What causes it?
In overweight people, excessive fat in the abdomen increases pressure on the stomach, forcing its contents upwards. Pressure of the growing womb during pregnancy can also press on the stomach, causing the condition.
Excessive eating, especially of fatty foods, can also cause acid reflux by stretching the stomach and lower oesophageal sphincter. Some foods such as chocolate, peppermint, coffee, fruit juices and alcohol, cause acid reflux because they stop the lower oesophageal sphincter from working properly, as does tobacco.
Tobacco also reduces the rate at which the stomach empties and increases stomach acid production. Other causes of heartburn are stomach ulcers or an infection.
Should I see a doctor?
Yes, if your attacks are frequent and severe. Your doctor will consider whether further tests should be carried out or what sort of medication is required.
The symptoms of acid reflux can resemble those of a peptic ulcer, chest pains, back problems or irritable bowel syndrome - these conditions will sometimes have to be ruled out before a diagnosis is made.
To confirm the diagnosis, a gastroscopy may be considered. During this procedure stomach ulcers and other conditions can be either found or ruled out.
How is it treated?
A number of lifestyle changes can significantly reduce the risk of acid reflux.
These include shedding pounds if you are overweight, avoiding highfat meals which tend to sit in the stomach, and avoiding eating late at night.
People with acid reflux should also limit coffee and alcohol, and stop smoking.
Many people tend to suffer acid reflux at night when lying down. You can counter this by using pillows to raise your chest and head up to 15cm above your stomach.
When symptoms do strike, they can be treated with overthecounter medications such as antacids including calcium carbonate, sodium bicarbonate or magnesium salts to control symptoms.
These work by neutralising the acid, but also reduce the absorption of iron. Some, such as sodium bicarbonate, increase blood pressure and can't be taken by heart or kidney disease patients.
Furthermore, although these over-the-counter treatments neutralise acid, they don't prevent symptoms occurring in the first place.
Some drugs called protonpump inhibitors such as omeprazole are designed to stop stomach cells from producing acid. But they can cause diarrhoea and interfere with the digestion of proteins.
In a small number of cases, the problem may be solved by a laparoscopical (keyhole) surgical procedure in which the oesophageal sphincter is strengthened.
Can diet help?
Certain foods have been show to trigger acid reflux attacks. Spicy and acidic foods such as curries, orange juice, tea, coffee and alcohol are the main culprits, and eliminating these from the diet can help to prevent attacks occurring.
Is there any hope of a cure?
Many people cannot isolate the cause of their acid reflux and, with symptoms not severe enough to justify keyhole surgery, they face using antacids or medication for life.
However, supplements of digestive enzymes have been shown to be successful at helping many acid-reflux patients in America.
One supplement called Di-En-Zymes, contains digestive enzymes designed to improve absorption across the gut. Taken before meals or at bedtime, it can prevent symptoms from occurring altogether.
The key ingredient for treating excess acidity is an enzyme called pepsin, which is thought to be deficient in some people with acid-reflux.
The supplement also boosts the body's ability to produce more of its own pepsin and stimulates stomach cells, making them more efficient.
CASE STUDY
Until two months ago, Alan Perkins, 34, lived in fear that each meal would cause agonising burning sensations in his stomach and throat:
'Most meals were fine, but some would leave me creased over in pain for hours,' says the salesman from Auckley, South Yorkshire.
Now, however, he's virtually cured, thanks to an enzyme supplement called Di-En-Zymes, which regulates stomach acid secretions and improves digestion.
'I'd suffered symptoms twice a week for around two years, and they were getting worse. Burning acid would well up into my mouth and throat at least three times a week.
'I had to avoid certain foods, especially curries, which tended to set it off. Sometimes acid attacks struck in the middle of the night and kept me awake.
'Until I found the enzymes, I relied on taking antacids such as Rennies and Gaviscon, which eased the symptoms, but the attacks could still last for hours.
I stuck to simple foods and ended up having to eat different meals from my family, which I didn't enjoy doing. I did try to cut out trigger foods such as coffee from my diet, but it didn't really have much of an effect.
'Then, at a barbecue two months ago, I had a really bad attack and was creased over in pain. One of the people there was into nutrition, and suggested these enzyme tablets which had just come over from America.
'As my symptoms were getting worse, I was ready to try anything. I started taking one or two tablets before each meal and I haven't had any attacks since.
'I'm really relieved. I can eat anything now, without having to worry.'
Di-En-Zymes, stockists: 0870 872 0121
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