Plenty
of things can be done to avoid simple heartburn that happens from time to time.
It is important to differentiate simple heartburn from persistent heartburn.
This could be a sign of an underlying condition such as gastro oesophageal
reflux disease. If heartburn is regular or persistent, it is important to
consult a doctor in order to receive an accurate diagnosis and proper
treatment.
What is heartburn?
Heartburn
is a burning sensation in the chest behind the sternum. This explains the
"heart" of heartburn. Besides the name and location, heartburn is not
related to chest pain due to heart. Yet, while chest pain or chest pressure may
indicate acid reflux, it is good for anyone suffering or ill looking for an
urgent medical assessment. Possible cardiac conditions should always be
excluded first.
Sometimes
indigestion is used to define heartburn, but this term is imprecise and people
use it to describe something from diarrhoea to belching.
"Dyspepsia"
describes pain in the upper abdomen (below the chest) that resembles that of a peptic
or digestive ulcer. It is important not to complicate dyspepsia with heartburn
because the treatments are completely different.
What causes heartburn?
In
order to help digestion, the stomach produces a very strong acid called
hydrochloric acid. We normally ignore this since the stomach is designed to
withstand this acid. However, the oesophagus or swallowing tube is not protected.
If the acid escapes from the stomach to the oesophagus (gastro oesophageal
reflux), it irritates or damages it.
We
have heartburn when the reflux - the return of the contents of the stomach -
occurs. To avoid this reflux, the lower oesophageal sphincter (LES), a band of
muscles at the lower end of the oesophagus acts as a gate or valve. It allows
the food to pass down and then closes to prevent the return of gastric contents.
This
works well most of the time, but many things such as overeating, obesity, aging
and some medications can compromise this protective mechanism. The hiatal
hernia (protruding from part of the stomach of the abdomen in the chest) can
also compromise the LES function.
If
your ERP does not work well, there are a number of things you can do to promote
reflux and make you suffer heartburn.
Tips to prevent reflux
Your
posture - Gravity plays an important role in controlling reflux. Stopping after
a big meal can overwhelm a less than perfect ERP. Food returns to the oesophagus
and heartburn occurs.
If
you are suffering from heartburn, think about whether it happens after meals,
when you lie down at night or if you take a nap after a meal. Maintaining a
vertical posture until the meal is digested can prevent heartburn.
If
heartburn happens frequently at night, consider raising the head of the bed or
inserting a triangular corner to keep your oesophagus over the stomach.
Avoid
physical exertion after a meal. It contracts the abdominal muscles and forces
food through a weakened sphincter. This is particularly true for tasks
requiring bending such as lifting or cleaning the floor.
How You Eat - How
is perhaps more important than what you eat. A large meal slowly evaporates
from the stomach and puts pressure on the ERP. A snack at bedtime is well
positioned to reflux when you lie down.
It
is better to have timely in the evening so that the food is digested by
bedtime. You could try to have the main meal at lunchtime and a lighter at
dinner time.
All
meals should be eaten in a relaxed environment without stress.
Lesser
meals, upright and relaxed position should help to minimize reflux.
What you eat - Some
foods compromise the ability of the sphincter to prevent reflux, and are best
avoided before bedtime or effort.
These
differ from one person to another, but many recognize these foods as
particularly troublesome:
•
Greases
• Onions
• Chocolate
Alcohol
often causes heartburn by compromising ERP, irritating the oesophagus and
stimulating the production of stomach acid.
Some
other foods may interfere with some people. When you notice that a food causes
your heartburn, try to avoid it or reduce it for a while.
Some
oral medicines will burn if they can rest in the oesophagus. To be sure, always
swallow the medications vertically and wash with water.
Other factors -
excess weight can promote reflux. The excess of abdominal fat exerts pressure
on the stomach and the very loss of a moderate weight makes that many people
feel better.
Pregnant
women are often troubled by heartburn, especially during the first three
months. Some hormones appear to weaken the LES, and the abdomen more and more
congested promotes reflux. Generally, if there has not been a lot of weight
gain during pregnancy, a woman's heartburn improves after childbirth.
Stress
or strong emotion can also affect heartburn.
The
most important measures are suggested by the information mentioned above. Avoid
going to bed or getting tired after meals, and raising the head of the bed is
important.
Early
dinners, smaller meals and the avoidance of fats, chocolate and onions seem
particularly useful. A review of the diet, medications and life stresses can
help you manage the symptom.
When
these measures fail, an antacid preparation can temporarily alleviate the
symptom by neutralizing gastric acid. An antacid containing an alginate will
float in the stomach and avoid reflux by blocking the lower oesophagus. These
are safe if used in moderation and as directed. There are now over-the-counter
drugs that reduce acid production and can be taken safely for a few days until
heartburn decreases.
Complications
If
heartburn occurs for 2 days or more per week despite the measures discussed
above, you should consult your family doctor.
If
you are 50 years old, your heartburn arises on exercise or if you have a family
history of heart disease, you should promptly get medical attention to ensure
that your heart is not the source of pain.
Consult
a physician promptly if you have difficulty swallowing, vomiting, transmitting
blood or significant weight loss.
If
your heartburn is occurring with breathing problems or hoarseness, you should
consult a doctor.
Antidepressant medications
There
are powerful medications that your doctor may prescribe for persistent symptoms,
and tests can be performed to rule out additional diseases. The
acid-suppressing action of these drugs controls the symptom of heartburn, but
the conditions that cause reflux remain. Therefore, heartburn is likely to
return once the drugs are stopped.
Many
people learn to control heartburn without using antioxidant medications. The
posture and dietary modifications mentioned above remain an important part of
the treatment.
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