A burning issue

As many as one in three people suffer from indigestion or heartburn caused by acid reflux, as a result of eating and drinking too much.

Sound Of Music starlet Connie Fisher, 25, suffers from reflux. She said it affects what and when she eats. She said: "I shouldn't eat acidic foods so try not to, and if you eat too late before bed, stomach acid burns your vocal chords, not fun!"

Gastro-oesophageal reflux disease (GORD) is the general term to describe the condition of reflux, which can cause indigestion, heartburn, nausea and oesophagitis - an inflammation of the oesophagus lining.

Consultant gastroenterologist Dr John de Caestecker said: Reflux happens when the sphincter, the circular band of muscle between the oesophagus and the stomach, gets too slack and stops acting as a one-way valve, allowing stomach acid to creep up the food pipe.

"Most cases of reflux occur after rich meals, citrus fruits, hot drinks or alcohol, which all impact on its function. Round about 30 per cent of the population get occasional heartburn.

"The typical situation would be going for a curry or over-indulging once in a while, such as at Christmas."

Heartburn, the most frequent symptom of GORD, is characterised by a burning feeling rising from the abdomen or the chest up to the neck or throat. It can be accompanied by a sour taste at the back of the throat due to the acid. They may also get chest pain, which isn't like heartburn, but may resemble angina (heart pain) or they may get indigestion in their tummy, or they may get various respiratory problems, a hoarse voice, coughs and in some cases asthma.

Certain people - including smokers, heavy drinkers, pregnant women and anyone overweight - may suffer more frequent attacks, which can affect their quality of life.

There are four main over-the-counter treatments available for heartburn and indigestion, but Dr de Caestecker says it's important to match the symptoms to the right medication to avoid over-treating the problem or masking a more severe one.

For occasional bouts of mild heartburn, antacids, such as Rennies, will neutralise the acid and relieve symptoms quickly, but the relief doesn't last long.

"If the symptoms are occurring more frequently, you're better off taking something that has a longer effect, " says Dr de Caestecker.

Alginates, such as Gaviscon, contain antacid, so they do have an immediate effect, but they work best if you take them after meals.

For those who experience symptoms every day, or are getting any other symptoms, like food sticking, vomiting or weight loss, it's important to see a doctor, who may investigate with an endoscope and may prescribe acid-suppressing drugs.

These are histamine receptor antagonists (H2 blockers), such as Zantac, or the more potent proton pump inhibitors (PPIs), such as omeprazole or lansoprazole.

"A low dose of omeprazole is available over the counter, but it is a very low dose which may not have great deal more efficacy than taking something like Zantac, " Dr de Caestecker says.

Always ask the pharmacist if you are not sure which one treatment is right for you.

"Using treatments that are either too mild or too strong can present problems -for example using antacids for more severe heartburn may prolong suffering and lead to more frequent medicating than is necessary, "Dr de Caestecker warns. "Likewise PPIs should be used with caution and not taken for milder symptoms as they may cause unnecessary side-effects."

Whether you are suffering from occasional or regular reflux, there are several lifestyle changes you can make to ease the symptoms.

If you're overweight, try to lose weight and then maintain a healthy weight.

Smoking and alcohol can affect reflux and you should also cut down on spicy foods, acidic foods like orange juice and fatty foods.

Try to eat smaller and more evenly spaced meals."

Reflux increases when you are lying down, so try to eat at least three hours before you go to bed or raise the head of your bed by 10cm.