This is a condition where you will feel a burning sensation in the chest behind your breastbone. This can happen at any time of the day. Certain activities such as lying down and bending over are more likely to bring on your symptoms. Some people get it after a big meal. Other people may experience the symptoms in any position or any specific activity. In some people it may not cause any burning sensation as such but may find a lot of fluid is coming into the gullet and sometimes taste the fluid at the back of the throat.

What causes heartburn?

Heartburn suggests that some of the acid from the stomach is refluxing into the gullet. The gullet isn’t built to be exposed to acid and therefore you feel the burning sensation when the acid comes into the gullet. 

All of us have some acid come into the gullet from time to time but don’t feel the heartburn. This is because only a small amount of acid enters the gullet. There is a valve between the gullet and the stomach which stops and limits the amount of acid coming into the gullet. Also, the gullet promptly pushes the acid back into the stomach. 

You will feel the symptoms if either the gullet is exposed to acid for prolonged periods, or a lot of acid refluxes into the gullet or if it happens frequently. 

There are many reasons why acid from the stomach will reflux into the gullet. This includes a weakening of the valve between the gullet and the stomach, or poor clearance of the acid by the gullet. 

Obesity is a known cause of reflux and heartburn. Heartburn improves with weight loss either by dieting or from weight loss surgery.


Does Hiatus hernia cause reflux / heartburn?

This is a popular myth. Hiatus hernia by itself if it’s a small one is unlikely to cause any significant symptoms. Not all patients that have a hiatus hernia have reflux and not all the patients that have reflux have hiatus hernia. Click Hiatus hernia (link to the Hiatus hernia page) for more information. 


What can untreated heartburn cause?

If untreated, the lower part of the gullet can develop inflammation from burning due to acid. In some, constant and recurrent burning can lead to scar formation and can cause problems with swallowing.

If the acid exposure continues untreated for many years, this can result in a condition called Barrett’s oesophagus, which increases the chances of developing cancer.

In rare situations, the acid that is coming into the gullet can enter the windpipe and cause asthma type symptoms and very rarely sinusitis.


What investigations do i need?

What investigations do i need?

All patients who are suffering from heartburn will need at least one endoscopy to assess the gullet and the stomach. If you want to consider having an operation, you will need a few more tests. This include a manometry (measurement of pressures in the gullet and also to assess if its moving properly) and pHmetry, to measure the amount of acid that the gullet has been exposed to and if your symptoms are caused by this acid exposure.

Treatment of heartburn ranges from doing nothing if it settles by itself, to short or long term antiacid medication and surgery. These options can be discussed at the consultation with Mr Jayanthi


Gastric Sleeve

A gastric sleeve surgery is a restrictive procedure where the size of your stomach is reduced therefore limiting the amount of food you can eat which will help towards weight loss.


Gastric Band

A gastric band involves dividing your stomach into two by placing a silicone band around the stomach therefore creating a small pouch at the top of your stomach (roughly the size of a golf ball).


Gastric Bypass

In the UK, the most common gastric bypass surgery is a combination of restrictive and malabsorptive procedure procedures called Roux-en-Y (RYGB) which creates a two-way weight reducing effect.

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