Heartburn: causes and treatment methods

Gastroenterologist

Vinogradov

Dmitry Alekseevich

4 years of experience

Gastroenterologist

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Millions of people of all ages suffer from heartburn. And only a quarter of patients turn to doctors for medical help. Symptoms include a burning sensation in the esophagus, a feeling of fullness in the stomach, pain in the lower chest and is accompanied by a bitter, acidic taste in the throat and mouth. Heartburn is not so harmless in its clinical nature. It is periodic or chronic in gastroesophageal reflux disease (GERD) and can vary in frequency and intensity. Pharmacy medications provide only temporary relief, so a visit to a gastroenterologist and the prescription of adequate therapy is the main recommendation.

Causes of heartburn

Unpleasant symptoms of heartburn occur due to irritation of the esophageal mucosa. Normally, the environment in the stomach is acidic; it is regulated by hydrochloric acid. In the esophagus – neutral. These two sections of the digestive tract are separated from each other by the sphincter. If the orbicularis muscle does not fully perform its function, reflux occurs (reverse movement of stomach contents). The esophagus is not protected from the negative effects of acid, which causes a burning sensation. The causes of heartburn may include the following:

• gastrointestinal diseases (GERD, ulcers, gastritis, cholecystitis);
• diaphragmatic hernia;
• cancer of the gastric cardia;
• frequent consumption of fresh baked goods, coffee, chocolate;
• drinking alcohol, smoking;
• diet with fatty foods;
• chronic stress;
• taking medications (NSAIDs, to lower blood pressure).

Symptoms

Unpleasant excessive salivation, foul-smelling belches, loss of appetite, fatigue, irritability, sometimes accompanied by vomiting. If symptoms associated with gastric disease or lesions of the esophagus predominate, heartburn can be quite intense. There may be concomitant diseases - these are lung diseases complicated by a severe cough.

Persistent heartburn can cause unwanted complications. For example, damage to the mucous membrane of the esophagus by aggressive body fluid (hydrochloric acid, concentrated bile), which causes the formation of peptic ulcers of the esophagus, stomach, and duodenum. In addition, regular entry of stomach contents into the esophagus can cause constant bleeding, caries, inflammation of the gums and mucous membranes of the mouth.

How to get rid of heartburn and its consequences

Chronic or frequent heartburn causes an inflammatory disease with a recurrent nature called esophagitis - this is the most common consequence. The resulting ulcers and their subsequent scarring provoke a narrowing of the esophagus, which interferes with food intake. Heartburn may also be accompanied by bloating. To improve your well-being, the following is recommended:

• exclude late dinner before bedtime;
• the upper body should be elevated 15-25 cm during rest;
• immediately after eating, you should not bend over or lie down;
• conduct an audit of food products;
• quit smoking and drinking alcohol;
• Avoid tight belts and clothing that compress the abdominal area.

When to urgently call an ambulance

If heartburn occurs in the stomach from inappropriate food, the situation is not so dangerous. You should be wary of pain and a burning sensation in the chest that occurs due to an attack of angina or an increasing threat of myocardial infarction. With progressive symptoms such as bloody vomiting and black stools, you should call an ambulance. JSC "Medicine" (clinic of academician Roitberg) in the Central Administrative District has emergency teams on staff, its own fleet of vehicles and the latest generation equipment. They work 24/7. Severe heartburn and stomach pain may also be due to an exacerbation of the ulcer, which is also a reason to call an ambulance. If necessary, the team will take care of transporting and accompanying the patient to the hospital for hospitalization, where a final diagnosis will be made and treatment will be prescribed.

When to see a doctor

If heartburn in the throat begins to bother you frequently, regardless of the time of day, body position, or with a balanced diet, you should consult a doctor. Attacks cannot be tolerated or ignored due to the possible transition of the underlying causes into a chronic condition. The formation of ulcers in the esophagus due to the constant influence of hydrochloric acid on the mucous membrane provokes bleeding. They can lead to Barrett's syndrome and the subsequent development of oncology. You need to make an appointment to undergo diagnostics and receive heartburn medication to stabilize your well-being.

Rennie

"Rennie" for heartburn is available in the form of fruit or mint tablets. The active ingredients of the drug are magnesium and calcium carbonate. Sold in pharmacies without a prescription. "Rennie" stimulates the production of protective mucus in the stomach, which protects the mucous membrane, and also neutralizes hydrochloric acid. Medicine for heartburn is prescribed from the second trimester of pregnancy, during gastritis with high acidity, exacerbation of ulcers, with GERD and overeating. The drug acts literally in 3-5 minutes, and its effect lasts for about 5-6 hours. Patients with impaired renal function and urolithiasis are prohibited from taking Rennie.

