Heartburn & indigestion
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What is heartburn, indigestion & acid reflux?
Heartburn, indigestion and acid reflux are common issues many people face. While they can be uncomfortable, they’re usually nothing to worry about and can be managed with care and support.
Acid reflux
Acid reflux happens when stomach acid flows back into the oesophagus. Heartburn is the most well-known symptom, but not everyone with acid reflux experiences it.
Indigestion (dyspepsia)
Indigestion, sometimes known as dyspepsia, is discomfort or pain in the upper tummy, often linked to eating. Most people experience it at some point, and while it can feel unpleasant, it’s rarely a sign of anything serious and can usually be relieved with simple lifestyle changes or treatments.
Heartburn
Heartburn is a burning feeling in your chest or throat. It can often happen after a meal. Heartburn is a symptom of acid reflux, where stomach acid rises up into the oesophagus (the tube that carries food and liquids from the mouth to the stomach). While it can be uncomfortable, heartburn is common and can be treated. When heartburn happens frequently, it may be diagnosed as gastro-oesophageal reflux disease (GERD).
Symptoms of heartburn, indigestion & acid reflux
Acid reflux can cause a burning sensation in the chest, known as heartburn, along with an unpleasant sour taste. Other common symptoms include:
- Persistent coughing
- A hoarse voice
- Bad breath
- Bloating
- Feeling nauseous
These symptoms tend to worsen after meals, especially when lying down or bending over.
Indigestion symptoms often happen after eating or drinking. You might experience:
- A feeling of fullness
- Bloating
- Discomfort
Some people also experience:
- Burping
- Nausea
- Regurgitating bitter-tasting fluids
While heartburn can accompany indigestion, it’s important to note that stomach aches or back pain are usually signs of other issues like constipation.
Whatever symptoms you experience, there are ways to help ease them and help you feel better.
If your symptoms last for 3 weeks or more after trying self-help measures which may include medicine, make sure to speak to your GP for advice.
What causes heartburn, indigestion & acid reflux?
Heartburn, acid reflux and indigestion share several common causes, and understanding these can help you better manage symptoms.
Some factors that can affect all 3 conditions include:
- Dietary triggers – foods like coffee, chocolate, tomatoes, alcohol and fatty or spicy meals can irritate your stomach or relax the muscle that helps to keep stomach acid in place
- Being overweight – carrying extra weight can put additional pressure on your stomach, which can push acid upwards, leading to discomfort
- Smoking – this can weaken the valve at the base of your oesophagus, making it easier for stomach acid to escape
- Hiatus hernia – this condition, where part of the stomach moves into the chest, can increase the likelihood of heartburn, acid reflux and indigestion
- A bacterial infection in your stomach called h.pylori
- Pregnancy can increase the likelihood of heartburn due to hormonal changes and pressure from the growing baby
- Everyday stress and anxiety can elevate acid production in the stomach, contributing to acid reflux
- Overeating or eating large meals can overload your digestive system, leading to feelings of discomfort or bloating
Though these conditions can be uncomfortable, with some lifestyle changes and the right care, they’re usually manageable.
Managing heartburn, indigestion & acid reflux at home
To help ease symptoms of indigestion, heartburn and acid reflux, there are a few lifestyle changes that can help.
These include:
- Cutting down on tea, coffee, fizzy drinks or alcohol to help reduce irritation
- Elevating your head and shoulders in bed to help prevent stomach acid from rising while you sleep
- Try to lose weight if you're overweight, as it can relieve pressure on your stomach
Try to avoid:
- Eating 3-4 hours before going to bed
- Eating rich, fatty or spicy foods
- Taking ibuprofen or aspirin unless prescribed, as they can worsen symptoms
- Smoking, as it can irritate your digestive system
Making the decision to quit smoking is one that can really benefit your health, in the short term and long term. If you need extra support quitting, consider using the NHS Stop Smoking Service1 if this is available near you, or speak to a member of the pharmacy team or GP for advice.
To help reduce indigestion, there are specific things you can do to help, like:
- Eating smaller, more frequent meals to be gentler on your stomach
- Avoiding overeating, as large meals can put extra strain on digestion
For heartburn and acid reflux, try to:
- Find ways to relax, as everyday stress can make symptoms worse
- Avoid wearing tight clothes around your waist as this can put pressure on your stomach
If night-time symptoms bother you, try raising the head of your bed by 10 to 20cm. This helps prevent acid from travelling upwards but avoid using extra pillows as this can increase pressure on your tummy.
