Keeping Your Cool With Heartburn

What Is Acid Reflux, Exactly?

Between your oesophagus (the tube that carries food from your mouth to your stomach) and your stomach, there's a little ring of muscle. Think of it as a one-way valve.

When you eat, the valve relaxes to let food into your stomach. Then it tightens again, keeping stomach acid where it belongs. But sometimes, that valve doesn't close properly or relaxes at the wrong time. When that happens, stomach acid splashes back up into your oesophagus. That's acid reflux.

Heartburn is the main symptom - a burning sensation in your chest, usually after eating. It might be worse when lying down or bending over. Other common symptoms include:

• Food or sour liquid coming back up into your throat or mouth

• A lump-in-your-throat sensation

• Chronic cough or hoarseness

• Feeling like food gets stuck

• Bloating or burping

  
  

If you experience these symptoms more than twice a week, you might have gastro-oesophageal reflux disease (GORD) - the chronic form of reflux.

What Triggers Acid Reflux?

Different things affect different people, but these are the most common culprits.

Foods and Drinks

• Spicy foods: curries, chilli, hot sauce

• Fatty or fried foods

• Tomato-based foods: pasta sauce, ketchup, pizza

• Citrus fruits: oranges, lemons, grapefruit

• Garlic and onions, especially raw

• Chocolate: contains caffeine and theobromine

• Mint: peppermint, spearmint

• Coffee and strong tea

• Carbonated drinks (cooldrinks, sparkling water)

  
  

Lifestyle Factors

• Eating large meals: stretches the stomach and increases pressure

• Eating late at night: lying down soon after a meal allows acid to flow back more easily

• Being overweight: extra belly fat puts pressure on the stomach

• Smoking: increases acid production

• Alcohol: increases stomach acid

• Stress

  
  

Medications That Can Worsen Reflux

• Some painkillers: ibuprofen, aspirin, naproxen, diclofenac

• Certain blood pressure medications

• Some muscle relaxants

• Osteoporosis drugs

  
  

If you take any of these and have heartburn, an online GP can help you sort out alternatives.

When Is Heartburn an Emergency?

Most heartburn is uncomfortable but not dangerous. However, sometimes chest pain isn't heartburn—it's a heart attack. And sometimes reflux causes complications that need urgent care.

Seek emergency medical help immediately if you have:

• Chest pain that feels like pressure, squeezing, or crushing (especially if it spreads to your jaw, arm, or back)

• Shortness of breath

• Pain that worsens with activity (not just after eating)

• Cold sweats, dizziness, or nausea with chest discomfort

• Vomiting blood or material that looks like coffee grounds

• Black, tarry stools

• Trouble swallowing that gets progressively worse

  
  

These are not normal reflux symptoms. Do not try to diagnose yourself at home. Go to the nearest Casualties or call 10111.

Simple Lifestyle Changes That Actually Work

Before you reach for medication, try these strategies. Many people find significant relief without pills.

1. Change How You Eat

• Eat smaller, more frequent meals - don't stuff yourself.

• Eat slowly - put your fork down between bites.

• Avoid lying down for 2 - 3 hours after eating.

• Don't eat within 3 hours of bedtime.

  
  

2. Adjust What You Eat

• Keep a food diary for a week. Note what you ate and when heartburn happened.

• Identify your personal triggers and avoid them for a while.

• Many people find that cutting out just one or two trigger foods makes a big difference.

  
  

3. Change Your Sleeping Position

• Elevate the head of your bed by 15 - 20 cm (use blocks under the bed legs, not just extra pillows - pillows can actually increase pressure on your stomach).

• Sleep on your left side - this keeps the junction between your stomach and oesophagus above the acid level.

  
  

4. Maintain a Healthy Weight

Even losing 5 - 10% of your body weight can significantly reduce reflux symptoms.

5. Stop Smoking and Limit Alcohol

Both increase acid production. Quitting smoking is one of the best things you can do for your reflux (and your overall health).

If lifestyle changes aren't enough, there are effective medications. An online GP can help you choose the right one.

How an Online GP Can Help With Your Heartburn

You don't need to sit in a waiting room to get help for acid reflux. An online doctor can:

• Take a detailed history (when it happens, what triggers it, what helps)

• Help you identify patterns and lifestyle triggers

• Recommend appropriate over-the-counter or prescription medications

• Prescribe a short course of strong prescription medication if needed

• Order blood tests if necessary

• Provide a referral to a gastroenterologist if you need an endoscopy

• Issue a sick note if your symptoms are affecting your work or sleep

  
  

All from your couch, during a short video call.

When You Might Need a Specialist

Most reflux can be managed by a GP. But an online GP can refer you to a gastroenterologist if:

• Symptoms persist despite lifestyle changes and medication

• You're losing weight unintentionally

• You have trouble swallowing (food feels stuck)

• You've had heartburn for many years and are at risk for complications

• You have anaemia or evidence of bleeding

  
  

Do not ignore persistent symptoms. Chronic untreated reflux can lead to inflammation, narrowing of the oesophagus, precancerous changes, and in rare cases, oesophageal cancer.

Take Heartburn Seriously (But Not Too Seriously)

Most heartburn is a nuisance, not a danger. Small changes to your eating habits, sleeping position, and stress levels can make a huge difference. But if your symptoms are frequent, severe, or not responding to lifestyle changes, don't suffer in silence. Help is available -without you leaving your home.

Book an online consultation today. Let's get that burning feeling under control.

Dr. Sonja Brandt is an online GP helping South Africans manage acid reflux, heartburn, and other common conditions—conveniently and confidentially from home.