New help for heartburn

"GORD" is the abbreviation used to describe the medical condition known as gastro oesophageal reflux disease.

There are a number of discomforting symptoms of reflux. The most commonly recognised is heartburn – that burning feeling rising upwards towards the throat from the stomach or the lower chest.

Regurgitation can also occur – it’s the sensation of semi-digested material being re-tasted and re-swallowed, and sometimes can be mistaken for vomit. Waterbrash is a term seldom used these days, but it describes one of the symptoms of reflux which is often experienced; that is the sudden and excessive salivation which occurs as a result of acid in the oesophagus (“food pipe”).

Reflux is not such a pleasant subject to bring up, but almost everyone of us will have suffered at least some of the symptoms at some time because studies show that nearly 50% of adults suffer reflux symptoms once a month or more and around 20% suffer reflux symptoms at least once a week.

No wonder, then, that after products for pain relief and coughs and colds, products in the bums and tums department are most commonly requested from pharmacies.

Effectively treating reflux is a bit of a challenge, especially as we often use different words to describe the same symptoms, or even the same words to describe a wide variety of symptoms. We need to differentiate between dyspepsia or indigestion and reflux/heartburn to be sure to get the most appropriate product and the best advice. There are a number of trigger or aggravating factors – alcohol, caffeine, smoking, spicy and fatty or greasy foods and fast over-eating are among them. However, the underlying cause of reflux is what is known as transient lower oesophageal sphincter relaxations.

The lower oesophageal sphincter (LOS) is the valve at the junction of the top of the stomach and the bottom of the oesophagus. When working well the LOS allows food and drink to pass down into the stomach and prevents the stomach contents and acid washing back.

Apart from the trigger factors mentioned above, just about anything that relaxes the LOS can cause reflux symptoms; being overstressed, overweight, pregnant and even a number of different medications.

Some lifestyle modifications might help in managing the symptoms of reflux. For instance, weight reduction, eating smaller meals, not lying down after eating, avoiding tight clothing around the waist. Avoiding fatty and spicy foods might help, too – and of course, avoiding caffeine, alcohol and smoking.

Some non-prescription medicines can help prevent and treat reflux. A new category of medicines – so-called proton pump inhibitors, has recently become available to treat recurrent reflux; so now there are three options.

The traditional antacids generally containing aluminium, calcium and/or magnesium salts act quickly but have only a short duration of action. Frequent use is required for reasonable effect. The H2 blockers (for example, ranitidine) have a longer duration of action; and once or twice daily dosage should control occasional heartburn symptoms.

When symptoms occur, two or more times per week, the proton pump inhibitors such as pantoprazole are by far the most effective. The duration of action is up to 36 hours, so once daily dosage is sufficient, and complete relief from reflux symptoms is experienced within two weeks by most people.

For more advice about reflux, the causes and some self help hints, ask your pharmacist for the fact card titled "Heartburn and Indigestion".