Heartburn

Possible causes of heartburn include:

• Being overweight - This puts pressure on the stomach, forcing its contents back up into the oesophagus
  
• Pregnancy - Around half of women suffer heartburn during pregnancy.[2] During the first trimester, this is due to hormone levels; towards the end of the pregnancy, it can be caused by the baby pushing up against the stomach
  
• Wearing tight clothes around the waist - Clothes that fit tightly around the abdomen will squeeze the stomach, forcing food up against the LOS, and cause food to reflux into the oesophagus
  
• Food and drink - e.g. fatty foods, spicy foods, alcohol, chocolate and coffee
  
• Eating large meals late at night
  
• Bending or lifting
  
• Smoking - Nicotine in cigarettes can relax the LOS. Smoking also stimulates the production of stomach acid
  
• Hiatus hernia - A medical condition where a section of the stomach gets pushed up into the chest cavity through a hole in the diaphragm.

Indigestion

Indigestion has similar causes to heartburn, including diet and smoking. Other causes include:

• Eating or drinking too much or eating too fast
  
• Not eating for long periods or missing meals
  
• Eating ‘on the run’
  
• Stress can increase the amount of acid the stomach produces
  
• Certain medicines can upset the acid balance in the stomach, including non-steroidal anti-inflammatory drugs such as ibuprofen.

<PRACTICE POINT>
Discuss with your pharmacist which types of customers with indigestion or heartburn should be referred to them for further advice.