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Heartburn is a burning pain in your chest. This pain is caused by stomach acid rising from your stomach into your oesophagus (the pipe that takes food from your mouth to your stomach).
This can cause:
- Burning pain in the middle of your chest
- Pain which is worse when you bend over or lie down
- Burning pain that radiates into your back
By learning more about the causes of, tests for, and treatment for heartburn, you can understand it better and make informed decisions to get back on track.

There are several possible causes of heartburn, and it’s important to find out what’s causing yours.
Here are the main causes of heartburn:
Gastroesophageal reflux disease (GORD)
Hiatus hernia, when part of your stomach moves up into your chest
Surgery you’ve had in the past (especially bariatric surgery)
Certain foods and drinks, such as alcohol, coffee, chocolate, and fatty or spicy foods
Being overweight
Smoking
Pregnancy
Stress or anxiety
Medication, such as anti-inflammatory painkillers
Overgrowth of bacteria in your small intestine (this is called SIBO)


Diagnostic testing allows us to pinpoint the exact cause so we can recommend the right solution.
At the Functional Gut Clinic, we use the following highly accurate and trusted diagnostic tools, to identify the underlying cause of your heartburn:
Oesophageal manometry – which measures the function of your oesophagus (food pipe)
24-hour pH impedance monitoring – which looks at whether you have any reflux
Carbohydrate malabsorption breath test – which finds out if you have certain food intolerances (lactose or fructose)
Small intestinal bacterial overgrowth (SIBO) breath test – which finds out if you have an overgrowth of bacteria in your small intestine (called SIBO)
Gastric emptying test – which measures how quickly food leaves your stomach

Research into the gut microbiome has expanded rapidly over the last decade. Now, with gut health and microbiome testing kits, the public can experience the benefits. People turn to tests to get answers if they’re struggling with bloating, IBS symptoms, fatigue, food intolerances, skin issues, or general health optimisation.
But one of the biggest blocks is price.
As patients browse the market, you can find tests ranging from ~£50-£80 to well over £250. Which one should you go for? How much does (and should) microbiome testing cost in the UK? And is it worth it?
Find out below.
The gut microbiome is a collection of trillions of bacteria, fungi, viruses, and other microorganisms living in your gut. It includes hundreds of different species. We rely on the microbiome for everything from digestion to immunity.
That’s why it’s so important to protect it.
A microbiome test involves sending a stool sample to the lab (usually with a home testing kit). The lab then analyses the sample, measuring:
·Gut bacteria diversity
·Digestive health markers
·Potential imbalances
You’ll receive your reports either via the post, an app, or email. More expensive tests often come with a consultation with an expert, explaining your results and advising on dietary and lifestyle changes.
Budget tests offer the bare essentials. These typically include basic diversity scores and limited insights. They’re helpful if you’re just performing a checkup after a previous test. You’ll sometimes receive a condensed wellness summary. However, you won’t receive the detailed insight that can lead to real change.
Mid-range tests include more detailed bacterial analysis. You’ll see a breakdown of different species, diversity scores, and more. That extra information helps create personalised dietary recommendations.
The extra cost often translates to app integration and tracking. So, if you have multiple tests, you can see your progress over time. It’s currently the most common price bracket in the UK.
Premium tests might seem pricey. However, you really do get what you pay for. They’re often led by a functional medicine specialist and measure additional markers for inflammation, parasites, and digestion metrics.
You’ll often receive a one-to-one consultation thoroughly explaining your results. It’s a great chance to ask any questions. It may be unnecessary for most people with minor microbiome issues. But it’s a smart choice for people with chronic gut issues.
The level of detail included in a microbiome test is the biggest factor determining price. Basic tests may only provide a simple diversity score and wellness insights, whereas advanced options detail bacterial strains, functional health recommendations, and personalised dietary changes using AI-driven analysis.
Tests that include professional guidance are usually more expensive. It’s common to find companies bundling microbiome analysis with nutritionist consultations or ongoing health coaching, which can balloon the cost.
The bigger the name, the higher the price. That doesn’t always translate to quality. However, established microbiome testing companies tend to have stronger research backing, larger datasets, and more advanced sequencing technology.
Microbiome testing works best over time. That means repeated testing. If the initial price seems a little expensive, you can save money with a subscription model. Often, companies add personalised nutrition plans or supplement recommendations as part of the overall cost.
It absolutely can be.
Microbiome testing is a great option if you’re dealing with uncomfortable GI symptoms. It can highlight patterns or imbalances that may help guide dietary and lifestyle changes.
That being said, microbiome research is still growing. We don’t know everything yet. And many of the health recommendations can overlap with standard healthy eating advice.
Just because something costs more doesn’t mean it’s better. Higher prices can come with more detailed analysis and practitioner support. That might seem helpful, but it might not be much use if you’re just dealing with mild, ongoing bloating.
In some cases, expensive tests offer more detail than most people realistically need. While premium options can provide deeper analysis, the practical recommendations are often similar to cheaper tests, especially for general gut health concerns.
For most people, £100-£250 is usually the sensible middle ground. Budget tests can be useful for general wellness insights, although they often provide less detailed analysis and support.
Expensive testing should generally be reserved for people with severe, chronic symptoms or those deeply invested in gut health tracking.
The Functional Gut Clinic is the UK’s first fully integrated full-spectrum microbiome clinic. We bring world-leading testing with grounded explanations. If you want to learn more about our tests (and their cost), you can apply online.
Read the next article: The Gut-Skin Axis: How Your Microbiome Affects Acne, Eczema and Rosacea
Heartburn is often experienced after eating and can last anywhere from a few minutes to several hours. The stomach releases more acid after eating certain foods, including spicy dishes, fatty foods, citrus fruits, tomato-based products, garlic, and caffeinated drinks. The more acid that is produced, the greater the risk of heartburn.
Other factors include obesity, smoking, stress, pregnancy, and eating too close to bedtime.



