Heartburn

What is heartburn?

Heartburn, or reflux, occurs when the contents of the stomach back up into the oesophagus and cause a burning sensation in the upper abdomen or behind the breastbone. Usually, when food or liquid travels through the oesophagus and into the stomach, a small band of muscle that sits between the oesophagus and stomach, closes. If this band doesn’t close tightly enough, the contents of the stomach, including stomach acid, can squeeze up through the sphincter and into the oesophagus causing irritation and heartburn. It’s estimated that 20% of people living in Western countries have problems with heartburn or regurgitation.

Healthy people can experience heartburn from time to time, which may be triggered by various diet and lifestyle factors. When heartburn happens regularly, it may be caused by an underlying health condition and needs to be investigated by a healthcare professional.

Symptoms of heartburn

Heartburn is a burning pain that spreads from the upper stomach, or from behind the breastbone, up into the throat. Other possible symptoms include a burning sensation in your throat, a bad taste in your mouth, and stomach noises.

What can cause heartburn?

Causes of occasional heartburn include:

• Overeating — Large meals exert pressure on your lower oesophagus, which can lead to reflux and heartburn.
• Too much alcohol or caffeine — Alcohol, coffee and other caffeinated drinks can relax or weaken the LOS, which can cause stomach contents to rise into the oesophagus, resulting in heartburn symptoms.
• Exercising after meals — Avoid exercise, heavy lifting or bending after meals to avoid putting pressure on your LOS.
• High-fat foods — High-fat foods can relax the lower oesophagus and trigger heartburn in some people.
• Acidic or spicy foods — Spicy foods like curries or acidic foods like tomatoes and citrus fruits can contribute to the discomfort of heartburn.
• Peppermint and spearmint — Peppermint can affect the LOS and lead to heartburn in sensitive people.
• Cigarette smoking — Smoking relaxes the LOS and stimulates acid production.
• Stress — Stress and a lack of sleep can increase acid production and lead to heartburn.
• Increased abdominal pressure — Being overweight or pregnant can cause heartburn symptoms, as extra pressure on the stomach can force the stomach contents up into the oesophagus.
• Medications — Some medications can cause heartburn. Speak to your healthcare professional for more information.

How can I avoid heartburn?

There are many things you can do to avoid heartburn including:

• Eating smaller meals — Eating smaller, more frequent meals, reduces pressure on your stomach and the LOS.
• Avoiding food triggers — Limiting foods that relax or weaken your LOS, including chocolate, spicy foods, coffee, peppermint, and garlic can help reduce the incidence of heartburn.
• Quit smoking — Quit smoking to reduce the effects of nicotine on stomach acid and your LOS.
• Reducing alcohol & coffee — Reduce your alcohol and caffeine consumption as they relax the LOS, causing heartburn symptoms.
• Avoiding soft drink — Steer clear of carbonated beverages as burps of gas can force the LOS open and promote reflux.
• Dressing comfortably — Wear comfortable clothing when eating and avoid tight‐fitting garments, as increased pressure on the abdomen can open the oesophageal sphincter.
• Staying upright — Stay upright after meals. Food inside the stomach is kept there by the force of gravity, so it’s important not to lie down after a big meal. Avoid lying down for at least 3 hours after a meal.
• Elevating your bed — Elevate the head of your bed to prevent reflux when you lie down.
• Maintaining a healthy weight — Lose weight if necessary or maintain a healthy weight to reduce pressure on the stomach.
• Reducing stress — Getting enough sleep and minimise stress through exercise and stress‐management techniquessuch as deep breathing, yoga, meditation or tai chi to help reduce reflux.
• Don’t exercise after meals — Exercising on a full stomach can cause heartburn. Give your stomach time to empty first.
• Chew xylitol gum after a meal — Chewing gum promotes saliva production, which helps neutralise stomach acid. Xylitol gum is sugar-free.

Most adults have experienced heartburn at some stage, especially after overindulging or eating a spicy meal.

Reduce the recurrence of heartburn by avoiding behaviours that weaken your lower oesophageal sphincter — the band of muscle that closes tight to protect your oesophagus from stomach acid — or add pressure to your stomach.

If you suffer from heartburn more than twice a week, it could be a symptom of an underlying medical condition and may require investigation by your healthcare professional.

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