Heartburn

What is Heartburn and what it feels like?

ID-10090127Heartburn is one of the most common digestive disordersthat usually resolves itself. It expressed in pain in the chest and in sense of burning down the esophagus, just below or behind the breastbone.The phenomenon occurs when a strong acid (hydrochloric acid or gastroenteritis), which serves the stomach to digest food, going back up into the esophagus and causes hypersensitivity, sense of fire and burning at gentle tissue.The feeling can recur frequently and sometimes even daily. The chest pain and burning feeling may worsen while tilting the head forward, when lying flat or while eating. Heartburn may also be more frequent and worsen at night.

Heartburn that appears often is a precursor of Gastro Esophageal Reflux Disease, resulting from a return of gastric and sometimes gallbladder juices into the esophagus.

What is Gastro Esophageal Reflux?

The stomach is a sac-like muscle, and its volume ranges from 50 ml to liter and a half. Stomach secretes acids and enzymes to digest the food that we eat.The stomach wall consists of mucous cells that replenished regularly and thus avoids damage to the stomach wall by the acid,but when the acid from the stomach rises to the esophagus, which is not protected, we feel the burning pain of acid and in case of severe heartburn, that appears often, may be damaged to the esophageal tissue.

In the stomach are found two ring muscles (sphincters), upper and lower, and they are responsible for the entry and exit of food to and from the stomach.The lower sphincter intended to enable exit only of digested food toward the small intestine and the colon and upper sphincter should allow entry only of the new food that we eat.Normally, sphincter between esophagus and the stomach completely seals up the opening and prevents the return of digestive acids up into the esophagus. Weakening of the upper sphincter allows stomach acid or semi-digested food from the stomach to go up into the esophagus and cause a feeling of heartburn.This phenomenon is called: Gastro Esophageal Reflux or Acid Reflux. The back flow of stomach acids worsens while lying down or stoop forward.

What are the common reasons for theheartburn?

Improper nutrition

Increased consumption of caffeine, chocolate, alcohol, carbonated beverages and fatty foods contributes to the weakening of the upper sphincter and increases the risk of heartburn. Foods such as onion, tomato sauce, mint and spicy foods, even though they are not considered unhealthy foods, increase the risk of heartburn.

Medications

Taking sedatives pills, antidepressants, calcium blockers for high blood pressure treatment, may also contribute to the weakening of the upper sphincter and cause heartburn. Drugs from non-steroidal anti-inflammatory group (NSAID)can increase the secretion of gastric acid and in this way increase the appearance of heartburn.

Overweight

Obesity creates pressure on the stomach and can cause the opening of the upper sphincter and consequently crossing of the gastric juices to the esophagus. Overeating is also may cause this kind of pressure, that's why sometimes there is a heartburn after massive meal.

Pregnancy

A quarter of pregnant women complain of heartburn, especially in the third trimester when the intra-abdominal pressure increases. Also, secretion of progesterone during pregnancy contributes to frailty of the muscles, including the upper sphincter.

Hiatal hernia

A hiatal hernia causes abdominal cavity organs squeeze into the lower chest cavity because of the enlargement of the hole in the diaphragm - which can be congenital or due to an increase in abdominal pressure as a result of obesity or other reasons. 10% of the population suffers from this digestive disorder that may also cause to the heartburn.If the hernia is very big it may worsen the symptoms of heartburn due to further weaken of the sphincter at the bottom of the tube of the esophagus.

Stomach obstruction

These obstructions may occur as a result of diabetes, ulcers, scar or tumor that interfere food to leave the stomach to the colon. These blockages cause accumulation of gastric juices and their rise up towards the esophagus.

Additional reasons

Smoking, lack of physical activity, excessive and frequent eating of fast and processed food, ulcers, dysfunction gallbladder, tension and stress, allergies and low level of digestive enzymes - are other factors that contribute to increase heartburn. Abnormal bowel movement that causes colonic inertia due to the excessive use of addictive laxatives - is a crucial reason for the development and worsening phenomenon of heartburn.

How to deal with heartburn?

There are two ways to deal with heartburn and acid reflux the first is to prevent its appearance and the second is the treatment of heartburn as it appears. The most effective way to treat heartburn is to combine both of them.

Prevention of heartburn

Reduce weight to decrease pressure on the stomach.

