Heartburn is a common symptom of acid reflux whereby acid travels in the wrong direction, up from your stomach and into your oesophagus. Unlike your stomach, your oesophagus isn’t designed for this acid and as a result triggers a burning sensation in your chest – otherwise known as heartburn.
Heartburn can often come about once you eat too much food as this creates an unequal pressure between your stomach and oesophagus. When this pressure reaches a certain level it opens your oesophageal sphincter – this acts as a door between your stomach and oesophagus – and allows acid to flow upwards into the oesophagus.
However, some people can experience this more frequently and isn’t related to overeating. This is known as gastro-oesophageal reflux disease (GORD). GORD is a common condition affecting 10% of adults. Some people are more genetically susceptible to GORD whilst certain diet and lifestyle factors can decrease your risk of GORD.
Some people may also experience heartburn without experiencing acid reflux, this is termed ‘functional heartburn’ and can be related to a dysfunction between the gut and the brain.
Managing heartburn and acid reflux
• Avoid large meals – instead of having 3 large meals during your day, try splitting it into 5-6 smaller meals during the day
• Don’t eat too close to bedtime, try and allow at least three hours between your last meal and bedtime. If you regularly get heartburn at night, try lying on your left side
• Keep and food and symptom diary – certain foods including high fat, carbonated drinks, citrus fruits/juices, spicy food, tomatoes, caffeine and alcohol are commonly related to symptoms. If you think there is a link, try minimising your intake and assess your symptoms.
• Being overweight can increase your risk of suffering from reflux, weight management may help reduce your risk.
• Constipation and bloating can also worsen your risk of reflux, therefore it is important to ensure these are well managed.
• Your gut-brain axis can trigger digestive symptoms including reflux. Mindfulness techniques like yoga and deep breathing can target the gut-brain axis to help manage symptoms
• When eating, avoid tight clothing around your waist and chest
• Smoking can increase your risk of reflux as it is thought to relax the oesophageal sphincter, which means acid can move up oesophagus causing acid reflux and heartburn. Stopping or reducing your smoking may help manage symptoms.
• Raise 1 end of your bed 10 to 20cm by putting something under your bed or mattress – your chest and head should be above the level of your waist, so stomach acid does not travel up towards your throat
If you are struggling with acid reflux and heartburn and diet and lifestyle changes aren’t having a significant impact, you may want to chat to your GP to recommend medication to help manage your symptoms. Common medications including is antacids which neutralise the acid or proton pump inhibitor (PPI) (including omeprazole and lansoprazole) which decrease the production of stomach acids.
Reflux and your gut microbiome
Whilst taking medication may be necessary to help manage your acid reflux and heartburn, it is important to note that these medications can have the potential to alter the balance of your gut microbiome. Your gut microbiome is like an ecosystem and it’s important to have a well diverse population of bacteria to support this ecosystem. An unbalanced gut microbiome (otherwise known as dysbiosis) can result in an increased risk of certain digestive symptoms.
When taking medication, it is important to look after your gut microbiome either through your food, lifestyle or supplements like friendly bacteria.
For advice on eating for good gut health, check out this article “Feeding Your Gut Microbiome”.