Heartburn

Overview

When stomach acid flows back into the food pipe, it is called reflux. It causes heartburn or acid reflux - pain behind the breastbone that frequently occurs when lying down is typical. A change in diet and losing weight, if applicable, can often provide symptom relief.

Symptoms

Main symptoms

• Burning and pain behind the breastbone or in the upper abdomen
• Symptoms worsen after meals or when lying down
• Acid belching

Other symptoms

• Nausea, vomiting
• Pain when swallowing and stomach ache
• Regurgitation of food

Occasional reflux of stomach contents is harmless and does not cause any persistent symptoms. When this happens over years, however, complications such as stricture, ulcers or cancer are possible.

Causes and treatment

Causes

• Weak lower oesophageal sphincter
• Increased pressure in the stomach or entire abdominal cavity
  • Obesity
  • Lying down flat shortly after a meal
  • Pregnancy
• Diaphragmatic hernia
• Psychological stress
• Gastritis, inflammation of the stomach lining
• Rheumatic diseases
• Medication
• Alcohol
• Nicotine

Further treatment by your doctor / in hospital

Possible tests

• Endoscopic examination of stomach (gastroscopy)
• Measurement of stomach acid (pH meter)
• Measurement of oesophageal pressure (manometry)
• X-ray

Possible therapies

• Medication to reduce the production of stomach acid (proton-pump inhibitors, “gastric protection”)
• Operation (e.g. for big diaphragmatic hernia )

What can I do myself?

• Low-fat diet
• Regular but small portions
• Last meal 3 to 4 hours before going to bed
• Avoid food that worsens the symptoms (coffee, spices, chocolate, etc.)
• Reduce overweight
• Elevate the head of the bed (e.g. use an extra pillow)
• Avoid alcohol and smoking
• Drink milk to neutralise stomach hyperacidity

When to see a doctor?

• Frequent heart burn/acid reflux
• If swallowing, lung or heart problems occur at the same time
• Blood in saliva or vomit
• Involuntary weight loss
• Blood in stools
• Black or foul-smelling stools
  

Further information

Magen Darm Liga Schweiz (Gastro-Intestinal League Switzerland)
www.gastromed.ch