Heartburn symptoms and GORD symptoms (gastro-oesophageal reflux disease)

Despite its name, heartburn has nothing to do with the heart (although some of the symptoms are similar to a heart attack). Heartburn is an irritation of the oesophagus caused by acid that refluxes (comes up) from the stomach. Heartburn is also a symptom of more serious gastro-oesophageal reflux disease ( GORD).

When swallowing, food passes down the throat and through the oesophagus to the stomach. Normally a muscular valve called the lower oesophageal sphincter (LOS) opens to allow food into the stomach (or to permit belching), then it closes again. Then the stomach releases strong acids to help break down the food. But if the lower oesophageal sphincter opens too often or does not close tight enough, stomach acid can reflux or seep back into the oesophagus, damaging it and causing the burning sensation we know as heartburn.

Not only can stomach acid in the oesophagus cause heartburn, but it can also cause ulcers, strictures (narrowing) of the oesophagus and cancer of the oesophagus.

Most people have felt heartburn at one time or another. Up to four in 10 people have heartburn each year in the UK. Although uncomfortable, heartburn does not usually pose a serious health problem for most people.

However if heartburn symptoms occur frequently and persistently, it may be a sign of a more serious problem, such as gastro-oesophageal reflux disease (GORD). GORD is a chronic reflux of acid into the oesophagus. Left untreated GORD can cause a host of complications, including oesophagitis, oesophageal ulcers, hoarseness, spasm of the “voicebox” muscles (laryngospasm), chronic lung disease and Barrett's oesophagus (a change in the lining of the oesophagus that increases the risk of developing cancer of the oesophagus).

Heartburn symptoms

Heartburn has several symptoms including:

• A burning feeling in the chest just behind the breastbone that occurs after eating and lasts a few minutes to several hours
• Chest pain, especially after bending over, lying down or eating
• Burning in the throat, or hot, sour, acidic or salty-tasting fluid at the back of the throat
• Difficulty swallowing
• Feeling of food "sticking" in the middle of the chest or throat

Reporting these symptoms to your GP is usually all that is needed for your GP to diagnose heartburn. However your GP may perform special tests such as endoscopy or pH monitoring to determine the severity of your problem or to monitor your treatment.

Heartburn causes

Various lifestyle and dietary factors can contribute to heartburn by relaxing the lower oesophageal sphincter and allowing it to open, increasing the amount of acid in the stomach, increasing stomach pressure or by making the oesophagus more sensitive to harsh acids. These factors include:

Dietary habits

• Eating large food portions
• Eating certain foods including onions, chocolate, peppermint, high-fat or spicy foods, citrus fruits, garlic and tomatoes or tomato-based products
• Drinking certain beverages, including citrus juices, alcohol, caffeinated drinks and fizzy drinks
• Eating before bedtime

Lifestyle habits

• Being overweight
• Smoking
• Wearing tight-fitting clothing or belts
• Lying down or bending over, especially after eating
• Stress

Medical causes

• Pregnancy
• Bulging of part of the stomach into the chest cavity, also called hiatus hernia
• GORD
• Taking certain medications, especially some antibiotics and aspirin