Heartburn and Indigestion

Symptoms

Heartburn is the common name for the symptoms of indigestion and gastroesophageal reflux disease (GORD). Reflux is a symptom that occurs when digestive juices (which contain stomach acids) spill back into the oesophagus or mouth and cause a “burning” feeling. This can happen when the muscles at the lower end of the oesophagus (food pipe), relax too much and allow acid to rise. Indigestion causes bloating and an uncomfortable feeling in the stomach after eating or drinking which may or may not be associated with reflux. The main symptoms are a discomfort or burning pain in the chest area near the breastbone (‘heartburn’). There may be a bitter or sour acid taste in the mouth, or a pain that worsens when sleeping or bending over. Symptoms of stomach ulcers can be similar to heartburn and indigestion, but some people may not feel any symptoms. One of the main causes of these ulcers is bacteria called H.pylori. Doctors recommend that anyone with symptoms of stomach ulcers should have a test to detect H. pylori which can then be treated with antibiotics.

See a doctor if you:

• get heartburn symptoms more than twice a week
• still get symptoms after using reflux medicines
• have problems swallowing
• have other symptoms like nausea, vomiting, weight loss or loss of appetite
• have pain in the stomach
• have blood in your vomit or bowel motions.

Pain caused by a heart attack can feel similar to reflux and indigestion. If you feel dizzy or nauseous and the pain feels more like a squeezing or tight sensation in the chest, or you are sweating, have shortness of breath, pain or a tight feeling in your neck, jaw, shoulders, back or down your arms, you need to call an ambulance straight away. Dial 000.

Causes

Many factors can trigger symptoms of heartburn and indigestion, such as:

• fatty foods (e.g. fried food)
• spicy or acidic foods (e.g. curries or citrus fruits)
• foods like onion and chocolate
• alcohol, coffee, peppermint flavour
• eating large amounts of food or eating just before bedtime.

Other factors that can make you more likely to experience heartburn and indigestion are:

• pregnancy
• wearing very tight clothing around the waist area
• certain medicines or medical conditions
• being overweight
• feeling anxious or stressed
• smoking.

Your pharmacist can talk to you and take your medical history to help determine what may be causing your symptoms, and determine if referral to a doctor is required.

Lifestyle options

You can manage heartburn and indigestion by:

• eating smaller meals and foods not high in fat
• avoiding eating 2 hours before bedtime
• avoiding foods and drinks that make your heartburn worse (see triggers above)
• losing excess weight
• avoiding wearing clothes that are too tight
• raising the head of your bed if your symptoms are worse while you sleep
• talking to your doctor or pharmacist about alternatives if you think your prescription medicine may cause your heartburn.

Pharmacy options

Always inform pharmacy staff if you are taking any other medicines, or if you have any other health conditions, because some over-the-counter medicines may not be suitable for you. Medicines can help heartburn by relieving symptoms, heal inflammation and reduce the chance of further complications.

• Antacids reduce the symptoms of heartburn by neutralising stomach acid, and their effects last for about four hours. Liquids work faster than tablets. Always use a measure for the correct dose. Don’t take antacids at the same time as other medicines, as they might interact. Ask your pharmacist for more advice.
• H2 antagonists can be used for mild symptoms, or if other medicines (e.g. Proton Pump Inhibitors – see below) are not appropriate.
• Proton pump inhibitors (PPIs) reduce the amount of stomach acid produced and are the most effective treatments. They are taken once a day. They should only be used short term (e.g. two weeks) without your doctor’s advice.

Ask your pharmacist for advice on the most suitable treatment for you.

More information

Health Direct: www.healthdirect.gov.au
Australian Dietary Guidelines: www.eatforhealth.gov.au
Gastroenterological Society of Australia: www.gesa.org.au

Disclaimer: The information provided is a guide only, is current at time of publishing, and is not intended to replace the advice of your pharmacist or doctor.

IN EMERGENCIES DIAL 000.