Heartburn & Indigestion

Overview on Heartburn

• A symptom of gastro-oesophageal reflux disease (GERD)
• GERD is due to the valve between the oesophagus and stomach not closing properly
• Stomach acid can wash back (reflux) into the oesophagus causing a burning pain


• Signs & symptoms
• A burning discomfort/pain felt in the stomach passing upwards behind the breastbone
• A ‘lump’ deep in the throat
• An acidic, sour or bitter taste in the mouth
• Condition exacerbated by lying down or bending forward

Overview on Indigestion

• Occurs after drinking or eating too much, which swells the stomach, causing discomfort.


• Signs & symptoms
• A bloated stomach, often relieved by burping
• Discomfort or pain in the stomach
• Stomach cramps
• Wind or flatulence

Causes

• Consumption of rich, spicy and fatty food
• Drinking alcohol or smoking
• Eating too quickly
• Diet low in fibre
• Stress
• Over weight
• Pregnancy

Self care

• Reduce intake of fatty /greasy foods, chocolate, tomato-based foods, garlic, onion and spicy food
• Avoid coffee, carbonated drinks or milk
• Eat small meals and avoid overeating
• Eat slowly and chew the food well before swallowing
• Try to avoid drinking or eating 2-3 hours before going to bed
• Do not slump in a chair, bend over and or lie down too soon after meals
• Maintain ideal weight
• Stop smoking

Medicines

Over-the-counter products (OTC)

• Antacids neutralises the acid in the stomach (eg. Actal plus tablets, Maalox tablets or Zellox-II suspension)
• Alginates form a coating on top of the stomach contents, stopping them from being pushed up into the oesophagus. Alginates products with low sodium content are useful for the treatment of patients on a restricted sodium diet (eg. Gaviscon liquid or Gaviscon tablets)




• H2 antagonists have been deregulated from prescription-only control for the short-term treatment which is up to 2 weeks. H2 antagonists have a longer effect (up to 8-9 hours) and a longer onset of action than antacids. They should be taken an hour before food. (eg. Cimetidine, Famotidine, Ranitidine)
• PPI (Proton Pump inhibitor e.g. Omeprazole, Pantoprazole, Esomeprazole. They are used as an initial short term treatment for GERD with severe symptoms. They should be taken half an hour after food.