For all 3 conditions, your pharmacist can offer medicines that may help provide short-term relief from symptoms. These can be bought over the counter or online.
They include:
- Antacids – these help to neutralise the acid in your stomach
- Alginates – these stop the acid in your stomach from coming up your food pipe or oesophagus
- Protein pump inhibitors (PPI) – these help to reduce the amount of acid the stomach produces
It’s important to take any medicines as instructed in the patient information leaflet. These medications can help ease discomfort, especially when taken after meals to extend their effects. If you struggle with heartburn and acid reflux at night time, your pharmacist can advise on medicines that work best after eating or at bedtime.If you’re pregnant, they can also guide you on options that are suitable for you.
While these medications can help manage symptoms in the short term, it’s important to speak with your GP for long-term solutions if you’re struggling with your symptoms. We’ve also put together a guide to help you manage your symptoms.
Treating heartburn, indigestion & acid reflux
If you’re experiencing heartburn, acid reflux or indigestion, there are several options to help manage your symptoms.
Proton pump inhibitors (PPIs) & H2 receptor antagonists
To help reduce stomach acid, your GP may start with a type of medication called a proton pump inhibitor (PPI). This is typically prescribed for four to eight weeks depending on symptom severity.
PPIs are also available over the counter for short-term relief. In some cases, a longer-term prescription may be needed if symptoms return after you stop the medication. If PPIs don’t fully relieve your symptoms, your doctor may suggest an H2 receptor antagonist, another medicine that helps to reduce how much acid your stomach makes. These work by lowering the acidity in your stomach and are generally taken as tablets.
If an endoscopy is scheduled, both PPIs and H2 receptor antagonists should be usually stopped at least 14 days prior, as they can mask certain conditions.
Side effects
Both PPIs and H2 receptor antagonists are usually well-tolerated, though mild side effects may occur with PPIs, like:
- Headaches
- Stomach discomfort
- Dizziness
- Nausea
It’s important to read the patient information leaflet before taking any medication.
Testing & treatment for persistent or severe symptoms
If your symptoms are persistent or severe, your GP may refer you to a specialist for additional testing.
This may include:
- Gastroscopy – a camera-guided examination of your stomach to check for any underlying issues
- Testing for H. pylori bacteria – if this is present, it can be treated with a combination of antibiotics and PPIs to help reduce symptoms
- Surgery – in rare cases where other treatments haven’t worked, surgery may be an option to help prevent acid reflux
Treating a H. pylori Infection
If H. pylori bacteria are causing your symptoms, your GP may prescribe ‘triple therapy,’ a treatment that includes 2 antibiotics and a PPI, taken twice a day for 7 days.
Following the full course helps to make sure the treatment is effective. If the infection persists, you might need further treatment.
Your GP and pharmacist can support you in managing symptoms and finding treatment for lasting relief.
You should speak to your GP if:
- You experience frequent indigestion, heartburn or acid reflux. This could be most days for three weeks or more
- Your symptoms persist after making positive lifestyle changes
- Your symptoms don't ease or come back after taking over-the-counter medicines
- You get food stuck in your throat
- You have unexplained weight loss
- You’re in severe pain
- You keep being sick
- You feel like you have a lump in your stomach
- You have bloody vomit or poo
During your appointment, your GP may assess you to rule out any serious causes of your symptoms and may also prescribe treatment. If your symptoms subside with medication but return soon after stopping, we’d recommend going back to your GP. They may prescribe medicine to be taken long-term to help control your symptoms. However, if prescribed medicines don’t help, your GP may refer you to a specialist to find out if there’s an underlying cause by doing further tests. It is also worth keeping a note of your symptoms to give your GP a clear picture of what’s going on.
As well as the above, keep an eye out for any changes in your bowel habits or persistent pain as these, (along with the prolonged symptoms of indigestion or heartburn and acid reflux), can sometimes be a sign of some cancers. If you think you have any symptoms such as these, you should seek medical attention as soon as possible.
Heartburn, indigestion & acid reflux during pregnancy
Indigestion and heartburn are very common during pregnancy, especially from around 12 weeks onward, as hormonal changes and the growing baby can put added pressure on your stomach.
