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Heartburn

What is heartburn?

Heartburn is not a disease but a symptom of burning discomfort in your chest, usually associated with an acid taste in the mouth. It is also referred to as indigestion or dyspepsia and is associated with drinking and eating.

What causes heartburn?

It is caused by the reflux of the acid contents of the stomach back up the oesophagus (gullet) and sometimes into the throat. It may be caused by a peptic ulcer. Reflux occurs because the valve made by a ring of muscle at the junction of the oesophagus and stomach does not close fully, and may be associated with a hiatus hernia.

Factors that bring it on are:

• particular foods (e.g. cabbage, onions, curries, cucumber, pastries, especially pies and pasties, fruit cake)
• certain drinks (e.g. wine, especially red, beer, carbonated drinks, coffee)
• eating too fast
• rich or big meals
• chewing gum long and hard
• stress and anxiety
• pregnancy or obesity
• old age
• certain drugs (e.g. anti-rheumatism drugs, aspirin)

What tests are done?

Tests may not be necessary, but if it persists or your doctor is concerned about an ulcer, X-rays may be taken or a tube called a gastroscope may be passed down into the stomach to inspect it.

How can it be prevented?

Don'ts

• Bolt your food down.
• Eat standing up.
• Smoke.
• Eat large or rich meals.
• Bend over for work.
• Strain at toilet.
• Drink wine with meals.
• Eat foods that 'burn'.

Dos

• Eat in a slow and relaxed manner.
• Eat sitting down.
• Avoid foods that 'burn'.
• Eat small or moderate meals.
• Squat rather than bend.
• Keep your bowels regular.
• Avoid stress: relax!
• Relax for half an hour after a meal.

What is the treatment?

1. Attend to the above preventive advice.
2. Learn what brings on your heartburn and deal with it.
3. Take antacids when you feel heartburn coming on and before bed at night.
4. Your doctor may prescribe other medicine to help.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia