Heartburn is the symptom of “burning discomfort” behind the “breastbone”.

• Heartburn results from acid in the oesophagus.
  • The stomach is designed to handle acid but the oesophagus has a different lining and is more sensitive to the effects of acid.
  • This sensitivity to acid varies significantly from person to person.
• The basic abnormality is weakness of the valve between the oesophagus and the stomach.
  • This "valve" is designed to allow food into the stomach but to prevent acid and food refluxing back into the oesophagus.
  • Weakness of the valve (sphincter) does not improve over time; in fact - it may tend to weaken further over the years.
  • This “valve” function is adversely affected by a hiatus hernia. A hiatus hernia is when the top part of the stomach is sitting up in the chest instead of being below the diaphragm. This causes the valve to be working at a disadvantage (not as effective for reasons that are not entirely clear).
    
    
• Reflux may be aggravated by
  • fatty foods; spicy foods
  • alcohol
  • smoking
  • chocolate
  • peppermint
  • caffeine
• Some drugs can aggravate reflux;
  • Asthma treatments.
  • Anti-inflammatory drugs.
  • Calcium channel antagonists - given for high blood pressure.
• Stress does not cause reflux but can make the symptoms more distressing.