Heartburn

Many people complain of a pain in the centre of their chest which is caused
by acid from the  stomach burning the lining of the oesophagus ( or gullet ). 
The pain is usually hot or stabbing in nature. It may be made worse by
bending forward or lying down. Certain foods or drinks may aggravate or 
relieve the pain. It may be relieved by eating, by belching or by medicines
like Rennies.

What causes it ?
The stomach has a lining which is resistant to the acid it contains to help 
digest food. The oesophagus (the tube food passes down to get from the 
mouth to the stomach) is less well protected.Usually a valve stops acid flowing
back up into the oesophagus. If this valve fails acid burns the oesophagus 
causing pain.


Why does the valve fail ?
Pregnancy,smoking,alcohol,coffee and tea,being overweight
- these can all make the valve fail and give you heartburn  

What can you do about it ?
Simple things work best. 
	Stop smoking
	Reduce your consumption of coffee and tea
      Slim down if you are overweight
      Put bricks under the head of the bed to raise it a little
      (this keeps acid in your stomach at night)
       Don't use more than 2 pillows

What can the doctor do about it ?
If simple measures fail then a range of drugs can help
i    Antacids neutralise the stomach acid and relieve the pain. Liquids work 
    better than tablets
    eg Magnesium Trisilicate, Gaviscon or Asilone(can be bought without a prescription) 
ii  Drugs to stop acid being made such as  Omeprazole or Cimetidine          
iii Drugs to help prevent acid getting into the oesophagus by closing the valve eg
    Metoclopramide or Cisapride