Heartburn – Causes: Gastroesophageal reflux disease

Heartburn is the symptom par excellence of reflux disease. Typical are burning pains especially behind the breastbone and acid burping.

When food paste mixed with gastric acid flows back from the stomach into the oesophagus, the acid irritates the mucous membrane of the oesophagus. Burning pain is the reaction. The sphincter muscle, which normally prevents this reflux, is then too weak or flaccid. Or the esophageal muscles are unable to push back the stomach contents.

More and more people suffer from a reflux disease (GERD for gastroesophageal reflux disease). A variety of factors can impair the functioning of the sphincter muscle and oesophageal muscles.

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The sphincter muscle can be too weak by nature.

Irritants such as nicotine or certain medications can reduce muscle tension.

It also has a negative effect if the stomach produces too much acid or empties too slowly – wrong eating, alcohol, stress, tight clothing, but also stomach diseases play a role here (see chapter “stomach complaints”).

The esophagus itself can be too narrow or can be altered by pathological influences.

Organic causes include a diaphragmatic hernia, which can occur more frequently in older people, an oesophageal cramp (achalasia), tumours or a tumour (see chapter “Diaphragmatic hernia”).

A reflux disease can cause inflammatory mucous membrane reactions (erosions). These can be detected by endoscopy (see below). Doctors then call the clinical picture ERD (erosive reflux disease; more on this in the chapter “inflammation of the esophagus”). If it runs without erosions, the abbreviation is NERD (non-erosive reflux disease).

Symptoms: Regular heartburn and burping of stomach acid or food residues occur at least once a week, sometimes even daily. This happens mainly after eating or in certain situations, when lying down or bending down, in tight clothing. Stress can also trigger reflux. The burning pain is felt behind the breastbone. If cramp-like pain in the upper abdomen is added, it is more likely to indicate a stomach problem.

In addition, swallowing, swallowing or burping air often causes discomfort and bad taste in the mouth. The tooth enamel can also be affected by the backflowing acid. At night, burping may cause breathing difficulties, and some people find yellow spots on the pillow in the morning. A morning cough, hoarseness, an occupied voice or asthma attacks can also be an expression of reflux. Sometimes these are even the only signs.

Diagnosis: Heartburn is the clearest and most common symptom of reflux disease. The doctor will ask about other complaints as well as life and dietary habits. If symptoms such as difficulty swallowing (dysphagia) or irritable cough are in the foreground, or if the exact questioning reveals that “heartburn” points more in the direction of heart pain, the doctor will take this into account in his diagnosis.

Therapy: The treatment depends on whether the reflux disease is accompanied by inflammation of the esophagus and corresponding damage to the mucous membrane or not. Far more than half of the cases cause unpleasant symptoms, but no lasting damage to the esophagus.

The most important therapeutic goal is then to alleviate or eliminate the symptoms. In general, it helps to live healthier, to avoid intolerable and stomach-irritating foods, to give up smoking, to lose weight when overweight and to counteract stress. Some people sleep better when the headboard of the bed is slightly raised.

The main drugs available for treatment are acid-inhibiting drugs, proton pump blockers (PPI). If a reflux occurs only occasionally and causes only mild symptoms, antacids or H2 receptor antagonists can sometimes help for a limited time. A liquid to be taken (a so-called liquid in pre-dosed bags), which protects the mucous membrane of the oesophagus, can also help to alleviate symptoms. However, such products, which are available over the counter in pharmacies, should not be used regularly or over a longer period of time without consulting a doctor.

Also from the group of proton pump blockers, certain active substances in smaller pack sizes / doses are also available over the counter in pharmacies. However, if the reflux symptoms do not improve after two weeks, it is advisable to visit the doctor or have a repeated check-up. PPIs can also be taken again after an initial treatment of up to four weeks under careful medical supervision if the symptoms recur after a break. Uncritical long-term use without medical consultation should be avoided because of possible risks. Visit http://www.operation.de/news/speiseroehrenentzuendung-erfolgreich-behandeln to know more about heart burn and acid reflux.

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