Heartburn primarily causes an uncomfortable or burning sensation in the middle of your chest. You may also experience:
A burning sensation in your throat
A strong acidic or sour taste in your mouth
Difficulty swallowing (dysphagia)
A feeling of pressure or pain behind your breastbone
Repeated coughing
Hoarse voice
In addition to these symptoms, the pain from the acid can get worse when lying down or bending over. This is because the acid flows out of the stomach and into the oesophagus. Whenever you lie down, you increase the risk of heartburn-related symptoms.
Constant heartburn is a sign of a severe underlying condition. Most people experience heartburn in episodic attacks – usually after consuming certain foods. If the heartburn is persistent, it’s crucial to speak to a medical professional. You can also consider organising a test via The Functional Gut Clinic (see below).


Heartburn occurs when the contents of the stomach enter the oesophagus (the food pipe connecting your stomach to your throat). Usually, the stomach contents are prevented from going back into the oesophagus by a juncture called the lower oesophageal sphincter. However, in some people, this sphincter doesn’t function properly.
Heartburn is a symptom of gastroesophageal reflux disease (GORD). GORD simply refers to the backflow of acid from the stomach into the oesophagus. GORD is the condition; heartburn is the symptom.

Several factors increase the risk of heartburn. The causes of heartburn and GORD either increase acid production within the stomach or affect the functioning of the lower oesophageal sphincter. These include:
Hiatal hernia. A hiatus hernia involves a part of your upper stomach penetrating through the diaphragm (the layer of muscle separating your chest from your stomach). This usually occurs due to a weakness or tear.
Pregnancy. If you become pregnant, the increased pressure during the third trimester (and sometimes earlier) forces the stomach contents backwards, causing heartburn.
Surgery. Previous surgery, especially bariatric surgery, increases the risk of not only heartburn but also a hiatus hernia.
Smoking. Smoking is closely linked to heartburn and GORD. People who quit smoking notice a significant reduction in heartburn symptoms.


