How to get rid of heartburn

Heartburn is an unpleasant condition associated with the backflow (reflux) into the esophagus of acidic stomach contents.Quite often it occurs after eating certain foods or overeating - so, given the upcoming New Year holidays, it is worth knowing in advance how to get rid of heartburn safely and effectively.However, sometimes a similar symptom manifests itself and extremely serious diseases, including cardiovascular - and about this we will also talk in our today's article.

Heartburn is manifested by a painful burning sensation in the chest and/or “under the scapula” (in the epigastrium, between the lower point of the sternum and the navel). Sometimes it rises higher, up to the root of the tongue - in such cases, there is a bitter or sour taste in the mouth. Severe heartburn can be complemented by such symptoms as:

• nausea;
• frequent belching - bitter or sour;
• bad breath;
• heaviness in the stomach;
• excessive saliva production;
• hiccups, coughing, and/or hoarseness of voice;
• spread of the burning sensation to the shoulders.

Causes of heartburn

So, the main cause of heartburn is the throwing of gastric contents upward, back into the esophagus (acid reflux). In this case, the lower esophageal sphincter (LES) between the stomach and esophagus is not sufficiently closed and does not fulfill its function as a “flap”. And gastric juice has high acidity, due to which it irritates the esophageal mucosa - a delicate tissue, which is not designed for such aggressive effects. That is, in fact, heartburn is a reaction of the esophageal mucosa to aggressive substances.

“Fire in the chest” can be conditionally divided into two types, depending on the causes.

“Normal” heartburn

Can occur in a practically healthy person after:

• overeating;
• consumption of certain foods and / or alcoholic beverages. Cause heartburn can almost any alcohol, not only dry wine. As for food - the culprits are often spicy / fatty / smoked foods, chocolate, sweet pastries and other sweets, black bread of some varieties, sour fruits, citrus fruits, coffee, tomatoes and ketchups, citrus fruits, vinegar, garlic and onions, some spices, sweet sodas, etc..;
• taking certain medications - acetylsalicylic acid (ASA - Aspirin, etc.), non-steroidal anti-inflammatory drugs (NSAIDs - ibuprofen, nimesulide), some sedatives, antihypertensive drugs (“for pressure”), motherwort preparations, etc.

In addition, heartburn often annoys pregnant women. In this case, the enlarged uterus presses on the diaphragm and stomach, from which it takes a more upright position. The muscles of the lower part of the esophagus, including the circular sphincter - “flap” between the esophagus and the intestine, in pregnancy relax under the influence of the hormone progesterone. Because of this, even shallow bending of the body provokes “overflow” of gastric juice into the esophagus.

The risk of heartburn is increased in smokers.

Sometimes it occurs with physical activity, bending over - especially after eating.

In some cases, heartburn may be associated with psycho-emotional stress or general anxiety, sleep deprivation - these conditions contribute to increased acidity of gastric juice.

Symptom of a certain disease

Often the cause of heartburn is:

• gastritis with increased acidity;
• Gastroesophageal reflux disease (GERD);
• gastric or duodenal ulcer, especially in the presence of gastric infection;
• esophageal ulcer;
• hernia of the esophageal opening of the diaphragm - when part of the stomach moves up into the chest;
• increased levels of certain hormones - estrogen, progesterone (for example, we have already explained above how high progesterone is related to heartburn in pregnancy).

Obesity (and sometimes just being overweight) may also be to blame for the increased frequency of heartburn attacks.

How to tell the difference between “simple” heartburn and a heart attack / heart attack

Heartburn is an “acid disorder” of the GI tract associated with the esophagus. However, the esophagus and the heart are located close together, so sometimes chest pain caused by a heart attack (angina) or heart attack can be confused with heartburn - and vice versa.

However, there are quite pronounced nuances and differences between true heartburn and heart problems - everyone needs to know them.

Differences in the localization of pain

Heartburn - sensations can be described primarily as burning. It originates in the upper abdomen and spreads to the chest, sometimes reaching the throat.

Heart attack - the pain can be burning, but more often it is squeezing (the most common complaint is “pressure in the chest”). It is localized in the center or left side of the chest, can go up to the jaw, down the arms, cover the back.

Differences in symptomatology

More or less “harmless” heartburn associated with digestive problems:

• Occurs after eating, especially in the supine position;
• rises upward from the stomach;
• often accompanied by a sour or bitter taste in the mouth, burning and sore throat;
• symptoms worsen in the supine position and when bending forward, but in the standing position heartburn “recedes” a little.

A heart attack produces symptoms in the form of:

• sudden onset pain;
• sweating, shortness of breath, dizziness, nausea;
• spikes in blood pressure;
• pain spreading to the neck, jaw or back;
• weakness, sometimes to the point of fainting;
• changes in posture do not bring relief.