How can a pharmacist help?
If lifestyle changes aren’t enough, your pharmacist can recommend medications for heartburn and indigestion, including:
- Antacids – these help to neutralise stomach acid for relief. Be sure to mention you’re pregnant, as not all antacids are suitable during pregnancy
- Alginates – these form a protective layer in your stomach to prevent acid from rising up
It’s important to avoid taking antacids within two hours of iron or folic acid supplements, as they can affect absorption.
When to see a GP or midwife
While heartburn and indigestion can be harmless, certain symptoms require a GP or midwife’s attention, including:
- A hoarse voice
- Difficulty when swallowing
- A cough that doesn’t get better, or keeps coming back
- Weight loss
- Swollen glands on each side of your neck
- Swelling or pain in your stomach
Your GP or midwife may examine you or suggest further tests to rule out any underlying conditions if symptoms are severe or persistent.
If you’re pregnant, you might find relief by making a few adjustments to your daily routine:
- Eat smaller, frequent meals
- Avoid eating within three hours of going to bed to help reduce night-time symptoms
- Sitting up straight while eating and after meals helps relieve pressure on your stomach
- Avoid caffeine, chocolate, rich, spicy or fatty foods, as well as fizzy drinks, as they can often make symptoms worse. Keeping a food diary may help identify triggers
- Raise the head of your bed by about 10-15cm, or use pillows to prop yourself up when sleeping to keep stomach acid down
- Avoid smoking as smoking can worsen indigestion and also impact your baby’s health, increasing risks like premature birth
- Avoid alcohol as alcohol can worsen heartburn and is to be avoided entirely during pregnancy
If antacids and alginates don’t work, your GP may prescribe additional medication to reduce stomach acid, tailored to your needs and suitable for use during pregnancy.
Remember, heartburn and indigestion are common in pregnancy and relief is available. By making some changes and using treatments, you can manage these symptoms and feel more comfortable.
Your GP, midwife, and pharmacist are here to support you for a healthy, comfortable pregnancy. If you’d like to know more, we’ve put together a guide on managing heartburn during pregnancy.
Frequently asked questions
There are several steps you can take to help manage acid reflux and improve comfort. These include:
- Eat smaller meals and avoid triggers like caffeine, fatty foods and eating just before bed
- Stay upright after eating and elevate your head when sleeping
- Lose weight if needed
- Use antacids or alginates for relief
- Quit smoking
We’ve covered more in the ‘Managing heartburn, indigestion & acid reflux at home’ section of the page.
In some cases, sipping water can help relieve heartburn by mildly diluting stomach acid and washing it down. Water can also help with digestion as it can help food to move from your stomach to your small intestine, which might help with acid reflux.
It’s best to avoid drinking large amounts at once, as this can worsen symptoms by putting pressure on the stomach.
Severe heartburn can be caused by:
- Spicy, fatty, acidic or caffeinated foods
- Large meals
- Drinking alcohol
- Smoking
- Being overweight
- Pregnancy
- Everyday stress
We’ve covered more in the ‘What causes heartburn, indigestion & acid reflux?’ section of the page.
If your symptoms are severe or getting worse, make sure to speak to your GP.
Frequent heartburn and indigestion can often happen due to common factors like certain foods, eating large meals, everyday stress or even changes in weight.
If you have heartburn and indigestion all the time, it’s important to speak to a GP. They can help to provide effective treatments and rule out any more serious causes of your symptoms.
Heartburn, indigestion, and acid reflux can feel similar, but they’re different. Heartburn is that burning sensation in your chest or throat, often after eating. It’s a symptom of acid reflux, which occurs when stomach acid moves upwards into your oesophagus.
Acid reflux happens when the acid from your stomach flows back up into your oesophagus, causing irritation. While heartburn is one of the main symptoms, you might also experience a sour taste in your mouth, bloating or a persistent cough.
Indigestion (also called dyspepsia) is a general term for discomfort in your upper abdomen, often after eating. You might feel bloated, full, or have a queasy stomach. Indigestion doesn’t always mean you have acid reflux or heartburn, and it can happen for many reasons.
These symptoms can be uncomfortable but they can be managed with simple lifestyle changes or treatments.
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