About a quarter of UK adults will be waylaid at some point by heartburn and indigestion, making it highly likely that pharmacy teams will face questions about over-the-counter (OTC) solutions and self care advice regarding the conditions on a regular basis – but although symptoms can be similar, these two digestive upsets are not the same.
“Heartburn is chest pain, or a pain behind the breastbone, that occurs after eating, lying down, or bending over and is most usually described as ‘burning,’” explains Julie Thompson, information manager at Guts UK Charity. “Whereas for indigestion, on the other hand, most people have their own pattern of symptoms which range from mild discomfort in the upper part of the abdomen to quite severe pain, and other people can experience a more general feeling of fullness (heaviness or bloating) and discomfort in the upper abdomen after a meal, and also feel sick too.”
Pharmacy teams may find it challenging to help customers tell the two conditions apart because people can have symptoms of both at the same time, and they often use the terms interchangeably within conversations, but there are some key signs and symptoms that can help identify what they are dealing with.
In general terms, while the symptoms of indigestion usually occur after eating or drinking, heartburn often seems worse specifically after rich meals or drinking acidic fruit juice, hot drinks or alcohol, sometimes with discomfort or pain on swallowing, and symptoms are commonly worse at night or when lying down.
Heartburn and acid reflux
The main culprit when it comes to heartburn is a backwash of stomach acid travelling back up the oesophagus from the stomach, causing the familiar burning pain of heartburn.
As with so many common ailments, certain lifestyle choices are thought to increase the risk of heartburn and reflux, such as smoking, drinking excess alcohol, and being overweight. Many women also experience temporary episodes of heartburn during the later stages of pregnancy as the growing baby pushes upwards on the stomach. In addition, people with a hiatus hernia – where part of the stomach slides upwards into the chest through a hole in the diaphragm muscle – seem to be more prone to reflux.
Causes of indigestion
Although there is rarely a serious underlying condition causing indigestion, data from Guts UK suggests 80 per cent of people with indigestion are ultimately diagnosed with functional dyspepsia, which happens when the nerves in the stomach become overly sensitive, causing symptoms of pain.
A much less common cause of indigestion is peptic ulcer disease, thought to affect eight per cent of people, and in rare cases indigestion may be a symptom of gallstones, pancreatic diseases or stomach cancer, but these conditions will often come with other symptoms as well.
