What to do if you've suddenly developed agonising heartburn

I’ve recently developed heartburn for the first time in my life. I do not eat spicy food nor do I smoke or drink, which I know can trigger this issue. Should I be worried that there is something else behind my symptoms?

Dr Philippa Kaye answers: Unexplained and prolonged heartburn should always be investigated by a doctor.

The condition, also known as acid reflux, occurs when stomach acid moves up into the food pipe. This can trigger an uncomfortable burning pain in the chest.

Other symptoms include bad breath, a hoarse voice and nausea.

It’s true that alcohol, smoking and spicy food can all increase the chances of heartburn occurring. However, there are other lifestyle habits that can make it worse too.

Overeating, consuming caffeine, wearing tight-fitting clothing and eating in the few hours before bed all aggravate heartburn.

Many heartburn patients use a drug called a proton-pump inhibitors (PPI) like omeprazole. These tablets reduce the amount of stomach acid produced, lowering the frequency of heartburn symptoms.

However, growing evidence shows that prolonged use of these tablets can raise the risk of serious complications like bone fractures, vitamin deficiencies and even potentially dementia. So PPIs are not a long-term solution to the problem.

For this reason, anyone who has heartburn for an extended period of time should see their GP for an assessment.

In some cases, heartburn symptoms can be triggered by an underlying health problem. For example, there is a type of bacteria, called H. Pylori, that can infect the stomach, triggering heartburn symptoms.

A GP can test for H. Pylori and, if necessary, treat it with a combination of antibiotics and other medicines.

In some cases, heartburn can be caused by a hiatus hernia, which is where the upper part of the stomach bulges up through the diaphragm, squeezing the stomach acid upwards.

In this situation, surgery may be needed to fix the hernia. Hiatus hernias are usually diagnosed via a gastroscopy, which is where a camera is inserted into the stomach to look for signs of the problem. 

A GP should be able to refer patients to hospital for a gastroscopy if necessary.

I’m thinking about purchasing one of those vibrating foot devices that apparently helps with puffy legs, feet and ankles. Do you think they actually work?

Dr Philippa Kaye answers: These devices can temporarily alleviate the uncomfortable sensation of puffy legs, feet and ankles. However, they do not treat the underlying cause.

The calves are sometimes referred to the as the ‘second heart’, because the leg muscles are crucial for pumping blood back up the legs towards the heart.

But when patients develop cardiovascular problems – such as heart failure or varicose veins – the calves often struggle to keep the blood flowing.

Another cause of this problem is a condition called peripheral arterial disease, where fatty deposits in the arteries in the legs restricts blood supply.

When this happens, fluid in the blood begins to leak out of the veins into the surrounding tissue. This is what causes the legs, feet and ankles to swell.

These vibrating foot devices are designed to stimulate the muscles in the calves, causing them to contract. This helps get the blood flowing and reduces some of the swelling.

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However, it is only a temporary measure because it does not treat the disease that’s restricting blood flow in the first place.

Heart failure is typically treated by making lifestyle changes like quitting smoking, cutting down on salt, losing weight, and exercising regularly. This would sometimes be along with medicines, such as statins and blood thinners.

Peripheral arterial disease is combatted by making similar lifestyle changes.

Varicose veins are hard to treat, but patients are often advised to wear compression socks, keep their legs elevated, walk often, avoid prolonged sitting or standing, and lose weight if needed.

Any patient who has swelling in their legs but has never had a diagnosis should speak to their GP so that the cause can be identified.

• Write to Dr Philippa Kaye at Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: health@mailonsunday.co.uk - include contact details. Dr Kaye cannot enter into personal correspondence. Replies should be taken in a general context. Consult your own GP with any health worries.