Heartburn, a burning sensation in the chest caused by stomach acid flowing back into the oesophagus, is a common digestive complaint.
It occurs when stomach contents move backwards into the oesophagus, often causing a burning sensation behind the breastbone or a sour taste in the mouth.
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While occasional heartburn is usually not a cause for concern, frequent episodes can be a sign of gastroesophageal reflux disease (GERD or GORD), a condition that occurs when acid reflux happens regularly and causes troublesome symptoms or complications.
Speaking with PT Health Watch, Owen Woghiren, a consultant gastroenterologist, explained that occasional heartburn does not necessarily mean a person has GERD.
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“Someone can occasionally experience heartburn without necessarily having GERD,” he said.
However, he advised people whose symptoms occur frequently, become severe or return whenever medication is stopped to seek medical assessment rather than continue self medicating.
When heartburn should not be ignored
Mr Woghiren said people with persistent heartburn should pay attention to symptoms that may indicate complications or a different underlying condition.
These include difficulty or pain when swallowing, a sensation of food sticking, persistent vomiting, gastrointestinal bleeding, black stools, unexplained weight loss, anaemia and persistent chest pain.
A significant change in longstanding symptoms should also prompt medical assessment, he said.
He also cautioned against assuming that every burning sensation in the chest is caused by acid reflux.
“New or severe chest pain, particularly with breathlessness, sweating or pain radiating to the arm or jaw, requires urgent assessment because cardiac pain can sometimes be mistaken for indigestion,” he said.
What can trigger heartburn?
According to Mr Woghiren, people should avoid labelling specific Nigerian dishes as universally harmful because foods that trigger reflux vary from person to person.
However, large meals and spicy, fatty or fried foods can worsen symptoms in susceptible individuals. He identified heavily oiled stews, chilli for people who are sensitive to it, alcohol, carbonated drinks and, in some cases, coffee as possible triggers.
The timing and size of meals can also play an important role.
“A common problem is eating a very large meal late in the evening and going to bed shortly afterwards,” he said.
He explained that lying down with a full stomach makes it easier for stomach contents to flow back into the oesophagus. Regular overeating and weight gain, particularly around the abdomen, can also worsen reflux.
People who experience frequent heartburn should therefore identify their individual triggers, reduce foods that worsen their symptoms and opt for smaller portions.
Long term effects of persistent reflux
Repeated exposure of the oesophagus to stomach acid can cause inflammation known as reflux oesophagitis.
Mr Woghiren said severe cases could result in ulceration, bleeding or scarring and narrowing of the oesophagus, which may eventually make swallowing difficult.
He also stressed that acid reflux should not be confused with peptic ulcers.
Peptic ulcers affect the stomach or duodenum and are more commonly associated with Helicobacter pylori infection or the prolonged use of non steroidal anti inflammatory drugs.
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Chronic reflux can also lead to Barrett’s oesophagus, a condition in which the lining of the oesophagus changes and which is associated with an increased risk of oesophageal cancer.
Mr Woghiren, however, said this should not cause unnecessary alarm, noting that most people with heartburn would never develop cancer.
The concern, he explained, is that persistent reflux should be properly assessed rather than treated with medication for years without determining its cause.
Lifestyle changes that can help
Making changes to eating habits and daily routines can help people manage reflux symptoms.
Mr Woghiren advised people to avoid large meals close to bedtime and leave about three hours between their final substantial meal and lying down.
People who frequently experience symptoms at night may also benefit from elevating the head of their bed.
Maintaining a healthy weight, particularly reducing excess abdominal weight, can also help. He advised people to reduce smoking and excessive alcohol consumption and pay attention to stress, which can affect eating and sleeping patterns and increase sensitivity to digestive discomfort.
Mr Woghiren said people should seek medical advice if they repeatedly depend on medication to control their symptoms.
“While occasional heartburn is very common, you should not ignore chronic symptoms,” he said.
He advised people who have been taking medication for heartburn for weeks or months to consult a doctor to determine the underlying cause.
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