Heartburn & indigestion
WHAT ARE HEARTBURN & INDIGESTION
If you notice discomfort in your upper abdomen, a burning sensation in your chest or an unpleasant sour taste in your mouth, these may be signs of indigestion, heartburn, acid reflux or gastro-oesophageal reflux disease (GORD), all of which are very common.
Whether you experience indigestion, heartburn or acid reflux from time to time, as a one-off or you’ve had it for a while, we’re here to help you take control of your digestive health with our advice, support and a range of products to help ease symptoms.
HEARTBURN & INDIGESTION BRANDS
SYMPTOMS, CONDITIONS & ADVICE
Here at Boots, we believe everyone’s health is individual to them. That’s why it’s important to take care of our health, from the inside out. From understanding what triggers indigestion, heartburn and acid reflux symptoms to the related conditions and causes, we’re here to breakdown the facts and share our top tips for relieving symptoms.
Indigestion (or dyspepsia), is a common condition caused by acid from your stomach irritating your stomach lining or throat (known as acid reflux).
Generally, indigestion happens after eating or drinking and can be felt in different ways, causing symptoms such as:
• heartburn – a painful burning feeling in the centre of the chest
• feeling full and bloated
• feeling sick (nausea)
• burping and flatulence (passing wind)
• bringing up food or bitter-tasting liquid in your mouth
These symptoms can range from mild discomfort to severe pain and can vary from person to person. While some may experience a feeling of fullness (such as bloating) and discomfort in the upper abdomen after eating, others may feel a painful sensation just below the breastbone – or may have a combination of all three.
Indigestion is often nothing serious and can easily be treated with a few lifestyle changes and certain medicines. However, if your symptoms last for three weeks or more after trying self-help measures which may include medicine, speak to your GP for advice.
Acid reflux occurs when stomach acid travels up the oesophagus (the food pipe that connects your mouth to your stomach) towards the throat. This can lead to pain or discomfort in the upper abdomen or a burning sensation in the chest behind the breastbone, known as heartburn. If this keeps happening, it’s what is known as gastro-oesophageal reflux disease (GORD). Indigestion and heartburn may occur together but may also occur alone.
The main symptoms of acid reflux are:
• heartburn (a burning feeling in the centre of the chest)
• an unpleasant sour taste in your mouth
• a reoccurring cough or hiccups
• a hoarse voice
• bad breath
• bloating or feeling sick
These symptoms can last anywhere from a few minutes to a few hours, they're often worse after eating and when lying down or bending over. Being in these positions can make it easier for the stomach acid to travel up towards the throat.
Much like indigestion, these symptoms are often nothing to worry about. However, if you experience any of the above symptoms for three weeks or more following self-help options, which may include medicine, speak to your GP for advice.
Generally, indigestion, heartburn and acid reflux can be triggered or made worse by:
• certain food and drink – such as coffee, tomatoes, alcohol, chocolate and fatty or spicy foods
• being overweight
• smoking
• pregnancy
• stress and anxiety
• some medicines, including anti-inflammatory pain relief like ibuprofen
• a hiatus hernia – when part of your stomach moves up into your chest
• an increase in some types of hormones, such as progesterone and oestrogen can make heartburn worse
In some cases, indigestion can be caused by a stomach ulcer (an open sore in your stomach lining) or underlying gastrointestinal disorders, including:
• peptic ulcers
• stomach cancer
• gastritis
• bacterial infections, such as Helicobacter pylori (H. pylori)
It’s important to remember that indigestion isn’t always caused by something more serious. The above conditions often come with other symptoms but if you’re unsure about your symptoms or they last for 3 weeks or more, it’s best to speak to your GP to rule out any possible underlying causes and for advice on treatment options.
If you think you’re experiencing symptoms of indigestion, heartburn or acid reflux, there are a few self-help options available to help ease them.
Eating at least three to four hours before going to sleep is recommended, but if symptoms strike at night, slightly raising your head and shoulders when you’re in bed can help to stop stomach acid from travelling up to your throat during the night. Similarly, try to avoid bending over where possible and refrain from wearing clothes that are tight around the waist, as this can press on your stomach too. Other lifestyle factors such as quitting smoking and trying to lose weight, if you’re overweight, can also help ease symptoms.
You can buy some medicines from our website or pop in-store to speak to a member of the Boots pharmacy team for advice on how to ease symptoms. They may also recommend considering an over-the-counter medicine. The medicines available to buy include:
• Antacids – these work by neutralising the acid in your stomach to help provide quick relief for a few hours
• Alginates – this helps stop the acid in your stomach from coming back up your oesophagus
• Protein pump inhibitors (PPIs) - these reduce the amount of acid your stomach produces.
