That burning sensation in your chest after a big meal? Often, people just brush it off as heartburn. While it’s usually just a normal digestive reaction, it can sometimes indicate more significant health problems.
One such issue is Barrett’s oesophagus, a condition where certain cells in your oesophagus grow abnormally, which heightens the risk for oesophageal cancer, according to the NHS website.
Beginning next year, around 1,500 individuals in London and the East Midlands will be provided with new “heartburn health checks” aimed at screening for Barrett’s oesophagus. This test requires swallowing a capsule attached to a string that dissolves in the stomach, releasing a small sponge. After a few minutes, NHS staff will retrieve the sponge, which collects cells from the oesophagus for laboratory analysis.
Professor Peter Johnson, the NHS’s national cancer director, mentioned: “For most individuals experiencing persistent reflux, these quick heartburn health checks will confirm that you’re not at a higher cancer risk. If Barrett’s oesophagus is detected, regular follow-up checks will ensure early identification of any further cell changes.”
But what is heartburn exactly? And what warning signs should you be aware of?
What is heartburn?
“Heartburn, or reflux, is marked by a burning discomfort or pain behind the breastbone, which may extend to the throat,” explains Dr. Matthew Long, a consultant gastroenterologist at The Lister Hospital, part of HCA Healthcare UK. “It usually manifests after eating or when lying down, driven by stomach acid irritating the oesophageal lining. Additional symptoms may involve a sour taste in the mouth, hoarseness, or a chronic cough.”
What typically causes heartburn?
As Dr. Long elaborates, “The most common cause of heartburn is acid reflux, which happens when the lower oesophageal sphincter – the muscle ring at the bottom of the oesophagus – weakens or relaxes incorrectly. It can also be associated with a hiatus hernia, where part of the stomach protrudes through the diaphragm into the oesophagus, allowing acid to rise.”
“Common triggers include sizable or fatty meals, alcohol, caffeine, smoking, and being overweight. Stress and some medications may also add to the problem.”
How is mild or occasional heartburn managed and treated?
Dr. Long notes, “Mild or infrequent heartburn is often manageable through simple lifestyle changes, like consuming smaller meals, avoiding late-night snacks, cutting down alcohol and spicy or fatty foods, and maintaining a healthy weight.” Over-the-counter treatments like antacids or proton pump inhibitors (PPIs) such as omeprazole may also prove effective. Persistent symptoms, however, warrant medical advice.
Do people confuse heartburn with chest pain related to heart attacks?
“Absolutely, the symptoms can overlap as both can cause burning or pressure within the chest,” confirms Dr. Long. “Typically, cardiac chest pain feels heavier and could radiate to the arms or jaw, often occurring during physical exertion.”
“If there’s any doubt, especially in someone with a heart disease risk, treating it as a potential heart attack is crucial. Delay can be dangerous.”
Can frequent or severe heartburn signal a more serious condition?
“Yes, persistent heartburn, especially if it happens most days over three weeks, might indicate a more serious issue,” warns Dr. Long, highlighting Barrett’s oesophagus as a concern. “Since this condition can raise the risk of oesophageal cancer, it’s vital not to ignore ongoing symptoms.”
What symptoms could suggest a more serious concern?
“’Red flag’ symptoms include difficulty swallowing, food feeling stuck, unexplained weight loss, persistent vomiting, and iron deficiency anaemia,” Dr. Long stresses. “If you experience any of these, seeing a GP is essential.”
When should you seek medical advice about your heartburn?
Dr. Long advises, “Consult your GP if you’re experiencing heartburn most days over three weeks. Reach out for urgent care if chest pain arises, particularly if it’s sudden, severe, or accompanied by sweating, breathlessness, or pain radiating to the arms or jaw.”
Dr. Cameron Braddy-Green, a consultant gastroenterologist at Nuffield Health St. Bartholomew’s Hospital, agrees, suggesting that those over 55 with new heartburn symptoms should definitely consult a healthcare professional, especially if symptoms don’t improve with PPI treatments like omeprazole, lansoprazole, or pantoprazole.