Begin a healthful diet that does not contain high-fat foods, caffeine, chocolate and alcohol.Avoid acidic foods like tomato based sauces, citrus fruits, vinegar, mustard, garlic, onions and spicyfoods.

Stop smoking.

Try to eat more small meals, even if it means increasing their number during the day rather than a few large meals.

Avoid eatingafter 19:00.

Avoid lying position about three hours after a meal to harness force of gravity to your fight against heartburn.

During sleeping, lay on an elevated pillow, it will prevent the return of food from the stomach towards the esophagus.

Handling of heartburn as it appears

The treatment also can be divided into several parts: remedies, treatment with nutritional supplements and treatment with medications.

Home remedies for heartburntreating

There are a variety of foods that are considered acidity regulates and can help treat heartburn naturally, as a glass of milk 3%, banana, a slice of toast or bread with no spread, roasted almonds with no salt, chewing on ice chips or a teaspoon of baking soda mixed with a glass of water.

As well, lying on your left side may be helpful in relieving heartburn. Lying in this way places the stomach below the esophagus and helps prevent acid crossing to this part.

Supplementation treatment of the heartburn

Aloe Vera juice

Helps to clean and soothing in cases of hypersensitivity and epigastric burning sensation.

Pancreatin and Bromelain

Enzymes from natural sources that are necessary for normal digestive processes. It is recommended to take them after meals.

Papaya enzyme tablets

The papaya considered as fruit that has many nutritional values. It contains a natural enzyme called Papain which has an important role in aiding digestion of protein foods. Enzyme Papain is also used as antacids and thus relieves heartburn and excessive acidity.

B-Complex tablets

Are needed for digestion in our bodies. Studies have shown that leafy green vegetables which rich with vitamin B can be used as an alternative treatment for GERD symptoms.

Medicines for heartburn treatment

Antacids

Antacids are the most commonly used product to treat heartburn. Antacids neutralize the acid in the stomach and should provide some immediate relief.They are the fastest way to relieve the symptomsof heartburn.Most of the antacids contain aluminum salts, magnesium and carbonates salts. Some of them are combined of two salts like Rennie (contains magnesium and calcium carbonate) and some of them contain single component like Tums (contains calcium carbonate).Sometimes antacid is also used as a dietary supplement of calcium, in case that addition of calcium is required.Constant use of antacids over long time will cause a "rebound effect". When gastric acid is neutralized it is leading to PH level to lift and following that rise inacid secretion again after several hours. Therefore prolonged use, on a regular basis of this kind of drugs is not so recommended.

H2 Blockers

H2 Blockers are a group of drugs that help reduce the production of acid in your stomach. They are very effective in providing extended relief. One dose may last up to 8 hours or longer. However, onset of relief may take a few hours. Example for medicine from this group is Famotidine and Gastro.

Proton Pump Inhibitors

Proton Pump Inhibitors (PPIs) are a group of products that help reduce the production of stomach acid like Losec, Lanton and Omepradex. The group belongs to the advanced generation of medicines to treat heartburn, GERD, ulcers, esophagitis and other stomach acid related conditions. When it comes to managing your heartburn symptoms over a 24-hour period, PPIs are generally very effective medications.

Esophageal Reflux in newborns

A phenomenon of Reflux Esophageal is observed at newborn babies. In this population, the sphincter muscle is not yet "due" and not strong enough to seal the passage from stomach to esophagus. As a result, two major problems are caused:Crossing of the digestion acids back into the esophagus causing to the burning strong sensations. In response, there is a significant decrease in infant compliance to receive food through the mouth.

Partially digested food from the stomach goes back up toward the esophagus and emitted through the mouth. As a result, absorption of the important food components like vitamins, minerals, essential amino acids and fatty acids, that are important for proper development of the baby at this crucial stage in his life, is prevented. Can be expected, not cases the common, retardation in growth and development in all spheres. In some cases, you can expect a delay in growth and development of the baby in all spheres.

When should I contact a doctor because of the heartburn? 

DoctorMost of the people who suffer from heartburn report a passing phenomenon that can be dealt with using antacids drugs or those that prevent acid formation. However, there are some situations where it is recommended to see a doctor:

  • When suffer severe heartburn
  • When heartburn is accompanied by chest
  • When heartburn accompanied by hoarseness, coughing or
  • When heartburn combined bleeding from esophagus.

These cases may indicate to the development of inflammation in the esophagus or other diseases, so it is advised to diagnose the condition with a gastroenterologist specialist.

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