Heartburn And Reflux
What are Heartburn and Reflux?
- Heartburn occurs when acid or other stomach contents “back up” or “reflux” into the oesophagus, which connects the throat to the stomach and where food passes through from the mouth. Also called acid indigestion, heartburn is a symptom of gastroesophageal reflux (GERD).
- The issue stems from the lower oesophageal sphincter (LES), a muscle that is located between your stomach and oesophagus. When it’s functioning well, it will open to let food into your stomach or to allow you to burp and close again. But if it is weak or relaxes at inappropriate times and doesn’t close tightly or quickly enough, it will cause acid backwash which results in heartburn. It can be described as a burning discomfort in the upper belly or below your breastbone.
- Heartburn is a common symptom. It is often caused by overeating or there is too much pressure on your stomach due to constipation, obesity or pregnancy. Consuming spicy food or taking alcohol can also relax your LES too much or increase stomach acid.
In Singapore, heartburn is a frequent complaint among individuals who experience digestive issues. Symptoms may vary in intensity, with some cases requiring lifestyle changes, while others need medical intervention. Seeking timely treatment from a clinic specialising in gastroenterology can help prevent complications and improve overall well-being.
When To See A Doctor For Heartburn
You should see a heartburn doctor if you experience the following:
- If you are reaching for antacids or medication more often than not, and you are not getting better, it’s time to seek medical help and head to a heartburn clinic. You may need additional investigation if the issue occurs more than once a week for six months or longer.
- Long-term heartburn or GERD can lead to serious problems such as Barrett’s oesophagus and eventually cancer of the oesophagus.
- Chronic heartburn can significantly impact daily life, affecting sleep and eating habits. If symptoms persist despite over-the-counter medication, consulting a specialist in Singapore is recommended. A thorough evaluation by a doctor at a dedicated heartburn clinic can help identify the root cause and provide effective treatment options.
Causes Of Heartburn
The risk of heartburn is increased when there is a greater production of acid in the stomach caused by the foods we eat and drink such as acidic juices (orange, grapefruit, pineapples), acidic foods (tomatoes), caffeine, alcohol, chocolate and carbonated beverages. Over-the-counter medications also may precipitate heartburn.
Other factors include smoking and consumption of high-fat content or spicy foods, pregnancy, and obesity.
Risk Factors Of Heartburn
Many lifestyle factors can contribute to heartburn and reflux
- Stress
- Cigarette smoking
- Alcohol consumption
- Obesity
- Medications
- Certain exercises involving body position bending over.
Identifying and addressing these risk factors is essential in managing heartburn effectively. Consulting a doctor for proper assessment and guidance can prevent symptoms from worsening and reduce dependency on medications. Lifestyle adjustments combined with professional treatment can significantly improve quality of life.
Diagnosis Of Heartburn
- Diagnosing heartburn and reflux involves a thorough evaluation of medical history, focusing on the location, duration, and severity of symptoms. It is also essential to assess any accompanying discomfort or related conditions. A physical examination may provide additional insights, helping to determine the underlying cause.
- Gastroenterology specialists may recommend further diagnostic tests, such as blood tests, CT scans, gastroscopy, or colonoscopy, to obtain a clearer picture of the condition.
- If heartburn and reflux persist despite treatment from your family doctor, consulting a heartburn specialist is advisable. Seeking expert evaluation within 2-3 weeks is crucial to avoid delays in diagnosis and ensure timely management of the condition.
Treatment Of Heartburn
- Share with the heartburn doctor or see a specialist in gastroenterology regarding your symptoms. The heartburn specialist may begin with a history and physical examination to make a diagnosis of GERD and recommend an appropriate heartburn treatment. He or she may carry out several tests needed to evaluate the underlying issue, and gastroscopy is often carried out for further evaluation. For refractory cases, specialised study such as 24-hour pH study may be carry out. In Singapore, this is available at any heartburn clinic such as GUTCARE or major Government hospital.
- Lifestyle modification and dietary changes can also help in managing heartburn. A modest weight loss can have significant benefit in term of symptom improvement. Avoid eating heavily or eating within two hours of bedtime, or lying down soon after a meal. Cut down or stop eating certain known foods like fatty, fried and acidic foods, citrus juices and alcohol. As everyone reacts somewhat differently to specific foods, keep a food journal to keep track of what you eat, what time, any activity that worsened the condition and how long is the duration. This way, you can correlate the offending foods with heartburn incidents.