There are plenty of options for over-the-counter medicines. If you prefer to take medicines in liquid form, you can buy over-the-counter medicines such as Boots Heartburn Relief (contains calcium carbonate, sodium alginate and sodium bicarbonate) or Gaviscon Double Action Oral Suspension (contains sodium, alginate, calcium carbonate and sodium hydrogen carbonate), which both tackle heartburn and indigestion at the source to provide fast-acting relief. Alternatively, you may wish to opt for chewable tablets like Boots Indigestion Relief Tablets (contains calcium carbonate) or Rennie Peppermint 24 Chewable Tablets (contains calcium carbonate and magnesium carbonate). You can also consider tablets or capsules such as Nexium Control 14 Tablets (contains esomeprazole) or Boots Heartburn and Acid Reflux Control 20 mg Gastro-Resistant Capsules (contains esomeprazole) for short-term relief of the symptoms of indigestion, heartburn and acid reflux.
Before taking any medicine, always read the label. If you have any questions, speak to your pharmacist or GP.
For more information on indigestion, heartburn and acid reflux, take a look at our guide for coping with and relieving symptoms.
We may all experience indigestion, heartburn and acid reflux at some point in our lives. There are some lifestyle factors you can try to help reduce the chance of getting indigestion. heartburn or acid reflux. Try to:
• cut down on tea, coffee, alcohol and fizzy drinks like cola
• avoid eating three to four hours before bed
• avoid eating foods that are rich, spicy or fatty
• eat smaller, more frequent meals rather than bigger meals three times a day
• maintain a healthy weight – take a look at our top tips for weight management
• find ways to relax and avoid everyday stress, if possible
• avoid taking pain relief such as ibuprofen and aspirin as these can make symptoms worse. Follow the instructions provided with any medicine you take as it's important that some medicines are not taken on an empty stomach.
Lose weight, if you’re overweight
Another factor that can impact indigestion, heartburn and acid reflux is being overweight, as your tummy fat can put pressure on your stomach, pushing the acid towards your throat. Losing weight is not only good for your physical and mental health, but can be beneficial for your digestive health, too.
A good starting point is to check your Body Mass Index (BMI). This is a measurement that gives an indication if you’re a healthy weight for your height. For most adults, a healthy BMI is between 18.5 kg/m2 and 24.9kg/m2 if it’s:
• Between 25kg/m2 and 29.9kg/m2– you're in the overweight range
• 30kg/m2 or over – you're in the obese range
If your results indicate that you need to make some changes, there’s plenty of help and support out there. You can speak to your GP for advice or take a look at the NHS Better Health website which has some great tips for losing weight. You can find out more information on BMI and how to lose weight with our useful guide. There are also online classes and webinars available, such as the FREE Boots Online Doctor Weight Management Webinars.2
Stop smoking, if you do smoke
If you smoke, this can have a negative impact on your overall health, as well as making the symptoms of indigestion, heartburn and acid reflux worse. Smoking releases chemicals into your body, weakening the muscles that control the lower end of the food pipe. This allows acid from the stomach to travel back up the throat. Acid reflux worsens the symptoms of heartburn and can cause stomach ulcers to develop or irritate existing ones, as well as aggravate inflammatory conditions of the bowel. Smoking can also put you at risk of developing more serious conditions such as stomach cancer as well as other types of cancer.
Making the decision to quit 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 Service if this is available near you, or speak to a member of the pharmacy team or GP for advice. Nicotine Replacement Therapy (NRT) is available, which, if suitable for you, can help combat cravings.
When to see a doctor
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 feel or are sick
- you have unexplained weight loss
During your appointment, they can 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 as you may prescribe medicine to be taken long-term to 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 a gastroscopy (where a camera on a thin tube is carefully passed down your throat into your stomach).
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 and indigestion are common during pregnancy due to changing levels of hormones. These can cause the muscles between the stomach and oesophagus to relax, making it easier for stomach acid to come up.
You’re more likely to get heartburn in pregnancy if you’ve experienced heartburn before getting pregnant or you’ve been pregnant before.
Although it’s possible to experience heartburn during the entirety of your pregnancy, it’s most common as you enter your third trimester (from 27 weeks), as the baby grows and presses on your stomach, forcing the acid upwards.
When should I seek help?
If your pregnancy heartburn symptoms are sudden and severe or you’re having trouble managing them, speak to your GP or midwife. They’ll ask about your symptoms and may recommend certain medicines to help ease the discomfort, such as Rennie Peppermint Tablets* which are suitable to take during pregnancy. They contain two antacids (calcium carbonate and magnesium carbonate) which help neutralise excess acid in the stomach, providing rapid relief.
Medicines can affect the unborn baby. Always talk to your doctor or pharmacist before taking any medicine in pregnancy. As with all medicines, the treatment duration should be limited as much as possible. Always read the label.
For more information on heartburn in pregnancy, take a look at ways to manage symptoms and the available treatment options.
Gastritis is a condition where the stomach lining becomes inflamed, causing pain and indigestion. This can trigger the onset of symptoms such as:
• tummy pain
• indigestion
• feeling full and bloated
• feeling sick (nausea)
• being sick (vomiting)
• having a low appetite or not feeling as hungry as usual
• burping and flatulence (passing wind)
There are a few factors that can cause gastritis, including:
• an infection with a bacteria called Helicobacter pylori (H. pylori)
• taking anti-inflammatory pain relief such as ibuprofen and aspirin
• drinking too much alcohol
• being very stressed and unwell, such as after surgery
• a problem with your immune system where it attacks the lining of your stomach
When should I seek help for gastritis?
