Understanding the issue

The main upper GI issues that can be treated over-the-counter are indigestion and heartburn.

Heartburn is usually described as a burning pain in the middle of the chest. It occurs when acid leaks upwards into the oesophagus. This can be uncomfortable as the oesophagus does not have the same protective lining as the stomach.

There are many reasons why these two conditions might occur:

• Pregnancy hormones can slow down the digestive process, and the growing baby can put pressure on the stomach, pushing its contents upwards
• Weakness of the lower oesophageal sphincter. The sphincter normally keeps the contents of the stomach where they’re meant to be. If it is weak, it can lead to gastro-oesophageal reflux disease (see panel)
• Lifestyle factors play a significant role. Being overweight, drinking alcohol, smoking, stress and anxiety can all cause symptoms. Having a poor diet is also a major factor. This can include the type of food that is being eaten (e.g. fatty foods), the speed at which it is eaten, or the amount of food consumed
• Some medicines can cause indigestion as a side effect. The most common culprits are NSAIDs such as ibuprofen and aspirin, but many drugs mention indigestion as a possible adverse reaction in their patient information leaflets
• Ulcers. The lining of the stomach or duodenum can be eroded and ulcers can form for reasons including Helicobacter pylori infection or NSAID use.

In many cases, more than one factor will be at play. For example, a customer who is overweight may also be eating meals with a high fat content. 

Symptoms differ from person to person, but discomfort is usually a feature. If this is experienced in the chest, it is referred to as heartburn, whereas pain slightly lower down may be referred to as indigestion. It is worth checking what customers mean when they use these terms, as they mean different things to different people.