How often you get heartburn is important when it comes to helping you manage your symptoms. Around 1 in 4 people suffer persistent heartburn symptoms, meaning at least once a day.
Infrequent: Once a week or less often
Frequent: At least two days per week for the past four weeks
The causes and symptoms of frequent heartburn or chronic heartburn
Frequent heartburn can be caused by gastro-oesophageal reflux disease, or GORD. This is also known as GERD, if the American spelling is used (gastro-oesophageal reflux disease), but it is the same thing. The most common signs of GORD are heartburn, acid reflux, cough, and hoarseness.
A simple explanation of GORD
GORD is caused by stomach acid leaking up into the food pipe (oesophagus), heartburn can progress into GORD when it causes troublesome symptoms and/or complications.
A scientific explanation of GORD
GORD is a multifactorial condition caused by a combination of factors including increased abdominal pressure, impaired gastric emptying, decreased oesophageal clearance, oesophageal hypersensitivity and a lack of neutralising saliva. These factors lead to an increase in gastro-oesophageal reflux and damage to the oesophagus.
Stomach ulcers are open sores that develop on the lining of the stomach, they are usually caused by helicobacter pylori (H. pylori) bacteria or non-steroidal anti-inflammatory drugs (NSAIDs) particularly if taken for a long time at high doses. Stomach ulcers can also be a cause of heartburn.
A hiatus hernia is where part of your stomach moves into the chest area, it’s not clear what causes a hiatus hernia but they’re common in over 50’s. This can also lead to GORD symptoms.
Medicines such as certain heart drugs, analgesics and some sleeping pills can also be a cause. If you need more advice on whether your medicine is causing your heartburn, talk to your pharmacist or doctor.
If your frequent heartburn has gone on for a long time (chronic heartburn), the acid and bile that refluxes from the stomach can cause further damage and lead to oesophagitis, where the lining of the oesophagus becomes inflamed. If this inflammation is severe, oesophageal ulcers can develop.
If you have severe and chronic heartburn, Barrett’s oesophagus can develop. This changes the make-up of the cells lining the oesophagus and can also increase the risk of oesophageal cancer.
When to see your doctor about heartburn
If you have long-term, chronic or recurrent heartburn symptoms you should see your doctor regularly for a check-up. You should seek medical advice if you have had heartburn most days for 3 weeks or more or if you:
- Are experiencing persistent vomiting
- Are vomiting blood
- Have stomach pain or pain/difficulty when swallowing
- Have a lump in the upper abdominal area
- Have a severe allergic reaction that causes difficulty breathing, swelling of the face, neck, tongue or throat
- Are over 55 years of age and developed heartburn symptoms for the first time, or your symptoms have recently changed or you have pain/fullness/nausea that has not got better with treatment
- Are over 55 years of age and taking over-the-counter heartburn treatments every day
- Are pregnant or breastfeeding
- Have another medical condition, such as liver problems
- Have jaundice
- Have lost weight, without trying
- Have blood in your stools, which makes them look dark, and/or are anaemic
- Have had a stomach ulcer or surgery or are about to have an investigation on your stomach, e.g. endoscopy
Article published January 1, 2021