Causes of heartburn
Heartburn is extremely common, affecting up to 1 in 4 adults in the UK.1
When we eat or drink, specialised cells in the lining of the stomach produce acid to help break down food and kill harmful bacteria. At the point where the food pipe (oesophagus) meets the stomach, there is a ring of muscle that acts like a valve, relaxing to let food through and then tightening to keep stomach contents in place.2
Sometimes this valve becomes weak or relaxes at the wrong time, allowing stomach acid to travel back up into the oesophagus. This is called acid reflux and can cause a burning feeling in the chest or throat, known as heartburn.2
If heartburn keeps happening, it may be referred to as gastro-oesophageal reflux disease (GORD).3
Signs and symptoms of heartburn
While the signs and symptoms vary from person to person, people with frequent heartburn may experience:
- a sour taste in the mouth
- a burning sensation in the centre of the chest
- a recurring cough or hiccups
- bad breath
- nausea and bloating
- symptoms worsening after eating, lying down or bending over
Risk factors for heartburn
There are a variety of factors that can put people at risk of heartburn, some include:
- being overweight
- smoking
- certain food and drink e.g. coffee, alcohol, fatty or spicy foods
- stress and anxiety
- some medicines, such as non-steroidal anti-inflammatory painkillers like ibuprofen
- a hiatus hernia or stomach ulcer
The impact of heartburn
For some people reflux is only an occasional nuisance, but for others it can become a recurrent problem that can affect people’s eating habits, the quality of their sleep, and their ability to socialise and work.4
Community pharmacy support
Community pharmacy teams play a key role in the management of heartburn and other upper gastrointestinal symptoms because, unlike GP surgeries, patients can walk in and speak to a trained member of the pharmacy team without an appointment.
As well as advice on the appropriate use of OTC treatments for heartburn and guidance on how to prevent symptom recurrence, self-care support may also include discussing dietary triggers, weight management, smoking cessation and other lifestyle factors that can contribute to reflux symptoms.3
Pharmacy teams can also advise on lifestyle changes that can relieve heartburn:3
- try to lose weight if overweight
- eat smaller meals, more often, with the last meal at least 3-4 hours before bed
- avoid food or drink that triggers symptoms
- stop smoking, and cut down on alcohol
- try to find ways to relax
Heartburn treatment options
There are a variety of OTC medicines in different formats that can help with heartburn symptoms.
Antacids are alkaline liquids or tablets taken at mealtimes and bedtime for short acting relief. They work by neutralising stomach acid.1
Alginates come in a range of formats that create a ‘raft’ on top of the stomach contents to help reduce reflux symptoms for short acting relief.1
Acid-suppressing medications work by reducing the amount of acid produced by the cells that line the stomach. These are split into two groups:
- Prescription-only (POM) histamine H2-receptor antagonists (H2 blockers) such as cimetidine, famotidine and nizatidine.
- Proton pump inhibitors (PPIs) are medications which block the proton pumps in gastric parietal cells to reduce acid production. Some PPIs, including omeprazole and esomeprazole, are available as over-the-counter (OTC) medications, while others are only available on prescription.
Patients should be advised not to stop taking prescription medications without speaking to their doctor first.
Nexium Control – treat the cause
Nexium Control 20 mg gastro-resistant tablets and Nexium Control 20 mg gastro-resistant hard capsules (Esomeprazole) are indicated for the short-term treatment of reflux symptoms (e.g., heartburn and acid regurgitation) in adults.
Just one dose a day of Nexium Control helps continuously prevent heartburn from recurring for 24 hours by inhibiting the proton pumps that produce stomach acid,5 giving patients protection all day and all night.
No other heartburn remedy lasts longer without a prescription; Nexium Control lasts six times longer than sodium alginates,6,7 and provides longer-lasting acid control compared to omeprazole.7
Do more than just treat the burning pain of heartburn: tackle it at its source and help your patients enjoy life without heartburn.
Signposting for further support
References
1. GUTS UK. Heartburn and Reflux. Available at: https://gutscharity.org.uk/advice-and-information/symptoms/heartburn-and-reflux/
2. NHS Inform. Gastro-oesophageal reflux disease (GORD). Available at: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gastro-oesophageal-reflux-disease-gord/. Accessed June 2026.
3. NHS. Heartburn and acid reflux. Available at: https://www.nhs.uk/conditions/heartburn-and-acid-reflux/. Accessed June 2026.