Differences in the effect of medications

An attack of heartburn is quickly enough stopped by certain drugs - antacids, alginates, etc. (more details about heartburn remedies we will tell you below).

The discomfort of a heart attack does not go away when taking antacids / alginates, but decreases when taking nitroglycerin sublingually (under the tongue).

When should I see a doctor for heartburn?

A visit to the doctor is necessary if heartburn is chronic - that is, its attacks recur 1-2 times a week or more often. For example, if it is associated with gastroesophageal reflux disease (GERD) - it is necessary to start treatment as soon as possible, because regular releases of gastric juice:

• damage the esophagus, “burning” it;
• make swallowing difficult;
• cause a frequent or constant sensation of a lump in the throat;
• can lead to degeneration of the esophageal epithelium (Barrett's syndrome) and even esophageal cancer.

Plan a visit to a gastroenterologist soon if:

• heartburn bothers you more than 1-2 times a week;
• does not go away, despite the fact that you have already visited the doctor and carefully take the medications recommended by him;
• you have difficulty swallowing;
• nausea and/or vomiting without reason;
• your body weight has decreased due to decreased appetite, nausea, or difficulty swallowing.

In addition, as we have already found out, - under the “mask” of heartburn can hide much more complex health problems, including heart attack. Immediately call an ambulance if along with “heartburn” appear:

• severe pain or pressure in the chest;
• chest pain that radiates to the arm or jaw;
• any breathing problems - shortness of breath, shortness of breath, difficulty breathing, etc.

Diagnosis

A gastroenterologist will interview and physically examine the patient and, if necessary, order additional tests - such as X-rays, endoscopy, or others. Some laboratory tests (blood, urine, feces) may also be needed, as well as:

• pH-metry to determine stomach acidity;
• manometry to determine the ability of the esophageal-gastric sphincter to prevent backflow of gastric juice;
• tests for chemoreceptor sensitivity in the esophageal mucosa.

Based on a complete picture of the patient's condition, the doctor prescribes adequate treatment.

Treatment of heartburn: effective methods

Unfortunately, for many people, the main remedy for heartburn is ordinary soda - the most popular “kitchen alkali”, sodium bicarbonate. Why “unfortunately”? Because, although baking soda really quite quickly relieves the unpleasant sensations of heartburn, it is no less quickly “eats away” the mucous membrane of the stomach. And when baking soda reacts with acid, it produces carbon dioxide (CO2), which can cause abdominal bloating and belching.

Important! Soda is prohibited when taking certain medications - antifungal agents, medications for dementia, etc.), as well as in the presence of such factors or suspected factors:

• pregnancy;
• appendicitis;
• intestinal or rectal bleeding;
• urinary problems;
• swelling of the legs;
• heart disease, kidney disease, liver disease;
• arterial hypertension (AH, high blood pressure).

Today, quite a few really effective heartburn medications are available in pharmacies, which (if used correctly) will not cause even more harm to the body. Now we will talk about these drugs in more detail, but we warn you in advance: in case of frequent episodes of heartburn (once a week or more often) you need to see a doctor as soon as possible. Regularly drink not only harmful soda, but also any pharmacy remedies for heartburn only on their own initiative is strictly forbidden.

Antacids

With heartburn, as we have already found out, the main harm to the esophageal mucosa is caused by gastric hydrochloric acid. Accordingly, in order to neutralize it are widely used drugs class antacids: they reduce the acidity of gastric juice, so that it stops its corrosive effect on the esophageal mucosa.

With heartburn help all antacids, but in general they are divided into two groups: those that are absorbed into the systemic bloodstream and those that are not absorbed into it, “working” only on the inner surface of the intestine.

Absorbable antacids contain calcium and/or magnesium carbonates. They react with gastric juice, neutralizing hydrochloric acid. This produces soluble calcium and magnesium salts, which are excreted by the kidneys.

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By the way, the already mentioned baking soda is also an absorbable antacid, but resorting to its help is still strongly discouraged. Other substances of this subgroup:

• magnesium oxide (“burnt magnesia”);
• a combination of different forms of sodium - bicarbonate, sulphate and phosphate (“Bourget's mixture”).

Non-absorbable antacids do not act as quickly as absorbable, but their action lasts longer (up to 3 hours). The main substances of this subgroup of heartburn medications are:

• aluminum salts of phosphoric acid;
• aluminum-magnesium preparations;
• aluminum-magnesium-silicon or sodium-calcium combinations with the addition of alginate (a product derived from algae ).
• aluminum-magnesium preparations with the addition of simethicone, a “defoamer” that eliminates flatulence (abdominal bloating associated with excessive intestinal gas).

