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Heartburn: A Serious Concern

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Professor Lovat
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It’s something that many, if not all of us, have experienced at one time or another; that unpleasant burning sensation in the chest, often after eating or at night. Because it is such a common complaint, many are inclined to dismiss it, reach for an over-the-counter remedy and move on. However, it can be an indication of something more serious.

Cardiac Concerns

A very small percentage – less than 1% – of patients presenting with heartburn may be in fact suffering symptoms of ischemic heart disease; because the heart and oesophagus share the same nerve supply, the pain of heartburn and, say, angina, can be similar. Because of the high risk connected with a cardiac issue going undiagnosed, it is important to rule this out.

However, there are certain indicators which might make it more likely to be heartburn than a cardiac issue; if you experience the symptoms directly after consuming a large or fatty meal, if you are young and fit and can usually do vigorous exercise, or if you’ve suffered indigestion in the past, it’s more likely to be heartburn caused by reflux; if the pain comes on after exercise or if you are also breathless, it is more likely to be a cardiac issue.

Man Suffering Heartburn_smaller

Barrett’s Oesophagus

Consistent, longstanding heartburn, alongside other symptoms such as trouble swallowing or dysphagia, may be an indication of a condition called Barrett’s Oesophagus. Named after the thoracic surgeon, Norman Barrett, who discovered it, this is considered to be a pre-malignant condition because of its links to oesophageal adenocarcinoma, and as such requires careful management and monitoring through endoscopy.

However, not all patients with Barrett’s Oesophagus will go on to develop cancer; the risk is quite small, only around 5%. Through expert monitoring, it is possible to identify patients with a higher cancer risk and ensure that early intervention can be provided. In addition, there are numerous research studies which aim to improve diagnosis, treatment and management of this condition.

Be Clear on Cancer

The Department of Health’s recent Be Clear on Cancer campaign advises that anybody who has suffered heartburn most days for three weeks or more should consult a doctor. This is because consistent heartburn may be an indicator of oesophageal cancer, or precursor conditions such as Barrett’s Oesophagus which may lead to cancer. This can be confirmed or ruled out with an endoscopy procedure.

At the London Gastroenterology Centre, we are of course highly experienced in performing endoscopy in London, and if you are concerned our specialists will be more than happy to set your mind at ease with further information on this subject.

GORD (Gastro-Oesophageal Reflux Disease)

The most common cause of heartburn is Gastro-Oesophageal Reflux Disease, a failure of the lower oesophageal sphincter. This essentially means that the valve which should prevent bile and stomach acid from travelling back into the oesophagus has failed, and this can lead to burning and inflammation of sensitive tissue in the oesophagus. There are a wide range of contributing factors, including obesity, a high blood calcium level, hiatal hernia, scleroderma and sclerosis, and the use of certain medicines. This condition can be diagnosed through oesophageal pH monitoring. Because GORD can cause damage to oesophageal tissues, it can lead to more serious issues, so diagnosis, management and treatment is important.

It is, of course, also important not to worry about your symptoms without due cause; sometimes, heartburn is simply heartburn, and if your symptoms are very occasional over-the-counter remedies may be all you need. For more information on heartburn, or to make an appointment to speak to one of our professional, specialist team, simply contact us on 020 7183 7965 today.

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