4. Haleon Data on File. Based on research in 2003 in 1001 frequent heartburn sufferers, divided into five segments based on attitudes on heartburn and treatment
5. Shin JM, Sachs G. Pharmacology of proton pump inhibitors. Curr Gastroenterol Rep. 2008 Dec;10(6):528-34.
6. Mandel, KG, Daggy BP, Brodie, DA and Jacoby, HI. 2000. Review article: alginate-raft formulations in the treatment of heartburn and acid reflux. Alimentary Pharmacology and Therapeutics, 14, 669-690.
7. Lind T et al. Esomeprazole provides improved acid control vs. omeprazole in patients with symptoms of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2000;14(7):861–7
Product Information:
Full information can be found in the Summary of Product Characteristics.
Nexium Control 20 mg gastro-resistant tablets and Nexium Control 20 mg gastro-resistant hard capsules (Esomeprazole). Indications: The short-term treatment of reflux symptoms (e.g., heartburn and acid regurgitation) in adults. Dosage: The recommended dose is 20 mg (one tablet or capsule) per day. Tablets or capsules may need to be taken for 2-3 consecutive days to achieve symptom improvement. Maximum treatment duration: up to 2 weeks. Not recommended for use in children and adolescents under 18 years of age. Contraindications: Hypersensitivity to the active substance, substituted benzimidazoles or to any of the excipients. Esomeprazole must not be used concomitantly with nelfinavir or rilpivirine (oral formulations). Warnings and precautions: Patients should consult a doctor if: They have significant unintentional weight loss, recurrent vomiting, dysphagia, haematemesis or melaena and when gastric ulcer is suspected or present, malignancy should be excluded to avoid delay in diagnosis. Also, patients should consult a doctor if: they have had previous gastric ulcer or gastrointestinal surgery, been on continuous symptomatic treatment of indigestion or heartburn for 4 or more weeks, have jaundice or severe liver disease, are aged over 55 years with new or recently changed symptoms, they have frequent wheezing, particularly with heartburn. Long-term recurrent symptoms of indigestion or heartburn require regular doctor consultation and those over 55 years taking any non-prescription indigestion or heartburn remedy daily should inform their pharmacist or doctor. Nexium Control should not be taken as a long-term preventive product. Treatment with PPIs may lead to a slightly increased risk of GI infections such as Salmonella and Campylobacter and in hospitalised patients, possibly Clostridium difficile. Patients should consult their doctor before taking this medicinal product if they are due to have an endoscopy or urea breath test. Co-administration of esomeprazole with atazanavir is not recommended. The potential for interactions with medicinal products metabolised through CYP2C19 should be considered. Concomitant use with clopidogrel is discouraged. Not to be taken with another PPI or H2 antagonist. Increased Chromogranin A (CgA) level may interfere with investigations for neuroendocrine tumours. PPIs are associated with very infrequent cases of subacute cutaneous lupus erythematosus (SCLE). If lesions occur, especially in sun-exposed areas of the skin, and if accompanied by arthralgia, medical help should be sought promptly, and discontinuation considered. SCLE after previous treatment with a PPI may increase the risk of SCLE with other PPIs. Severe cutaneous adverse reactions (SCARs) have been rarely reported with esomeprazole treatment. Advise patients of the signs and symptoms of SCARs. They should seek immediate medical advice and discontinue treatment with esomeprazole if any signs or symptoms are observed with additional medical care/close monitoring provided as needed. Rechallenge should not be undertaken in these patients. Contains sugar spheres (sucrose). Not suitable for patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency. Side effects: Refer to the SPC for full details. Common: headache and GI disorders, including abdominal pain, constipation, diarrhoea, and nausea/vomiting, fundic gland polyps (benign). Uncommon: peripheral oedema, insomnia, dizziness, paraesthesia, somnolence, vertigo, dry mouth, increased liver enzymes, dermatitis, pruritus, rash and urticaria. Legal category: GSL (7s and 14s) and P (28s). Product licence number: GSL: Capsules PLGB 44673/0221 & Tablets PLGB 44673/0222, P: Tablets PLGB 44673/0225. MAH: Haleon UK Trading Limited, The Heights, Weybridge, Surrey, KT13 0NY, U.K. RRP (excl VAT): Tablets: 7s £5.99, 14s £10.39, 28s £20.42. Capsules: 14s £11.19. Text prepared: Jan 2026
PM-GB-NEX-26-00004