BBC Morning Live doctor says 'avoid Christmas heartburn with four-hour rule'

A BBC Morning Live doctor is urging people to stick to a four-hour rule which will help avoid heartburn this Christmas. The expert warns that at this time of year many people are eating a lot and overindulging on festive treats. But it can be avoided with just a few simple tricks.

Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux). But if it keeps happening, it may be called gastro-oesophageal reflux disease (GORD). Dr Xand Van Tulleken explains that heartburn occurs when "one of the things your stomach does is break the food up and mix it with acid. The point of the acid is not just to digest your food, but actually to clean and sterilise it, so that acid is very powerful."

The 46-year-old doctor further elaborates that the "stomach is designed to protect yourself from the acid so it doesn’t burn your stomach, so your stomach is lined really well. But if you have a big meal and the acid splashes up out of your stomach into your food pipe, into your esophagus, then that can literally cause a chemical burn that can be very painful."

"So if you have a look here [picture below] there is a muscle called the diaphragm and the diaphragm separates your chest from your tummy. The food pipe has to pass through it and that helps along with the sphincter muscle, that helps keep the acid in the stomach." But on the right hand side you can see acid splashing up, it’s red and it’s inflamed. "This can be painful and it can cause problems in the long term", the doctor explains.

When it comes to the triggers, Dr Xand says that the following can make it worse:

• Having a big meal
• Caffeine
• Chocolate
• Alcohol
• Spicy foods

In fact, over Christmas, the top of the list for searches on the NHS website as heartburn and "it’s a particular problem at Christmas because of the way we eat", he says.

What are the symptoms of heartburn?

The main symptoms of acid reflux according to the NHS are:

• heartburn – a burning sensation in the middle of your chest
• an unpleasant sour taste in your mouth, caused by stomach acid

You may also have:

• a cough or hiccups that keep coming back
• a hoarse voice
• bad breath
• bloating and feeling sick

Dr Xand heartburn hacks - and the four-hour rule

"These are my hacks, my top tips and the ways to think about heartburn", he says. He explains: "Is it every meal? It’s very unlikely you're just getting it after Christmas dinner or once a year. Instead you’re going to be getting it fairly regularly and you can dismiss it because it goes away, but actually if you’ve got a cupboard full of tablets to reduce the acids - those sort of things - then start to think I might have a bit of an issue.

"Secondly, monitoring triggers. Think about what might be causing it, particularity related to foods because if you can avoid those foods, then you’ll get less irritation." Thirdly, he says you should try and "avoid eating late. Stop eating chocolate 3 to 4 hours before bed because as you lie down your reflux can get worse because the acid can get into your food pipe more easily. Finally, you’re sleeping position - if you have an old phone book or a brick or something like that, you can use it to prop up the head of your bed and that slight slope will bring the stomach contents down."

Dr Xand cancer warning

The irritation of your oesophagus can lead to something called Barrett's oesophagus, says Dr Xand. If you have heartburn often, it can put you at a higher risk of oesophageal cancer, "so it’s really important if you have long-term heartburn and you’re struggling to manage, talk to your doctor. It might be something else entirely, so check in with your GP", Dr Xand concludes. You can read all about Barrett's oesophagus - and the signs and symptoms via the Macmillan Cancer Support webiste here.