Hard to swallow

Many people can stand on their heads without acid reflux occurring. This is because there is a ring of muscle (a sphincter) at the bottom of the gullet, acting as a valve which relaxes to let food down but tightens to prevent stomach contents refluxing back up again.

Reflux occurs when pressure in the stomach rises higher than the muscle can control, for example during pregnancy, when acid leaks back into the gullet but is not pushed back down again. The pressure problems in pregnancy are compounded by the effect of hormones softening the muscle ring. Other causes of valve failure include obesity and high fat meals. Less commonly, it can also occur when part of the stomach slides up into the lower part of the chest above the diaphragm, making it impossible for the valve to function properly. This is called a hiatus hernia. Some people develop a troublesome cough and even wheezing when acid refluxes all the way up to the throat and larynx. The role of Helicobacter in reflux disease is not yet well known.

Gastritis
This refers to inflammation of the lining of the stomach and can be caused by Helicobacter infection, NSAIDs and also by alcohol excess.

Gastric and duodenal ulcers
An ulcer occurs when the surface lining of the stomach or duodenum becomes raw. This can be caused by Helicobacter infection or taking NSAIDs. Ulcers can give you similar symptoms to indigestion but the pain tends to be more severe. Ulcers can be dangerous if they burst, or perforate, leaking acidic stomach contents into the abdominal cavity. Occasionally they can also bleed. Both these situations are medical emergencies and need hospital treatment. You would recognise these conditions by sudden severe abdominal pain or vomiting blood, or the passage of loose black stools that look like tar.

What can you do to help yourself?

Stop smoking
Acid reflux is more common in smokers. The chemicals from cigarettes can increase acid production and slacken the stomach valve, so if you can stop smoking your symptoms will improve.