Heartburn – what is it. What helps against it?
Almost everyone has experienced heartburn at one time or another. The unpleasant sensation of acid regurgitation, followed by an unpleasant burning sensation in the esophagus and sometimes into the mouth and throat. This is especially common after eating a large meal or drinking a lot of alcohol. In principle, heartburn means nothing more than that some stomach acid reaches the esophagus. While the stomach itself is protected from the aggressive stomach acid by a protective layer, other mucous membranes (and this includes the esophagus) are severely irritated by exposure to gastric juice. This reflux of stomach acid is also known as reflux. In the case of chronic heartburn that occurs repeatedly, the term reflux disease (also: gastroesophageal reflux disease or GERD) is used.
Typical symptoms of heartburn
feeling of prere in the area of the sternum
Feeling of soreness in the throat and esophagus
mild hoarseness and/or sore throat
sour taste in the mouth
Occasional heartburn is usually harmless
If heartburn only occurs from time to time and can be attributed to a special event (such as the consumption of a fatty feast), it is almost always unproblematic. However, anyone who suffers from heartburn more frequently should definitely have the causes clarified by a doctor. Even if the majority of reflux diseases are harmless and can be treated well, heartburn sometimes manifests itself as a symptom of a more serious disease. However, even if the actual cause should be harmless, the correct treatment of heartburn is important. Incorrect treatment methods can make the problem even worse or lead to further sequelae. The clarification of the cause has the highest priority with recurring heartburn.
Can heartburn be prevented?
Depending on the cause, there are a number of things you can do to prevent heartburn. This is how obesity promotes sphincter weakness in the esophagus. Can lead to problems with the general "mechanics" of the abdomen due to higher prere on the stomach (z. B. over the diaphragm). Overweight is usually associated with an unfavorable diet, which can be too acidic or high in fat. If necessary, you should eat appropriate foods in smaller quantities, if you can not or do not want to do without them completely. Exercise can help improve general muscle tone and thus also strengthen the muscle groups involved in heartburn in the esophagus, stomach and abdomen. As a matter of principle, you should avoid nicotine and alcohol if you are prone to heartburn – and also want to live a healthier life in other ways. Timing also plays a role when eating – best not to eat too late in the evening. Nothing should be eaten around four hours before going to bed if the heartburn occurs mainly at night. You can also change the position in bed – the higher your upper body is positioned, the lower the risk that stomach acid can flow back upwards.
How does the doctor diagnose the cause of heartburn?
First, the doctor takes the patient's medical history (anamnesis) in the patient interview, if it is not known to him or her. This is important because heartburn can also be a side effect of other diseases or be related to the use of certain medications. Family history may also be relevant, for example if heartburn is common in the family. The actual cause of heartburn is usually a dysfunction of the sphincter muscle that separates the entrance to the stomach from the upper part of the esophagus. Then stomach contents can rise up into the esophagus (medical term for food pipe). The reason for a malfunction of the sphincter can in turn have many causes.
Common causes of heartburn
sphincter weakness or. Dysfunction of the muscle at the entrance to the stomach
Lush, high-fat meals, if necessary. Alcohol
frequent consumption of acidic foods (z. B. citrus fruits)
certain gastrointestinal diseases (e.g. B. ulcerative colitis, Crohn's disease)
esophageal diverticula (protrusions of the esophageal wall)
Diabetes (due to malfunction of the nerve control of the esophagus)
Important: Heartburn can also be mistaken for early symptoms of a heart attack. So your doctor should also be aware of any pre-existing conditions of your cardiovascular system and include them in his or her considerations.
What examinations does the doctor order?
After an initial physical examination and, if necessary. In addition to blood tests in the laboratory, the doctor can use other methods to diagnose heartburn. Endoscopy (gastroscopy) is a particularly effective means of clarifying the condition of the esophagus and stomach and looking for obvious causes (e.g. B. a sphincter weakness or ulcers) to look for. In this case, tie samples can also be taken directly for histological clarification. Even if tube swallowing is unpleasant for many people, the examination makes sense in many cases. Nowadays endoscopes are much smaller than in the past. Can be swallowed more easily. In addition, sufficient sedation is possible during the examination, so that most patients sleep in a relaxed manner during the examination. Further examination methods are the determination of the pH value (acid measurement) as well as a prere measurement in the esophagus, in order to be able to judge the function ability of the sphincter muscle. Depending on the results of the examinations, the doctor can often already make a definitive diagnosis.
