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22nd December 2016

How do you avoid horrible holiday heartburn?

It's no surprise that adverts for antacid tablets come into full swing at the same time as the Christmas festivities. For some people, heartburn is an unwelcome, but regular, visitor during the season of good will. Dr Mark Austin, consultant gastroenterologist at The Montefiore Hospital in Hove, explains how to reduce the symptoms and when to seek help.

With its excess of food and alcohol, the Christmas party season can bring on the symptoms of heartburn even for those who do not suffer for the rest of the year.

Pain behind the chest bone can be excruciating and is caused by acid going up into the oesophagus from the stomach. I have seen many patients who initially thought they were having a heart attack – only when this was ruled out did they discover it was heartburn.

Men are twice as likely to suffer than women, and being overweight can magnify the problem. With obesity on the rise, I have witnessed a 10% increase every year in the number of patients suffering with heartburn and indigestion problems.

Often, a couple of over-the-counter antacids, and a return to a normal diet, will see symptoms disappear. But for some people, heartburn is a regular occurrence, waking them up in the early hours of the morning and leaving them feeling exhausted during the day. Eating stops being a pleasure and they can feel nauseous.  Some even find it hard to swallow.

If this is happening to you, most days, for three weeks or more, tell your doctor. Chances are it's nothing serious, but you're not wasting anyone's time by getting it checked out. Over time, the acid could damage the lining of the gullet, leaving it scarred. In some cases, this could lead to cellular change and cancer, so early detection makes it easier to treat.

But for many, antacids on prescription will be enough to calm the problem. If heartburn continues, then a referral to a specialist will be necessary. You will likely be referred for an endoscopy to check the health of the gullet and ensure there are no underlying conditions causing the heartburn. An endoscopy is a nonsurgical procedure, using a flexible tube with a light and camera, to examine the digestive tract.

If there are no underlying conditions, such as a hiatus hernia or cellular change indicating cancer, and no physical damage to the gullet, then, for most people, a course of medication and lifestyle advice will ensure symptoms reduce.

But there is a lot you can do to help yourself:

  • Eat smaller meals more frequently throughout the day.
  • Avoid eating large meals late at night.
  • Reduce your intake of caffeine, nicotine and alcohol – these stimulants relax the lower end of the gullet muscle and increase the risk of heartburn.
  • Do not lie down for two to three hours after a meal.
  • Sleep with your pillows propped up.
  • Lose weight if you are overweight or obese.
  • Avoid increased pressure on your abdomen, such as from tight belts or doing sit-up exercises.
  • If you suffer with heartburn, but can’t avoid eating a big meal late at night this Christmas, then take an over-the-counter antacid tablet as a preventive measure.

First published in Brighton and Hove Independent on 16 December 2016

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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