Rennie

Bayer Bitterfeld GmbH, Germany

The drug is taken for diseases of the gastrointestinal tract associated with increased acidity of gastric juice
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Root causes and treatment of heartburn

Symptoms may return if the underlying cause is not determined. In severe cases, the doctor may recommend going to the hospital to clarify them. At JSC “Medicine” (academician Roitberg’s clinic) in the center of Moscow, you can undergo diagnostics and take tests to establish the correct diagnosis. For this purpose they prescribe:

• laboratory blood tests (general, biochemical, for the presence of antibodies to Helicobacter pylori);
• gastroscopy;
• urease breath test (detection of Helicobacter pylori infection);
• esophageal pH monitoring;
• esophagomanometry, etc.

Symptom of heartburn during pregnancy

It is a fact that 80% of women experience heartburn when carrying a child from the first months of pregnancy. Increased progesterone in the body relaxes the muscles, which causes dysfunction of the esophageal sphincter. Another reason is increased abdominal pressure due to fetal growth. Heartburn pills (antacids) without complex chemical compounds help to cope with poor health. They usually have a minty flavor, which helps get rid of the sour and bitter taste in the mouth. They are prescribed by a doctor after consultation.

Treating heartburn at home

A fast-acting remedy for heartburn is baking soda in the amount of 1/2 tsp. per glass of water. You need to drink in small sips. The method is suitable only for emergency cases, but with frequent use of sodium carbonate, the acid-base balance is disturbed. To maintain it, you should also give up citrus fruits and carbonated drinks, raw onions and garlic, hot and spicy foods.

Following a diet is better than soda for heartburn during periods of exacerbation. Small meals 5-6 times a day will also be useful. Chamomile tea and drinking low-alkaline mineral waters can also help. Popular folk remedies or how to get rid of heartburn at home is a set of the following recommendations:

• drink tea from St. John's wort and plantain (1 tbsp per 200 ml of water);
• drink 1 tbsp. 15 minutes before meals, infusion of dried dried fruit (20 g per 200 ml of water);
• eat buckwheat daily;
• chew barley grains during an attack.

Medicines to treat heartburn

Popular pharmaceutical drugs - antacid agents:

• Almagel (antacid) - quickly relieves heartburn. Such products have a protective effect and help neutralize the acidity of gastric juice.
• Maalox is produced in the form of chewable tablets, suspension and gel, so you can choose the most optimal and convenient option for yourself.
• Phosphalugel
• The drugs well protect the wall of the stomach and esophagus from harmful factors and eliminate discomfort, relieve heartburn quickly in 10 minutes. Fosfalyugel and Almagel are available in sachets and have a pleasant taste. Take according to instructions, usually after meals or during an attack of heartburn.

In addition, your doctor may recommend the following remedies to relieve heartburn:

• Chewable tablets Rennie and Gastal
• Gaviscon
• Fulling clay

Prevention is the best cure for heartburn

Preventing reflux is part of treatment by following a diet and limiting negative factors. Remember that heartburn from water is reduced by diluting the amount of hydrochloric acid in the stomach. Drink it throughout the day. Avoid eating large portions of food and lead a healthy lifestyle. In this case, heartburn and nausea will not bother you. If attacks are frequent and symptoms last for 2-3 months, you need to undergo an examination, which will prevent the exclusion of severe diagnoses.

Alginates

According to the pharmacological index, alginates belong to antacids and adsorbents, although they have different mechanisms of action. Structurally, alginates are neutral polysaccharide polymers and belong to dietary fiber. Alginates stabilize viscous suspensions, forming films and turning into a gel form. Alginate reacts with gastric acid to form dioxide, which is captured by the gel. The dioxide gel foams and floats on the surface of the stomach contents (even when lying down), creating a kind of gel barrier, or “raft,” that prevents further acid and pepsin from entering the esophageal mucosa. It is this “raft” of alginate that prevents the reflux of both acidic gastric and alkaline duodenal contents into the esophagus. The alginate “raft” works for more than 4.5 hours. Another undeniable advantage of alginates is their proven safety at any stage of pregnancy, as well as during lactation.