Overweight or obesity. Being overweight or obese is a major risk factor for GORD. This is likely due to the increased pressure in the stomach alongside a diet high in fatty, processed foods.
Medications. Certain medications, such as anti-inflammatory painkillers (e.g., ibuprofen or aspirin), sedatives, and blood pressure medications, can increase your risk of heartburn.
Stress or anxiety. An increase in stress or anxiety can increase acid production in some people, leading to heartburn. It’s often accompanied by another factor.
Small intestine bacterial overgrowth (SIBO). Excessive bacterial growth in the small intestine leads to increased abdominal pressure and subsequent acid reflux, which can cause heartburn. Managing SIBO often reduces these symptoms.
Acid production is a normal part of the stomach’s function. The acid helps digest food. Certain foods require more acid to digest, triggering an increased production in the stomach.
For most people, this isn’t an issue as the acid flows into the small intestine. However, if you struggle with heartburn and GORD, then it’s sensible to limit or avoid certain foods. These include:
Citrus fruits (like oranges and grapefruits)
Tomatoes and tomato-based products
Spicy foods
Garlic and onions
Chocolate
Mint
Fatty or fried foods
Caffeinated beverages (such as coffee and tea)
Carbonated drinks
Alcohol
It’s not just the food. Eating an excessively large meal, wearing tight clothes, and lying down soon after eating can increase the risk of heartburn. If you’re experiencing persistent heartburn, it’s often linked to diet rather than another factor.

No. Heartburn specifically refers to the burning sensation in the chest. GORD is the underlying condition involving the backflow of acid. Heartburn is a symptom of GORD. Acid reflux is sometimes used as shorthand for GORD – however, not every attack of acid reflux is an example of GORD.
Acid reflux refers to any episode of acid backflowing into the oesophagus. If the episodes occur two or more times a week, it is diagnostic for GORD. Most people experience acid reflux episodes occasionally. This can increase in frequency as acid reflux progresses to GORD. You should speak to a doctor if you notice this change.

Heartburn is always caused by the backflow of acid into the oesophagus. Several other conditions can create a similar sensation. For example:
Oesophageal ulcers. Ulcers occur due to erosion of the oesophageal lining. Often associated with acid reflux or overusing anti-inflammatory medications.
Oesophagitis. Severe inflammation of the oesophagus is closely linked to GORD. However, it can also be caused by medications and infections. An allergic condition known as eosinophilic oesophagitis can also cause heartburn.
Functional heartburn. Unlike the other conditions, this isn’t a problem with your oesophagus or stomach. It’s caused by a disorder of the gut-brain connection. It involves the same heartburn symptoms but without any signs of acid reflux or inflammation. It’s connected to overactive nerves.


Heartburn is not a permanent condition. It lasts as long as the acid is present to irritate the oesophagus and throat. Most people experience heartburn and GORD for between a few minutes to several hours. The timespan often depends on the underlying cause. For example, if your heartburn is due to your diet, it might go away within a few minutes. In contrast, if you have a hiatus hernia, the heartburn might persist for much longer, even after standing up.
Constant heartburn is a rare symptom. It’s a concerning sign, as the acid can continue to damage your oesophagus. If you’re constantly feeling heartburn (or using lots of antacids), then it’s critical to speak to a doctor.
Most cases of heartburn aren’t serious. It’s common to experience heartburn after a large meal or eating certain foods. However, if the heartburn becomes repeated or constant, it can cause long-term damage. Usually, the damage caused by acid reflux heals like any injury. If it happens regularly, then the oesophagus lining can become permanently injured.
Potential long-term complications include:
Oesophageal strictures. The lining of the oesophagus becomes replaced with scar tissue due to repeated inflammation. This scar tissue causes a narrowing of the oesophagus (stricture), which prevents food from getting through.
Intestinal metaplasia. The tissue lining of the oesophagus undergoes a change to look more like the lining of your intestines, protecting it from damage. It is called Barrett’s oesophagus and is a precancerous condition.
Oesophageal cancer. Cancer is a rare complication of GORD and heartburn. It occurs due to persistent inflammation and cellular changes. The longer your heartburn persists, the greater the risk of cancer.
Heartburn and GORD can also indicate problems in your stomach. For example, excess acid production can lead to gastritis (stomach inflammation) and stomach ulcers. It may also aggravate preexisting conditions such as asthma.

