January highlights Action Against Heartburn month20 January 2015
Heartburn affects up to 40 per cent of the population and has been a cause of pain and discomfort for millions, including Barack Obama, Ashlee Simpson, and Joss Stone. With this in mind, we’ve been speaking to the experts at London Bridge Hospital on the symptoms and underlying risks of heartburn, in line with the Action Against Heartburn campaign.
Heartburn is characterised by a burning feeling in the chest caused by stomach acid rising up into the oesophagus, (the food tube that links your throat to your stomach). It is also referred to as acid reflux, and can be unpleasant and painful for sufferers. Mr James Gossage, Consultant General Surgeon at London Bridge Hospital, comments, “Heartburn is experienced by up to 40% of the population at some point in their life, with medication to treat heartburn being one of the largest annual pharmaceutical expenditures in the UK. With regard to the key risk factors, eating large meals and eating late in the evening are both more likely to result in heartburn. Alcohol is also a trigger, and at this time of year it tends to be consumed more than at any other time.”
Mr Andrew Davies, Consultant General Surgeon at London Bridge Hospital, comments, “Reflux is extremely common, and most people will experience it from time to time. The focus of this campaign is to pick up on those whose symptoms persist despite treatment or those warranting further investigation, particularly patients with Dysphagia (difficulty swallowing). President Obama is a good example of an average patient with reflux: a middle aged male with a stressful job and a diet that may include unpredictable meal times, particularly eating late at night which may exacerbate symptoms of indigestion.”
Through the prolonged exposure to acid, heartburn can damage the cells of the oesophagus lining, and there is a small risk that this can lead to Barrett’s oesophagus, increasing the likelihood of developing Oesophageal cancer. Oesophageal cancer is the sixth most common cause of cancer death with approximately 8,000 cases diagnosed each year.
“The consequences of reflux may include Barrett's oesophagus, in the minority of heartburn sufferers, where the lining of the oesophagus changes to adapt to its acidic environment,” Mr Davies comments. “Barrett's oesophagus is a pre-malignant condition that mandates surveillance in the form of endoscopy. However, only the minority of patients who suffer from acid reflux will develop Barratt’s oesophagus and, of these, only a small proportion will go on to develop cancer. Nonetheless, oesophageal cancer tends to be diagnosed at an advanced stage so the early detection of symptoms is crucial if we are to improve survival rates. Patients on surveillance for Barrett’s oesophagus tend to have earlier detection of oesophageal cancer.”
New research into heartburn aims to improve the success of curative treatment by raising awareness of symptoms that should be checked; Mr Gossage comments, “Early detection of abnormal cells results in very effective treatments. New endoscopic devices can now treat abnormal areas without the need for surgery. The aim of the campaign is to make patients aware of symptoms to look out for. The oesophagus can then be checked and any abnormal areas treated before the changes become more advanced. Currently the majority of oesophageal cancers present very late with only 20-30% suitable for curative treatment. We hope this will be improved dramatically by this campaign.”
Mr Davies highlights the main symptoms that should prompt further investigation:
- Dysphagia (difficulty swallowing)
- Food sticking in the gullet
- Persistent hiccups
- Persistent indigestion and vomiting despite treatment
- Unexplained weight loss
Find out more information on our Gastrointestinal Surgery, Gastro-oesophageal reflux at London Bridge Hospital.