Heartburn and acid reflux are common symptoms that can affect your everyday life. This advice is here to help you understand what might be causing your symptoms, how diet and lifestyle can impact reflux, and when you might need to seek further investigation from your GP.

What Are Heartburn and Reflux?

Heartburn is a burning sensation in your chest, often after eating, and is a symptom of acid reflux. Acid reflux happens when stomach acid or contents flow back up into the oesophagus (the tube that connects your mouth to your stomach), causing discomfort. If this happens frequently, it may be referred to as gastroesophageal reflux disease (GERD).

Common Symptoms of Heartburn and Reflux:

• Burning sensation in the chest (heartburn), often after eating
• A sour or bitter taste in the mouth
• Difficulty swallowing or the sensation of food being stuck in the throat
• Regurgitation of food or acid into the mouth
• Chronic cough or hoarseness

Possible Causes of Heartburn and Reflux:

Several factors can contribute to heartburn or acid reflux. Some of the most common include:

1. Weak lower oesophageal sphincter (LES): The LES is a ring of muscle that keeps stomach contents from flowing backward into the oesophagus. If it weakens, acid can escape.

2. Obesity or being overweight: Excess weight can put pressure on your abdomen, leading to acid reflux.

3. Pregnancy: Hormonal changes and pressure from the growing baby can contribute to reflux.

4. Certain medications: Some drugs, like painkillers, antidepressants, or blood pressure medications, can relax the LES and trigger reflux.

5. Hiatal hernia: A condition where part of the stomach pushes up through the diaphragm, which can lead to reflux.

6. Dietary and lifestyle factors: Your diet and habits can play a significant role in triggering symptoms.

Irritating Factors in the Diet:

Certain foods and drinks can trigger or worsen acid reflux. These include:

• Spicy foods
• Fried or fatty foods
• Citrus fruits (e.g., oranges, lemons)
• Tomato-based products
• Chocolate
• Mint
• Garlic and onions
• Caffeinated drinks (e.g., coffee, tea, sodas)
• Alcohol

How to Improve Your Diet and Lifestyle:

Making a few simple changes to your diet and lifestyle can significantly improve your symptoms:

1. Eat smaller, more frequent meals: Large meals can increase pressure on the stomach and trigger reflux. Try eating smaller meals throughout the day.

2. Avoid lying down immediately after eating: Wait at least two to three hours after eating before lying down. This allows food to move through your stomach and reduces the risk of acid reflux.

3. Maintain a healthy weight: Being overweight increases the pressure on your abdomen and can worsen reflux. Gradual weight loss through a balanced diet and regular exercise can reduce symptoms.

4. Quit smoking: Smoking relaxes the LES and can increase acid reflux symptoms. Quitting smoking is one of the best steps you can take to reduce heartburn.

5. Limit caffeine, alcohol, and carbonated beverages: These can increase stomach acid production and irritate the esophagus.

6. Eat a balanced diet: Focus on eating lean proteins, whole grains, and plenty of fruits and vegetables that are less likely to trigger reflux.

7. Drink plenty of water: Staying hydrated can help neutralize stomach acid and aid digestion.

Medication Use and Heartburn:

Certain medications can contribute to acid reflux symptoms. If you are using medications like NSAIDs (non-steroidal anti-inflammatory drugs - ibuprofen or naproxen), some blood pressure medications, or certain antidepressants, discuss with your doctor whether these could be contributing to your symptoms.

If you are taking medications for reflux, such as proton pump inhibitors (PPIs) or H2 blockers, it's essential to follow your GP's advice on proper use. These medications help reduce stomach acid but should be used as part of a broader strategy involving lifestyle changes.

When to Seek Further Investigations:

While heartburn and reflux can often be managed with lifestyle changes and over-the-counter medications, if your symptoms persist, worsen, or are accompanied by more severe signs like weight loss, difficulty swallowing, or vomiting, it's important to seek further medical advice.

Your GP may recommend investigations such as:

• Endoscopy: A procedure where a thin tube with a camera is inserted into your esophagus to check for signs of damage or more serious conditions.
• 24-hour pH monitoring: This test measures acid levels in the oesophagus over a 24-hour period.
• Barium swallow X-ray: To examine the shape and function of the oesophagus.

These tests are usually considered when symptoms don’t improve with lifestyle changes and medication, or if there are warning signs suggesting a more serious condition, such as esophageal damage or even cancer.

Heartburn and acid reflux can usually be managed effectively with changes to diet, weight management, and appropriate medications.

However, if symptoms do not improve or become more severe, it's essential to speak to your GP for further assessment. Each case is different, and your GP will tailor the approach to suit your individual needs.

By understanding the causes of reflux, making mindful dietary choices, and maintaining a healthy weight, you can often reduce or eliminate symptoms. However, always feel free to seek help if you're unsure or if your symptoms don't improve.