Medical Q&As

Heartburn - what's the cause?

I have been having constant heartburn for the past year of so. Have tried all sorts of antacids but none seem to be very effective. I'm 32 and married with 3 children. I am worried about this problem, as I never suffered from heartburn except during pregnancy. My sleep is also being disrupted by this constant heartburn. What’s the cause of this?

The sensation we describe as heartburn is due to the burning effect of gastric juice as it passes from the stomach back up into the oesophagus or gullet. One of the principal irritants in the gastric juice is hydrochloric acid, which is a strong acid. The stomach has a special lining that prevents the acid from damaging the stomach but the gullet has no such lining. Therefore when the gastric juice flows back into the gullet the lining of the gullet becomes inflamed due to the burning effect of the hydrochloric acid contained in the gastric juice. The lower end of the gullet becomes more chronically inflamed under the influence of this continuing regurgitation. The fact that your sleep pattern is disrupted suggests that the sphincter or valve at the lower end of your gullet is not working properly and is permitting free flow of acid back into the gullet when you are lying down in bed. The sphincter is a one-way valve that permits food and liquid to pass into the stomach and not come back into the gullet. Hiatus hernia is a very common cause of malfunction in the valve. Since you have been very patient with this condition and have soldiered on for the past year by using various antacids I would suggest that a visit to your GP would be appropriate at this stage. I am very confident that your current level of discomfort can be considerably reduced.