How to beat heartburn

As many as one in four adults has experienced the fiery heat of heartburn, according to the charity Guts UK.

Heartburn can be painful but there are solutions.

As many as one in four adults has experienced the chest-stabbing pain and fiery heat of heartburn, according to the charity Guts UK.

It’s caused by acidic stomach juices washing back up the oesophagus towards the throat — or acid reflux — and, as anyone who has had it will tell you, it’s deeply unpleasant. It’s worse after eating and aggravated by bending or lying down.

“Reflux is not caused by too much acid in the body but by the valve called the lower oesophageal sphincter, at the bottom of the food pipe, not working properly,” says Nicholas Boyle, gastrointestinal surgeon at the Lister Hospital in Chelsea, west London.

“It means that acids head in the wrong direction and back up towards the throat.”

Your susceptibility to it depends upon many things but if you are overweight, stressed or smoke you are not helping matters.

“One of the heartburn risk factors is obesity, as visceral and body fat create pressure in the body that cause reflux. It’s also common in pregnancy,” says Guts UK chief executive Julie Harrington.

Surgery may be required.

“Many are unaware that technology to treat it is minimally invasive,” Boyle says.

One option is Stretta needling, which involves inserting a probe with tiny needles that apply 50C heat to the faulty valve.

This thickens the muscle tissue to prevent reflux.

“Stretta can be effective but there’s not a lot of evidence to show the effects last beyond two years,” Boyle says.

Another option is Linx, a keyhole operation that involves “inserting a tiny ring of magnetic beads around the valve of the oesophagus so that it opens and closes”. It has higher success rates

“Eighty five per cent of people are still off antacid pills five years after having the op,” Boyle says.

Keeping tabs on your acid reflux is paramount.

“In most cases it won’t be a sign of anything more serious but the gullet changes in elasticity and in what it can do as we get older,” Harrington says.

Certain foods and drinks act as triggers for acid reflux, with rich and spicy foods often the most problematic

“Caffeine relaxes the valve at the bottom of the gullet, so drinking lots of tea and coffee can make reflux worse,” Boyle says.

“Foods like citrus and white wine, which are acidic, should be avoided if you are prone.”

Simple strategies such as raising your upper body with extra pillows at night can ease symptoms.

And, although exercise will help if you are overweight, gym-work could be counter-productive.

“I see a lot of people whose reflux symptoms get worse when they exercise,” Boyle says.

“Often this is in activities like running or high-impact workouts where the stomach goes up and down, or weight training, all of which place pressure on the oesophagus.”

Over-the-counter medications such as antacid tablets or proton pump inhibitors can manage the symptoms in the short-term, but have potential side-effects.

“A lot of people take these sorts of pills long-term and affect the status of their microbiome. A healthy gut is now thought to be linked to a lower risk of acid reflux,” Boyle says.

“Ironically, taking antacids long-term can cause symptoms such as acid belching, which people mistake as reflux.”

If you suffer heartburn more than twice a week you should see your GP because it could be a symptom of gastro-oesophageal reflux disease, which requires more focused medical attention.

“Also, if you suddenly experience reflux for two weeks or more, you should get checked out. In some cases, acid reflux can be a symptom of something more serious such as ulcers or oesophageal cancer,” Boyle says.

The Times