Heartburn and Gastro-oesophageal Reflux explained

What is reflux?

When you have something to eat or drink, it passes down the oesophagus (gullet) into the stomach. The flow of traffic should definitely be one-way. However, reflux occurs when whatever happens to be in your stomach travels in the wrong direction back up into the oesophagus. Unlike vomiting, which is quite a violent activity, reflux mostly occurs without us being aware that it is happening.

Why does reflux happen?

There is a ring of muscle around the lower end of the oesophagus which is there to stop reflux. When we eat or drink, the muscle relaxes but it then tightens up when we have finished. If the muscular ring gets too slack, reflux can occur.

Does reflux always cause symptoms?

Certainly not. Almost all of us have a little reflux from time to time, but we just don’t know that it’s happening. However, if reflux happens more often than normal, this may well lead to symptoms developing.

What symptoms might I expect?

The most frequent symptom is heartburn which is a burning sensation in the chest. Run your hand down your breastbone. Heartburn is often most noticed at the lowest end of the bone and the discomfort rises upwards to an extent that varies from individual to individual. Sometimes the burning feeling can reach all the way up to the throat. Heartburn often seems worse after rich meals, citrus fruits, hot beverages or alcohol. Occasionally it can be felt deeply within the chest – almost within the back. Some patients notice reflux when some of the contents of their stomach ‘repeat’ by coming back up the oesophagus as far as the throat or even the mouth. A few patients notice discomfort or pain as they swallow. It is quite common for these symptoms to be worse at night or at other times when patients lie down.