How to deal with heartburn

Heartburn is a symptom of the condition known as acid reflux. This is when stomach acid refluxes or comes up into your food pipe- the oesophagus. The lining of the oesophagus isn't designed to withstand acid in the same way that your stomach lining is and so if acid gets into the oesophagus it can cause pain. Heartburn sufferers usually describe their symptoms as:

• A hot or burning pain
• A tight feeling in the chest area
• An acidic taste  in the mouth - possibly with the feeling of sickness

Help yourself to avoid heartburn

There are several known triggers and causes of heartburn, which can vary from person to person. So avoiding whatever triggers or causes your heartburn may help you to avoid suffering acid reflux in the first place.

Avoiding triggers

Heartburn triggers include: spicy foods such as curries, onions, garlic, tomatoes, peppers, citrus fruits; and fatty foods such as crisps, high-fat biscuits, chocolate and anything fried, oily or creamy. There's a long list of known triggers, but these are the most commonly recognised ones. Finding out what triggers your heartburn really is a key step for you. If you're unsure exactly what it may be, try keeping a food diary to help you identify the cause.

You could also consider checking food packaging for ingredients; for example, black pepper can be a trigger for some people. And if you're eating out, and know what your triggers are, ask specifically what's in the food before ordering, just in case. You wouldn't want to spoil a nice evening by triggering heartburn after dinner, or have to work all afternoon while suffering heartburn after lunch.

Lifestyle changes

Other ways to help you avoid heartburn are to address your lifestyle. Stopping smoking, avoiding, or cutting down on alcohol and caffeinated drinks and losing some weight, may all help to prevent heartburn occurring. Eating small meals frequently, rather than three big meals a day, may also help you. This is because larger amounts of food can lead to more acid production. What's more, if your stomach is very full, it can increase the chances of stomach contents pushing upwards and into your oesophagus.

Some people can get heartburn during or following exercise or other physical activities. Anything that causes jolting to your stomach may force stomach acid to move upwards and into your oesophagus. Other movements, like bending forward or backwards during exercise, can put your body into a position that makes acid reflux easier to occur. So after you eat, it is advisable to wait at least a couple of hours before any physical exertion. Also, consider doing exercises that don't require you to move too quickly, involve jarring movements or bend over too much or too often.

What about heartburn during pregnancy?

Being pregnant will obviously involve lifestyle changes. As your body adjusts to pregnancy and your baby begins to grow, one new aspect you may need to deal with could be heartburn. And this may also require a change in lifestyle, as far as meals and drinks are concerned. But please be reassured that you will not be the only pregnant woman to suffer, since heartburn commonly occurs in pregnancy. In fact, almost three quarters of women suffer heartburn and indigestion during pregnancy.[1] There are two well-known reasons for this:

• A surge in the levels of the hormone progesterone causes muscles to relax. If this affects the ring of muscle (sphincter) at the entrance to your stomach, stomach contents and stomach acid can pass up into your oesophagus and heartburn can be the result
• As your pregnancy progresses, your baby grows and physically begins to put more pressure on your digestive tract. This can have the effect of pushing acid up into your food pipe, and again result in heartburn

It can obviously help if you try to avoid any known food or drink triggers while you are pregnant. And eating small meals often can help to ensure that your stomach doesn't become overloaded. However, you may also need to ask for advice from your doctor or pharmacist for suitable heartburn treatments to take during pregnancy, should you be suffering severe and/or regular heartburn

Treatments for your heartburn

Regardless of knowing the trigger or cause, if you still suffer heartburn from time to time, you'll probably want to treat it. So next we'll look at the wide choice of treatments available from various sources.

There are three broad categories of heartburn treatments. Some you can buy yourself, whilst others may need to be prescribed by a doctor. Treatments in categories one and two below are mostly used to treat heartburn once it starts, whereas treatments in category three are widely used to help prevent heartburn before it starts.

1. Home treatments.

These are sometimes referred to simply as "natural remedies” or even "home treatments" for heartburn. They include peppermint oil and tea made from fennel or anise seeds.  A couple of tablespoons of the herbal treatment Slippery Elm, in water after meals, has also been suggested.¹ Aloe Vera juice has been known to reduce inflammation and may have this effect on the oesophagus, so it has been suggested that it can be drunk before meals to help treat heartburn.[2] 

Chewing gum following a meal is believed to stimulate the flow of saliva, which helps to wash away stomach acid and helps to prevent it from causing heartburn.² Sodium bicarbonate (baking soda) mixed with water may also help, since it is alkaline and has the potential to help neutralise acid.² Even sipping hot water alone is believed by some to help get rid of heartburn.

