Persistent heartburn? Get it checked out...

Many people treat heartburn with over-the-counter remedies from a pharmacy, without visiting their GP for advice.  A new survey by Public Health England has revealed that only one in two people would visit their doctor if they had heartburn most days for three weeks or more. Yet persistent heartburn could be a sign of oesophageal or stomach cancer (collectively called oesophago-gastric cancers). Nearly 60 percent of people surveyed didn't know that heartburn could be a sign of cancer, with just 15 percent saying they were certain that it's a symptom.

Public Health England (PHE) launched its national 'Be Clear on Cancer' campaign today. Around 12,900 people in England are diagnosed with oesophago-gastric cancers each year, with approximately 10,200 people dying from these diseases annually. This equates to 28 people dying from either oesophageal or stomach cancer every day. Oesophago-gastric cancers are the fourth and fifth most common causes of cancer death in men and women respectively.

The PHE survey also highlighted that difficulty swallowing food is another possible symptom - 70 percent of respondents didn't know food sticking in the throat could be a sign of cancer, and just 13 percent said they were sure it's a symptom.

An early diagnosis of oesophageal or stomach cancer is crucial and means treatment is more likely to be successful. Around 67 percent of people diagnosed with these cancers at the earliest stage survive at least five years. This figure drops to around three percent for those diagnosed at a late stage.

According to Dr Richard Roope, Cancer Research UK's GP expert: "The advice we give is: if in doubt, check it out - this would not be wasting your GP's time. Often your symptoms won't be caused by cancer, but if they are, the quicker the diagnosis, the better the outcome. Seeking prompt advice from your GP about symptoms, either on the phone or during an appointment, could be a life-saver, whatever your age. And the good news is that more than half of all patients diagnosed with cancer now survive for more than 10 years."

Heartburn tips
If you are prone to heartburn, try the following self-help measures to reduce your symptoms:

• Keep your weight within the normal range for your height.
• Give up smoking.
• Eat smaller, more frequent meals during the day, rather than three large meals.
• Make sure you have your evening meal three or four hours before bedtime. 
• Limit, or avoid, alcohol, coffee, chocolate, tomatoes and/or fatty/spicy foods.
• Raise the head of your bed by around 20 cm (8 in) by placing a piece of wood or blocks under it. However, don't use extra pillows, as this may increase pressure on your abdomen.

Over-the-counter treatments

Many effective heartburn remedies are available over the counter, but these are not suitable for everyone. 

Antacids neutralise excess stomach acid and are ideal for occasional indigestion. These shouldn't be taken with certain other medicines, as they can affect their absorption, so check the label carefully or ask the pharmacist for advice. If you suffer from heartburn as well as indigestion, you can buy antacids combined with alginates, which produce a protective coating over the top of your stomach contents to stop stomach acid rising up into your oesophagus.

If antacids (with or without alginates) fail to work, you may be able to try a short course of an over-the-counter proton pump inhibitor (PPI), which reduces stomach acid production. Another option is an H2 antagonist, which also blocks acid production. However, don't use these over-the-counter heartburn medicines for longer than seven days without speaking to your pharmacist or consulting your GP.  Before buying any medicines, it's important to tell the pharmacist your age and if you are pregnant, suffer from any chronic medical conditions (e.g. high blood pressure) or take any other medicines or dietary supplements.

If your symptoms persist, always get them checked out. PHE highlights the following warning signs to look for:

• Heartburn most days for three weeks or more
• Food feels like it's sticking in your throat when you swallow
• Indigestion on and off for three weeks or more
• Losing weight for no obvious reason
• Trapped wind and frequent burping
• Feeling full very quickly when eating
• Feeling bloated after eating
• Nausea or vomiting
• Pain or discomfort in your upper tummy area.

Remember though, it's important not to panic or worry. Persistent heartburn often isn't a sign of cancer or any other serious medical problem. It may simply be caused by lifestyle factors (see heartburn tips above) or pregnancy or by a treatable problem, such as hiatus hernia. That's why it's important to seek medical advice from your GP for a proper diagnosis.