Heartburn or gastro-oesophagal reflux

Heartburn is a symptom of the digestive system arising as a result of acid in the stomach leaking backwards and upwards into the oesophagus (gullet) and sometimes, as far as the mouth.

It is a relatively common complaint - many people have experienced bouts of heartburn eating too much, or food that is too spicy or fatty. In these situations, acid reflux is a ‘normal’ symptom and does not indicate an underlying health problem.

Others however, may be troubled by repeated episodes of heartburn, making these painful or uncomfortable experiences. Recurring episodes of heartburn, without an underlying cause, is known medically as gastro-oesophageal reflux disease (GORD).

In normal circumstances, acid is prevented from entering the gullet because of a type of valve lying at the junction of the gullet and stomach. This valve, made from muscle, normally sends food in one direction, but in certain circumstances, can leak.

When it does leak, acidic contents of the stomach travel backwards and upwards, towards the mouth. This gives rise to a number of symptoms. A number of factors and health conditions can encourage this leakage. These include:

• Health conditions, such as indigestion, a hiatus hernia, obesity or pregnancy
• Lifestyle habits, including eating too much or too quickly
• Some types of food such as fatty or acidic foods
• Some medicines including common painkillers such as aspirin or ibuprofen
• It is normal for newborn babies to show a degree of reflux. This is caused by an immaturity in their digestive system and they grow out of the condition within a few months.

The symptoms of heartburn are distinctive and characteristic, and hence usually easy to recognise. They share many common characteristics with symptoms of indigestion but typically worsen when lying down flat.

Common symptoms of heartburn are:

• Sour taste in the month
• Regurgitation(food travelling from the stomach back to the mouth)
• Nausea
• Wind or feeling bloated
• Hiccups
• A dry cough
• Hoarseness

Heartburn is often influenced by what you eat, so making changes to your dietary habits should be the first step to consider. Certain types of food aggravate the condition but on the other hand, there are foods that can help.

Although not the best remedy for long term use, people have found relief from acid reflux symptoms with baking soda (sodium bicarbonate). Dissolve half to one teaspoon in a glass of water – this helps to neutralise acid in the stomach.

Ginger has been used since ancient times to help treat gastric problems, and many people find that this spice can help to ease digestive symptoms, including reflux.

Finally, there is some research to suggest that liquorice sweets can help ease general digestive symptoms. However, if you suffer from high blood pressure, take liquorice with care and only in small amounts.

• Avoid copious meals if possible: the fuller the stomach, the more gastric juices escape upwards.
• If possible, stop smoking. The chemicals contained in cigarettes can increase the production of gastric acid and trigger heartburn. Stress can also have the same effect.
• It’s preferable to avoid having an empty stomach: eat several light meals per day.
• Take the time to eat and, if possible, avoid drinking during meals.
• Eat at least 3 hours before going to bed. In a lying down position, gastric juices tend to flow up from the stomach. 
• To reduce gastric reflux when lying down, raise the head of the bed by 10-12 centimetres and let gravity do its work.
• Obesity causes strain on the abdomen, which can make heartburn worse. Losing a few kilos can help reduce heartburn significantly.
• Pay attention to the medication and/or supplements you take, as some of them can cause heartburn, particularly salicylic acid and anti-inflammatory drugs.
• Learn to manage stress: exercise regularly, get enough sleep, work reasonable hours, take time off for yourself, and take one day at a time.

With acid reflux, stomach bitters are usually the first port of call. This class of medicinal herbs includes artichoke, dandelion and boldo and work by stimulating the correct balance of stomach acid and enzymes, helping the stomach digest (break down) food more efficiently.