Heartburn, Indigestion and Acid Reflux

• A burning feeling in the middle of the chest
• An unpleasant sour or bitter taste
• Food or fluid coming back into the mouth
• Burping
• Bloating
• Feeling sick
• A cough or hiccups that keep returning
• A hoarse voice
• Bad breath

Symptoms may be worse after eating, when bending over or when lying down. Many people notice them most in the evening or at night.

Indigestion may cause:

• Heartburn
• Feeling full or bloated
• Feeling sick
• Burping or passing wind
• Bitter-tasting fluid coming into the mouth

Not all stomach or back pain is indigestion. Pain in the tummy or back has many other possible causes, some of which need treating quickly. Please do not assume pain is indigestion, especially if it is severe, sudden or unusual for you.

• Certain foods or drinks
• Large, rich, spicy or fatty meals
• Coffee and alcohol
• Smoking
• Pregnancy
• Stress and anxiety
• Being overweight
• Eating shortly before bed
• Some medicines, including anti-inflammatory painkillers
• A hiatus hernia
• Stomach ulcers
• A bacterial stomach infection

Triggers vary a great deal between people, so something that affects one person may not affect another.

Do not stop prescribed medication without speaking to a GP, pharmacist or prescriber. If you think a medicine may be causing symptoms, ask them about it first — there may be alternatives, or something that can be taken alongside it.

• Eat smaller meals.
• Avoid food and drink that clearly trigger symptoms.
• Avoid eating for three or four hours before going to bed.
• Avoid smoking.
• Limit alcohol.
• Avoid tight clothing around the waist.
• Seek advice about maintaining a healthy weight where appropriate.
• Raise the head end of the bed rather than simply adding more pillows, so the head and chest are slightly higher than the waist.

These measures help many people, but we cannot promise they will cure the condition. If symptoms continue despite them, that is a good reason to speak to a GP rather than to keep trying on your own.

A pharmacist can advise about short-term treatments such as antacids or alginates, and can tell you what is suitable for you. You do not need an appointment.

• These treatments may relieve symptoms, but they do not necessarily treat the underlying cause.
• They should not be used regularly for long periods without professional advice.
• Pregnant people and anyone taking other medicines should ask a pharmacist or GP what is suitable, as not all treatments are appropriate for everyone.

We do not give medicine doses. Please follow the instructions given by the pharmacist or on the packaging.

Contact a GP if:

• Heartburn occurs most days
• Symptoms repeatedly return
• Lifestyle changes or pharmacy treatment are not helping
• Food feels stuck
• Swallowing is difficult
• The person keeps being sick
• There is unexplained weight loss
• There is blood in vomit or poo
• Symptoms are getting worse
• The person has iron-deficiency anaemia
• There is a lump or persistent swelling in the stomach area

It helps to write down how often symptoms happen, what you have already tried, and a list of any medicines you take, including anything bought without a prescription.

A GP may:

• Review your symptoms and the medicines you are taking
• Test for a stomach infection
• Prescribe acid-reducing medicine
• Refer you for a gastroscopy — a thin, flexible camera passed down the throat to look at the food pipe and stomach — or for specialist assessment
• Consider further treatment if symptoms are severe or continuing

We do not recommend individual prescription medicines or say how long treatment should last. Those decisions depend on the person, their other conditions and their other medicines, and belong to the GP or specialist looking after them.

If symptoms keep coming back, a simple written record can make appointments much more useful. Note down:

• When symptoms happen
• Food and drink consumed beforehand
• Whether symptoms are worse at night
• Any medicine being used, including anything bought over the counter
• Any difficulty swallowing, sickness or weight changes

A symptom diary may help a medical appointment but cannot diagnose the condition. Take it with you and go through it with the GP or specialist.

Continuing reflux can affect sleep, eating and mood. If it is wearing you down, say so at your appointment — that matters as much as the physical symptoms.