If you’ve eaten a large spicy meal only to be plagued later by a burning sensation in the stomach, you’d assume it was heartburn and take a couple of over-the-counter (OTC) antacid tablets. However, recurrent heartburn should be investigated by a doctor to eliminate other causes, including gastroesophageal reflux disease (Gerd).

The problem, as a new study suggests, is that many Gerd patients continue to take OTC remedies when their condition could be hugely improved with proton pump inhibitors (PPIs).

Heartburn is the consequence of excess acid in the stomach “refluxing” back into the oesophagus, resulting in that familiar sensation of burning below the breastbone. While food is an obvious culprit, other factors include smoking and being overweight. Antacids work by neutralising the acid.

While an estimated 20 to 40 per cent of all adults in the West experience regular heartburn, around 10 to 20 per cent of people whose heartburn affects their daily life may have Gerd, says Professor Roger Jones, Wolfson Professor of General Practice at King’s College London.

Gerd is characterised by the regular rising of acid in the throat from the stomach, and may be accompanied by oesophagitis — inflammation of the oesophagus. If untreated, it can cause extreme discomfort and more serious complications such as ulceration. Many patients with Gerd report having to eat less than usual, feeling generally unwell or extremely tired — and as the new study has found, more than half had been woken up by their symptoms during the previous week.

For 20 years Lynne Thackeray suffered from what she thought was chronic heartburn. It was so bad that she was losing sleep and becoming “extremely irritable”. “It affected my marriage because I was constantly ill and tired,” she says. “People used to laugh because I had the heartburn medicine everywhere. They’d work for an hour or two but then the symptoms would return.”

Thackeray, 43, put herself on a restricted diet, and gave up her social life and alcohol, but the problem remained. But two years ago she went to her GP and he diagnosed Gerd and prescribed PPIs. “I thought I would be back to his surgery within a week but within four or five days I was symptom free,” she says. The new study revealed that many Gerd sufferers think prescription drugs won’t help — which is why more than two thirds continue to take OTC medicines even after these no longer seem to work work.

Writing in the journal Gastroenterology, the researchers report that nine out of ten Gerd patients in their study who took PPIs experienced a dramatic improvement in symptoms. As Professor Jones, who led the study, explains: “PPIs offer a clear advantage over OTC remedies for the treatment of Gerd because they actually ‘switch off’ the proton pump mechanism in the lining of the stomach wall so that less acid is produced, giving more effective symptom relief and an improved quality of life.

“If you are getting heartburn after a curry and can cure it quite easily with an OTC medication that’s fine,” he says. “However, when the symptoms of heartburn start interfering with your life — that’s when a diagnosis of Gerd is usually made.

“OTC remedies are only designed to relieve occasional heartburn and should not be relied upon for long-term symptom control. I find it worrying that so many Gerd sufferers are currently taking OTC medicines or remedies to manage their symptoms.”

Reckitt Benckiser Healthcare UK, which manufactures the antacid Gaviscon, believes that both antacids and PPIs have a role to play in the relief and long-term control of reflux symptoms.

“Self medication for uncomplicated heartburn with an antacid product is recommended within the Nice guidelines,” a spokesperson says. “However, anyone who suffers constantly with symptoms, as with any persistent medical condition, should consult their GP for advice. Many GPs are now recognising antacids like Gaviscon may be used as a ‘step down’ therapy when weaning patients off PPIs.”

Symptoms include...

Hoarseness or persistent cough, dental erosion, laryngitis