The following tests may be used to diagnose what is causing your heartburn:
Oesophageal manometry – which measures the function of your oesophagus (food pipe)
24-hour pH impedance monitoring – which looks at whether you have any reflux
Carbohydrate malabsorption breath test – which finds out if you have certain food intolerances (lactose or fructose)
Small intestinal bacterial overgrowth (SIBO) breath test – which finds out if you have an overgrowth of bacteria in your small intestine (called SIBO)
Gastric emptying test – which measures how quickly food leaves your stomach
The following tests may be used to diagnose what is causing your heartburn:
Oesophageal manometry – which measures the function of your oesophagus (food pipe)
24-hour pH impedance monitoring – which looks at whether you have any reflux
Carbohydrate malabsorption breath test – which finds out if you have certain food intolerances (lactose or fructose)
Small intestinal bacterial overgrowth (SIBO) breath test – which finds out if you have an overgrowth of bacteria in your small intestine (called SIBO)
Gastric emptying test – which measures how quickly food leaves your stomach

Most people who experience occasional heartburn symptoms can benefit from lifestyle changes. This involves limiting exposure to potential triggers. You might want to try:
Avoiding trigger foods, such as fatty foods or caffeinated beverages
Eating smaller meals
Avoiding tight clothing
Avoiding lying down immediately after eating
Quitting smoking and alcohol consumption.
Often, people find that small changes to their diet can stop or reduce episodes of heartburn. If the heartburn continues, it’s usually a sign that something else is going on. It’s crucial to get to the bottom of your symptoms; otherwise, they will persist.



As heartburn is caused by acid, neutralising this acid relieves symptoms. The primary treatment for heartburn is an over-the-counter (OTC) antacid, such as Gaviscon or Alka-Seltzer. These medications provide immediate relief from your symptoms – perfect for tackling a sudden acid reflux attack. If you experience constant heartburn, it’s sensible to carry antacids with you. However, excessive use of antacids can cause other problems.
Your doctor may prescribe medications that prevent acid production. This includes:
Proton Pump Inhibitors (PPIs). These medications reduce stomach acid production by blocking the enzyme in the stomach lining that produces acid. Common examples include omeprazole, esomeprazole, and pantoprazole. PPIs are used to treat GORD by allowing the oesophagus to heal and preventing further damage.
H2 Receptor Antagonists. These drugs work by blocking H2 receptors on stomach cells that signal the production of acid. This results in decreased stomach acid output. Examples include ranitidine, famotidine, and cimetidine. They are effective in relieving GORD symptoms and are generally used for milder cases.

In the majority of cases, lifestyle changes and medication are enough to prevent heartburn symptoms. If GORD doesn’t respond to medication, surgery might be a potential option. This can repair a hiatus hernia, strengthening the lower oesophageal sphincter and permanently preventing the backflow of acid.
Procedures include:
Nissen fundoplication. This procedure tightens the junction between the stomach and the oesophagus.
Transoral incisionless fundoplication. A similar procedure performed non-surgically using an endoscope.
LINX device. A tiny ring of magnets is placed around the junction between the stomach and oesophagus to prevent reflux. It’s a type of minimally invasive surgery.
Heartburn is extremely uncomfortable. However, most cases are relatively mild and treatable with antacids. Speak to a medical professional if:
You experience heartburn more than once a week
You have other associated symptoms
You have difficulty swallowing
Your heartburn persists despite treatment
You’re over the age of 60
You have a tight or squeezing chest pain
You cough up blood
Remember, occasional heartburn is relatively normal. But if you have constant heartburn, it’s crucial to get tested. The Functional Gut Clinic is highly experienced in diagnosing acid reflux. We’ll organise your test and provide advice on what to do next.

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Burning mid-chest, worse when bending or lying down

Difficulty going to the toilet, unusual stools, often with stomach ache or intestinal cramps, bloating, nausea or appetite loss

Feeling uncomfortably full and tight, excess belching/breaking wind, abdominal pain or gurgling

Bringing food or drink back up, difficulty swallowing, feeling that food or drink is stuck in your throat, horrible taste in your mouth

Dysphagia - difficulty swallowing, feeling that food or drink is stuck in your throat, horrible taste in your mouth

Loose or explosive stools, can’t get to a toilet in time

Cramps; sharp or dull pain, Bloating, Excessive belching, Nausea or vomiting

Stools leak unexpectedly, Can’t get to a toilet in time

Abdominal pain or cramping, bloating, changes in bowel habits and urgency, gas