If you think you might have gastritis, speak to your GP. They’ll ask you about your concerns and symptoms and might arrange a series of tests to find what’s causing your gastritis symptoms. These tests can include:
• a test on a poo sample
• a blood test
• a breath test to check for the bacteria Helicobacter pylori (H. pylori)
If your GP arranges a breath test, you’ll be told how to prepare for your breath test four weeks before the date. During your test, you'll be given a special drink, followed by a breath check.
If any tests have confirmed you have gastritis, treatment options can vary depending on what the root cause is. You may need:
• a course of antibiotics
• medicines to control stomach acid, such as antacids, to neutralise the stomach acid. Some medicines also contain ingredients that form a raft on top of the stomach contents to prevent the acid from travelling up the food pipe (oesophagus)
• medicine, such as a PPI (proton pump inhibitor), to help reduce the amount of acid your stomach makes
• to talk to your doctor about stopping anti-inflammatory pain relief, such as ibuprofen or aspirin and trying a different medicine, if possible
• to stop drinking alcohol if your gastritis is caused by alcohol
If left untreated, gastritis could worsen and lead to a stomach ulcer. If your gastritis isn’t getting better after treatment or your symptoms are becoming more severe. In that case, your GP might refer you to a specialist stomach doctor (gastroenterologist) who may carry out a test, called a gastroscopy, to look inside your stomach.
What can I do to help?
If gastritis is causing you mild indigestion, you can try to implement some simple lifestyle changes, including losing weight (if you are overweight), reducing the number of drinks containing caffeine you have and propping the head of your bed up at night to help stop stomach acid travelling up your throat while you sleep. These can help you manage your mild symptoms.
Lactose intolerance is a common digestive problem that can start at any age, where a person cannot digest lactose (a sugar found in dairy products) due to low levels of the lactase enzyme. It’s often confused with a milk allergy, but lactose intolerance is not an allergy.
If lactase activity is low, undigested lactose passes into the colon (large intestine), where it can trigger symptoms. These can start anywhere from a few minutes to a few hours after eating or drinking foods containing lactose and include:
• tummy pain or discomfort
• bloating
• flatulence (wind)
• diarrhoea or constipation
• feeling or being sick
You may also experience longer-lasting symptoms such as a rash (eczema), headaches, joint pain, feeling tired, and finding it hard to concentrate.
What impact does this have on indigestion & heartburn?
Fatty foods can worsen the symptoms of indigestion, heartburn and acid reflux. Although lactose intolerance can’t directly cause these, it’s thought that high-fat dairy products made from cow’s milk (like milk and yoghurt), can trigger symptoms of indigestion, heartburn and acid reflux.
For most people, avoiding foods containing lactose is usually enough to ease symptoms. To help improve lactose digestion, some may consider taking a lactase supplement, such as Boots Good Gut Lactase Enzyme, before eating or drinking foods containing lactose.
When should I seek help for lactose intolerance?
Speak to your GP if you have symptoms of lactose intolerance if:
• you have recurring symptoms that often happen after eating
• you've noticed changes in your poo, such as looser poo, pooing more often, or constipation for three weeks or more
• you've noticed blood in your poo for three weeks or more
• you've had tummy bloating and discomfort for three weeks or more
• you've had unexplained weight loss
It’s a good idea to keep a food diary to keep track of your symptoms and what triggers them. If your GP thinks you are lactose intolerant, you may be asked to try eliminating lactose from your diet or swapping out these products for plant-based alternatives to see if your symptoms improve. It isn't recommended to exclude food groups from your diet unless under medical supervision. They may also arrange for you to have a blood test or do a hydrogen breath test (where hydrogen gas in your breath is measured to find out how well you digest lactose).
In some cases where another health condition like Coeliac disease causes lactose intolerance, treatment may be available for the underlying cause.
For more information on lactose intolerance, visit Allergy UK.
LEARN MORE ABOUT INDIGESTION
FREQUENTLY ASKED QUESTIONS
While there’s some similarities between indigestion, heartburn and acid reflux, they’re all different.
Indigestion (dyspepsia) causes pain or discomfort in the upper abdomen or lower chest and generally happens after eating or drinking, this can also trigger heartburn.
Heartburn causes a painful, burning feeling in the chest, behind the breastbone when stomach acid travels up towards the throat.
Acid reflux occurs when stomach acid travels up the oesophagus (food pipe) towards the throat, leaving an unpleasant sour taste in the mouth.
If you are experiencing heartburn or acid reflux, pop into your local Boots store and speak to a pharmacist who may recommend a medicine to help provide short-term relief from symptoms. These can be bought over the counter or via our website and include:
• Antacids – these neutralise the acid in your stomach
• Alginates – these stop the acid in your stomach from coming up your food pipe/oesophagus
• Protein Pump Inhibitors (PPI) - these help to reduce the amount of acid the stomach produces
Instructions on how to take the medicine will be provided in the patient information leaflet - please make sure you read this before taking the medicine.
1 Subject to availability. Eligibility criteria may apply. Charges may apply