2. Non-systemic treatments:

This category of heartburn treatments do not need to be absorbed into your blood stream to provide relief. It includes two very well-known and commonly used treatment types, called antacids and alginates.

2a. Antacids

Antacids are treatments that contain acid neutralising substances, hence the name "ant(i)acid." These frequently include calcium carbonate, magnesium carbonate or aluminium hydroxide.  Some antacids can also coat the surface of the oesophagus to help protect against the potential effect of stomach acid.³

Antacids tend to be used by those who suffer mild bouts of heartburn, or are perhaps a first port of call. They come in convenient formulations, such as a liquid designed to be taken by the spoonful, or chewable tablets.

Antacids are available over-the-counter and can be purchased from pharmacies and other outlets. They may not be suitable for everyone, for example people with kidney disease. However they are considered suitable for use if you are pregnant and suffer heartburn.[3]

2b. Alginates

Gaviscon Extra is a well-known example of this type of treatment.  It contains sodium alginate (a rafting agent), together with calcium carbonate and sodium bicarbonate.  Here's how Gaviscon Extra works:

• Firstly, the sodium alginate in Gaviscon forms a protective layer, or raft, on top of the stomach contents soon after it has made contact with stomach acid. This raft creates a strong physical barrier that helps to prevent stomach acid moving up (refluxing) into the oesophagus. As a result, it helps to keep stomach contents (including stomach acid) where they belong and not in the oesophagus where they could cause pain. If you click here you can see a video describing how this happens.
• Secondly, the calcium carbonate and sodium bicarbonate ingredients in Gaviscon Extra work to quickly neutralise stomach acid. So, not only does Gaviscon create a barrier to acid, it neutralises acid too - in a similar way to antacids.

Gaviscon is not only fast acting, but it also offers a long-lasting effect- up to twice as long as antacids.

Gaviscon Extra (and other formulations in the Gaviscon range) can be bought over-the-counter or may also be prescribed by doctors. And like antacids, Gaviscon is suitable for women to take during pregnancy. It isn’t absorbed in your blood stream and doesn't need to be in order to provide effective relief.You'll find further details of the whole Gaviscon range of products here.

3. Systemic treatments

A key difference with this category of treatments, compared with the two above, is that they need to be absorbed into your blood stream before they can start to work. There are two main types:

3a. Histamine H2-receptor antagonists (H2- antagonists or H2-blockers)

Stomach acid is produced by special cells found in the stomach lining. H2-antagonists work by turning off chemical receptors in these cells. This greatly reduces acid production.

Like Gaviscon, these treatments can be bought over-the counter, or prescribed by a doctor.  But your pharmacist or doctor will advise you what's best for you.

3b. Proton pump inhibitors (PPIs)

Like H2-antagonists, proton pump inhibitors also work by stopping the production of stomach acid. But, as their name suggests, PPIs work in a different way to H2-antagonists. Again they work in the cells of the stomach lining, but they actually block what are known as "acid pumps" which are the source of acid in the stomach.

As with Gaviscon and H2-antagonists, some PPIs can be bought over-the-counter, but others can only be prescribed by doctors.  Also like H2-antagonists, it may be necessary to take a PPI each day, for a period of time - as advised by your healthcare professional.

Asking for help

As we've seen, there may be several reasons why you suffer heartburn. But, reassuringly, there are also several ways to help you avoid or get rid of it. Watching what you eat and adjusting your lifestyle are certainly good starting places.

However, if you're in any doubt about your symptoms of heartburn, or experience heartburn frequently and/ or severely, always ask for professional medical advice from pharmacists and doctors.

 

 

All information presented is not meant to diagnose or prescribe. Gaviscon Extra Oral Suspension, and Gaviscon Extra Chewable Tablets contain Sodium Alginate, Sodium Hydrogen Carbonate, Calcium Carbonate for Heartburn & Indigestion. Always read the label. If symptoms are severe or prolonged you should consult a doctor or pharmacist.