Positive effects of taking alginates:

• protect the esophagus from the pathological influence of gastric juice, without changing the acidity of the latter;
• act quickly;
• promote the healing of erosions, stomach and duodenal ulcers;
• with hyperacid gastritis (inflammation of the gastric mucosa with high acidity) reduce increased appetite;
• adsorb harmful substances, excess hydrochloric and bile acids, pepsin;
• suppress the activity of pathological microflora;
• are an additional source of dietary fiber.

Antacids and alginates

Heartburn with gastritis: which doctor should I contact?

A gastroenterologist specializes in the treatment of gastrointestinal diseases. If additional research is necessary, other specialized specialists may be involved. For consultation, examination and treatment, please call +7 (495) 775-73-60 or leave a request for feedback on the website with your contact details. The clinic is located at: Moscow, 2nd Tverskoy-Yamskoy lane, building 10, Mayakovskaya metro station. The following stations are also within walking distance: Belorusskaya, Tverskaya, Novoslobodskaya and Chekhovskaya.

Heartburn: symptoms, causes and treatment

More than half of the adult population of our planet is familiar with heartburn. The fire inside can flare up after eating, during sports training, or when you lie down on the sofa. Few take heartburn seriously; more often it is treated as a problem that just needs to be endured.

Sometimes heartburn is a relatively harmless consequence of eating inappropriate foods, but often it turns out to be a symptom of serious diseases that require immediate treatment. How to recognize how great the danger is? Answers to important questions about heartburn will be given by an endoscopist of the highest category at LDC "Medexpert" in Engels, President of the Association of Endoscopists of the Saratov Region Gladkov Vasily Vladimirovich.

How to determine if you have heartburn? What sensations does a person experience with this disease?

Gladkov V.V. : Heartburn occurs when aggressive gastric juice containing hydrochloric acid enters the lower esophagus and irritates its mucous membrane. Normally, this does not happen: the esophagus is separated from the stomach by a special valve - a sphincter, which allows food to enter the stomach, but does not allow it to get back. However, under certain conditions, the valve stops working correctly - this is when hydrochloric acid refluxes into the esophagus. This causes a real burn that feels like a burning sensation. But patients do not necessarily experience a burning sensation; it could be a feeling of fullness, pressure or warmth. Heartburn is most likely with high acidity, but can also occur with low or normal gastric acidity. According to statistics, from 40 to 60% of the population of developed countries periodically experience heartburn, while 10-20% experience this condition more than once a week. Most often, heartburn occurs approximately 15-30 minutes after eating.

What are the main causes of heartburn?

Gladkov V.V. : There are several main causes of a burning sensation: diseases of the gastrointestinal tract. As a rule, heartburn is one of the most common symptoms indicating problems in the digestive system, for example, chronic diseases of the gastrointestinal tract (peptic ulcer, chronic gastritis with increased gastric secretion, gastroesophageal reflux). Another common cause of heartburn is an unbalanced diet, in particular a passion for sweets and flour products. Especially if sugar-containing foods are combined with protein: the duo causes fermentation. Rare meals and dry food can also stimulate the release of acid. And, of course, overeating. If holidays follow one after another, or if you eat small portions more than once every three or four hours, but chew constantly and in large quantities, then the food simply no longer fits in the stomach and is therefore thrown back.

The cause of persistent heartburn is most likely a serious illness. Therefore, a frequently occurring burning sensation behind the sternum requires immediate intervention: delay in receiving medical help can cost a person’s health and sometimes life. In this context, modern and high-quality diagnostics are of great importance. It is important! In some cases, a burning sensation behind the breastbone is a medical emergency. The “mask” of heartburn can hide an attack of angina and myocardial infarction. With timely contact with a gastroenterologist and further examination, this terrible disease can be avoided and stopped at any stage.

What methods exist for diagnosing and treating heartburn?

Gladkov V.V. : Diagnosis of heartburn is complex. A thorough examination of the gastrointestinal tract, namely gastroscopy, can help establish the correct diagnosis. The endoscopic equipment used at LDC MedExpert is represented by modern video endoscopes operating in magnification and narrow-band imaging (NBI) modes. These modes make it possible to detect not only early forms of cancer, but also to see suspicious areas of the mucous membrane (precancerous changes).

Heartburn is not as harmless as many who experience it are accustomed to think. If attacks are repeated systematically, this is a reason to suspect the disease. In such cases, you cannot hesitate, because the consequences can be very serious. If you experience frequent or severe heartburn, you should consult a gastroenterologist to make a diagnosis and prescribe appropriate medications.

Look for our articles on the pages of the Volozhka newspaper, Marx. You can find the publication of this article in the newspaper issue dated March 7, 2019 (No. 10)