Acid reflux service

Acid reflux occurs when acid travels from your stomach up towards your throat. This creates a burning feeling in your chest (known as heartburn) and a sour taste in your mouth. You may also have a hoarse voice or bad breath, hiccups or a cough that keeps coming back, or feel bloated or sick.

The chronic severe form of acid reflux is known as gastroesophageal reflux disease (GERD or GORD).

What is the difference between heartburn, acid reflux and indigestion?

Acid reflux and heartburn are different words to describe the same thing: acid from your stomach travelling up towards your throat. They are symptoms of indigestion, which is the general term for when the stomach acid irritates your stomach lining or throat.

The common symptoms of acid reflux are:

• a burning sensation in the middle of your chest, which is known as heartburn
• an unpleasant taste in your mouth
• a burning feeling in your throat

Other symptoms can include:

• bad breath
• hoarse voice
• bloating
• feeling sick
• persistent hiccups
• persistent cough

How long does heartburn last?

Heartburn can last from a few minutes to several hours, depending on what has caused it. It can also return after an initial episode when you lie down or bend over.

For some people, there is no obvious cause of heartburn, for others it’s easier to pinpoint. The following factors can cause or make acid reflux worse:

• specific foods, for example, tomatoes or chocolate or those with a high-fat content or spicy foods as these take longer to digest and may be more acidic, which increases the risk of excess stomach acid. High fat content foods take longer to digest as fat does not dissolve in water which means they need to be broken down before they can be transported into the bloodstream - this requires stomach acid.
• certain drinks, such as coffee and alcohol: these can cause the muscles that connect the stomach with the oesophagus to relax, allowing stomach acid to travel up
• smoking: nicotine can also cause the muscle connecting the stomach to the oesophagus to relax
• pregnancy: hormonal changes and the weight of the baby on your stomach can cause acid to travel up the throat
• stress & anxiety: as these slow down digestion and mean there is more chance of a buildup of stomach acid
• being overweight: this can increase pressure on your stomach causing an increase in stomach acid.
• some medicines, for example, painkillers that are anti-inflammatory (like ibuprofen)
• suffering from a hiatus hernia: this happens when part of your stomach moves up into your chest and means the stomach acid is more likely to build up.

Does pregnancy cause acid reflux?

Acid reflux is common in pregnancy, especially after 27 weeks. The hormonal changes of pregnancy as well as the baby pressing on your stomach can cause heartburn.

If you are pregnant and regularly experiencing heartburn, you can treat it by changing your lifestyle and by taking certain medication.

You can treat acid reflux by changing how and what you eat and drink and other aspects of your lifestyle. There are also medications available: antacids and indigestion tablets. Many people also use home remedies to treat acid reflux.

Prescription Acid Reflux Treatment

A doctor can prescribe you a medicine called a proton pump inhibitor (PPI) to reduce the amount of acid your stomach makes. You take PPIs 30 minutes before you eat either once or twice a day. They normally take two to four days to start working, and your doctor will usually recommend you take them for between four and 12 weeks. If you take them for a longer period, the reduction in stomach acid can raise your risk of side effects, but this will depend on how long you're taking medication, and even then the risks are small.

There are different types of PPI. They all work similarly, but their ingredients mean that some are more suitable for certain people and specific conditions. This means you may be prescribed a PPI for acid reflux that is different to someone else. For example, you cannot take Lansoprazole if you are pregnant, but Omeprazole is safe for you to take. Your doctor will be able to give you a prescription for the right PPI for you.

Using Superdrug Online Doctor, you can get a prescription for the following PPIs quickly and easily.

• Lansoprazole
• Omeprazole
• Pantoprazole
• Esomeprazole

Antacids

Antacids are medications that are either liquid or chewable tablets that you can buy without a prescription. They work by neutralising the acid in your stomach, which means there is less acid to cause heartburn. Brand names include Gaviscon and Pepto-Bismol.

Antacids relieve the symptoms of acid reflux but do not treat the underlying cause. As a result, they are not recommended as long-term medication.

Lifestyle changes

The following can help reduce the occurrence or severity of acid reflux:

• stopping smoking
• reducing your alcohol intake
• avoiding food or drink that triggers your symptoms
• eating smaller meals more frequently and avoiding eating within 3 hours of going to bed
• losing weight if you are overweight
• reducing your stress and anxiety if you are stressed and anxious
• sleeping with your head and chest above the level of your waist
• avoiding wearing clothes that are tight around your waist
• talking to your doctor before you start or stop taking medication

Home remedies

There are various home remedies that people use to treat acid reflux. There is little research to show how effective they are:

• Milk can act as a buffer in the stomach and stop acid increasing; however, the fat content in some types of milk can also aggravate acid reflux.
• Ginger is alkaline and anti-inflammatory, neutralising the acid and easing irritation in the digestive tract.
• Apple cider vinegar and lemon juice have acidic properties, but when diluted with warm water, some people find they help their acid reflux. Research is unclear why this is and some people find it does not work or even aggravates their symptoms.

Any prescription medicine can have side effects. These can vary from person to person and in how severely they impact your life. In most cases, the side effects will clear up over a few days. Talk to your doctor if they do not or they are impacting your life.

You should seek immediate medical attention if you notice any of the following rare but severe side effects of taking PPIs:

• sudden wheezing, swelling of your throat, lips and tongue, rash, fainting or difficulty in swallowing (signs of a severe allergic reaction)
• dark pee, yellow skin and tiredness (signs of liver problems)
• reddening of the skin with blisters or peeling, especially in the lips, eyes, mouth, nose and genitals (signs of erythema multiforme or Stevens-Johnson syndrome)
• increase in the number of infections (sign of low white blood cell count)
• diarrhoea (sign of infectious diarrhoea)

Common side effects of PPIs affect 1 in 100 people and include:

• headaches
• feeling or being sick
• constipation
• diarrhoea
• stomach pain
• farting (flatulence)

Rare side effects affect 1 in 1000 people, and very rare side effects impact 1 in 10,000 people. The patient information leaflet for each medicine details these.

If you take PPIs for more than three months, it is possible that the levels of magnesium in your blood may fall. This can impact you through tiredness, muscle contractions, dizziness and disorientation and increased heart rate. Talk to your doctor if you experience any of these symptoms.

PPIs are safe to take, but certain health conditions mean your doctor will carefully consider your situation before prescribing you a PPI for acid reflux.

Do not take Lansoprazole, Omeprazole, Pantoprazole, or Esomeprazol if you are allergic to any of the ingredients.

Your doctor may need to adjust your dose if you have any of the following conditions:

• liver problems
• have ever had a skin reaction after treatment with a similar medicine
• low Vitamin B12 levels
• due for a specific blood test (Chromogranin A)

You should tell your doctor if you are taking any other medication as they may interact with the PPI they are prescribing you.

If you are pregnant, breastfeeding or trying to conceive, talk to your doctor before taking PPIs.