What treatment methods are available for heartburn? Depending on the severity of the heartburn. The cause of this can be treated in very different ways. For mild cases that occur only occasionally, home remedies that can help reduce the acid concentration in the stomach can be helpful. For this, in addition to starchy foods (the liquid. Thus also acid can bind) also means such as sodium bicarbonate or mustard to recommend. In the pharmacy there are also over-the-counter remedies for heartburn. Prescription drugs. Antacids or acid blockers, which can neutralize an excess of gastric acid, are most frequently used. Known products are z. B. Rennie (tablets) or also agents in liquid form such as Maaloxan. Liquid antacids have the advantage that they can often reduce some of the unpleasant heartburn already in the esophagus because they wet the mucosa and neutralize acid. Those who find this too inconvenient or who have problems with the taste of liquid remedies can take tablets against heartburn, which, however, only take effect in the stomach. Without medical advice, however, these remedies should only be used for a short time, especially since they only make sense if the cause is known. Antacids can often alleviate the symptoms, but cannot causally combat an overproduction of gastric acid. Also the sphincter weakness of the esophagus or an infestation of the stomach with Heliobacter pylori cannot be remedied in this way. In the latter case, a certain combination therapy with antibiotics almost always helps to eliminate the bacterium in the stomach and to eliminate the cause of stomach ulcers and an acid overproduction. However, such a bacterial infection must first be verified by appropriate diagnostics. Stress reduction is always recommended. In this case, relaxation techniques (e.g. B. autogenic training) can be helpful.
Surgical treatment of reflux disease
If the heartburn is due to a functional disorder of the esophageal sphincter that cannot be adequately treated with medication, or if ulcers or. If tumors are to be removed, the visit to the surgeon is indispensable. The so-called anti-reflux surgery is the most common procedure to treat heartburn. In this case, the upper part of the stomach is placed around the termination of the esophagus and fixed there with a suture. This supports the activity of the sphincter and can greatly reduce reflux and the associated heartburn. Not all patients can manage without medication after the operation, but an improvement in symptoms almost always occurs.
Heartburn in pregnant women
Pregnant women in particular often suffer from heartburn temporarily. Almost every second woman has corresponding symptoms during pregnancy. Particularly in the last trimester, heartburn increases in pregnant women. This form of heartburn is almost always completely harmless, but it is very unpleasant for many patients.
Why does heartburn occur more frequently in pregnant women??
There are two main reasons that explain the increased incidence of heartburn during pregnancy. On the one hand, the hormonal change ensures that the smooth musculature remains looser. This is to prevent unwanted contractions in the uterine area, but it also has a slackening effect on smooth muscles in other areas of the body. Among other things, this also affects the sphincter between the stomach and esophagus, which explains most of the reflux symptoms. In addition, there is the static "remodeling" of the body during pregnancy. The larger the uterus becomes during pregnancy, the more prere it exerts on other organs. Frequent urination is a typical consequence of the higher prere on the bladder. But the intestines and stomach are also affected, which favors acid rising into the esophagus. Sometimes it is simply the child's "fault" because he or she punches or kicks the mother in an unflattering place. So heartburn is a temporary matter during pregnancy.
What treatment options pregnant women have for heartburn?
As with all conditions during pregnancy, the use of medication is often problematic. Also with the heartburn it is necessary to follow some precautions. Thus, only agents that directly bind gastric acid are recommended. Drugs designed to interfere with acid formation or to empty the stomach more quickly are recommended only after careful consideration of the pros and cons. Consultation with the attending physician is therefore always necessary. However, there are other things pregnant women can do to relieve the discomfort of heartburn, or. prevent them. Foods that bind acids are particularly helpful.