Relief from heartburn
Posted on 30 July 2012
Meet our expert Dr Peter Barrow, a gastroenterologist at Mediclinic’s Wits Donald Gordon Medical Centre.
Could my chest pain be heartburn, and is it anything to do with my heart?
Heartburn has nothing to do with your heart. Despite the sensation of burning in the centre of your chest, heartburn is all about your digestive system. And you are not alone in suffering it – it is estimated that 1,5 million South Africans complain of heartburn every day, that’s 2% of the population.
How do I know I have heartburn?
Symptoms may include:
• the feeling of burning or pain and discomfort in the centre of the chest, which sometimes spreads to the throat
• an acid taste in the mouth
• unexpected regurgitation
• trouble swallowing
Why does heartburn happen to me?
Here is a quick biology lesson: when we eat, our food passes to the stomach via a pipe called the oesophagus that uses muscles to push the food to the stomach through a series of wave-like movements called peristalsis. This allows you to swallow food even when upside down! Once in the stomach it is kept there by a circular muscle or sphincter that acts as a one-way valve to let food into the stomach but not out again. However, sometimes this lower oeosphageal sphincter becomes weak or abnormally relaxed, allowing contents from the stomach to wash back into the oesophagus, especially after meals or more rarely while sleeping. This is called reflux.
My doctor says I have GORD. What is that?
Some people who suffer these symptoms at least twice or three times a week may have gastro-oesophageal reflux disease or GORD. These are the commonest symptoms of GORD, but you might also have stomach pain, persistent hoarseness, laryngitis or a sore throat and a chronic cough.
Why does it burn so?
It is because you are suffering from what is known as acid reflux. The stomach uses hydrochloric acid to sterilise the food and accelerate digestion. While the stomach is adapted to tolerate this strong acid, your oesophagus is not, which is why when you suffer from reflux it burns and can cause damage or GORD.
My doctor says I could also have a hiatus hernia. What is that?
This is a condition that could be contributing to your reflux. En route to your stomach your oesophagus passes through your diaphragm – a large, flat muscle at the base of your lungs that contracts and relaxes when you breathe – via an opening known as the diaphragm hiatus.
Ordinarily a help when bending, coughing or straining a weak diaphragm hiatus allows stomach contents to slip back through the diaphragm into the chest which makes reflux more likely.
The amount of acid reflux required to cause GORD varies from person to person and it may be partly genetically determined. In other words, if your parents or siblings suffer from GORD, you may be more likely to suffer too.
Your doctor will have made a diagnosis based on your symptoms, and if you have no evidence of complications, your doctor is likely to put you on a trial of dietary changes and will possibly recommend non-prescription medication such as antacids without needing to do further tests.
However, if your diagnosis is unclear, or there are worrying signs or symptoms then your doctor will be required to do specific tests to make a full diagnosis.
In Dr Barrow’s next post, he writes about GORD, its complications, diagnosis and treatment. If you’d like to know more about heartburn and how to treat it, post your questions here.