexible tube with a camera at the end being passed into the mouth and down the throat to check the condition of the oesophagus and lower oesophageal sphincter. This procedure is carried out while you're awake and is uncomfortable but not painful. You may be offered a sedative to relax you and an anaesthetic spray is applied to the back of the throat.