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Proton pump inhibitors (PPIs)

Proton pump inhibitors, or proton pump inhibitors, are antisecretory drugs for heartburn and other acid-dependent conditions: omeprazole, pantoprazole, lansoprazole. They do not act as quickly as antacids, and are used not as an “emergency aid” to relieve symptoms, but to prevent new attacks. PPIs inhibit the synthesis of hydrochloric acid, as a result, the stomach stops producing it in excessive amounts.

H2-histamine receptor blockers/antagonists

H2-antagonists are also antisecretory drugs, as well as PPIs, but they act differently, blocking histamine H2-receptors of parietal cells of the gastric mucosa. Under this influence, not the level of acidity is reduced, but the very production of hydrochloric acid in the stomach.

Like many other drugs, the drugs of this group are divided into “old” and “new” by generation:

• Generation I - cimetidine;
• Generation II - ranitidine;
• III generation - famotidine;
• Generation IV - nizatidine;
• V generation - roxatidine.

Like PPIs, H2-antagonists are also used mainly as part of complex treatment of various GI diseases, one of the symptoms of which mayor may not be heartburn - chronic gastritis, duodenitis, acute and chronic pancreatitis and others.

Home methods and natural remedies to combat heartburn

The most common (and, as we have already found out - the most undesirable and harmful) folk method to fight heartburn remains the same baking soda. Unfortunately, yes. We recommend if not to refuse to take it at all, then at least take it no more than 1-2 times a month.

Sometimes you can get rid of an attack of heartburn by drinking a glass of milk. However, the body of some people, especially adults, reacts to milk without much joy, resulting in heartburn and diarrhea can be added to the heartburn. Orient on your own feelings. If even low-fat milk causes you a “storm” in the stomach - it is better to drink a glass of alkaline mineral water (you can also drink it 50 ml 2-4 times a day - to prevent heartburn). In addition, a useful drink in this case can be a natural carrot juice.

In some cases, chewing gum for 15-30 minutes can help with heartburn. Chewing stimulates the production of saliva, which “washes” acidic gastric juice from the walls of the esophagus.

Good reviews as a remedy for heartburn get raw sunflower seeds. To relieve an attack, it is necessary to eat a handful of these seeds.

Also may be useful and some medicinal herbs. Help from heartburn and for its prevention can decoctions:

• chamomile;
• melissa;
• licorice root;
• licorice root, etc.

And, of course, if you are prone to heartburn, you should limit your intake of certain foods and add foods to your diet that help reduce acidity.

Nutrition for heartburn

If heartburn bothers you often enough - in addition to the obligatory visit to the gastroenterologist, make some changes in your diet, if possible, refusing from:

• smoked, spicy, sour, too salty dishes;
• confectionery and muffin bakery products, rye bread;
• alcoholic beverages, sweet carbonated water;
• canned foods;
• fatty fried meats and fish;
• citrus fruits;
• sour fruits and freshly squeezed fruit juices;
• some fermented milk products, chocolate, tomatoes, ketchup, garlic/onions and other spices and seasonings, hard-boiled eggs (here, as in the case with milk, you should be guided by your own feelings).

There is no specific “strict” diet for heartburn, but in case of increased stomach acidity it is recommended to rely on products that reduce the pH level. Ideally, the diet should consist of:

• cereal porridge, light broths, lean meat and fish;
• raw, baked or boiled vegetables (cucumbers, zucchini, potatoes, carrots), fruits (not acidic). Pears, bananas, persimmons are allowed;
• products containing probiotics (yogurt, kefir, fermented products - sauerkraut, etc.).

In addition, be sure to drink enough water - at least 1.5-2 liters per day for an adult (but only in the absence of contraindications - kidney disease, hypertension, etc.).

Heartburn prevention

For maximum effectiveness, the prevention of heartburn should be comprehensive. First of all, it is necessary to cure diseases that are accompanied by heartburn - to do this, you need to see a doctor and carefully adhere to his recommendations for taking medications.

In addition, it is desirable to:

• stop or minimize the use of alcohol, smoking;
• Do not overeat and, if possible, eat right. A brief basic list of desirable and undesirable products is posted in the previous section - supplement it depending on the individual characteristics of your body;
• avoid deep forward bending for 2-3 hours after eating;
• control body weight in accordance with BMI norms for age and sex, avoid excessive pounds;
• raise the headboard of the bed - sleeping without a pillow or on a very thin pillow can be the cause of morning heartburn. If the headboard is raised at least 20 cm - stomach acid during sleep will remain in the stomach, and not slowly overflow into the esophagus;
• control stress. If willpower, meditation, yoga and other similar techniques do not give results - see a neurologist for the prescription of sedatives;
• if you have gastritis or peptic ulcer disease - monitor your health, take preventive courses in a timely manner.

Be sure to take into account all the information from our today's article. Do not forget that heartburn is often a symptom of serious diseases, and therefore you should not ignore it.