Heartburn is a condition in which fluid from the stomach enters the esophagus (reflux). This fluid can cause inflammation and damage to the mucous membrane of the esophagus, although there are no visible signs of inflammation in most patients. It usually contains acids and pepsin, which are produced in the stomach, and may also contain bile, which enters it from the duodenum. Acid is believed to be the most harmful component. Bile and pepsin can also damage the esophagus, but their role in causing inflammation and damage is not as obvious as the role of acid.
Why is there heartburn?There are quite a few different factors that cause heartburn: from the hiatal hernia to the production of abnormally large doses of acid in the stomach. Let us dwell on the most common reasons.
1. Violations of the lower esophageal sphincter.
Violations can be different, but all reduce the ability of the sphincter to contract and prevent the backflow of fluid from the stomach.
2. A hiatal hernia .
If it is present, a small part of the stomach, which is attached to the esophagus, is pushed up through the diaphragm. Thus, the barrier effect is reduced, and fluid from the stomach can easily enter the esophagus.
3. Contraction of the esophagus. In preventing heartburn, swallowing plays an important role, which causes ring waves of contraction of the muscles of the esophagus, narrowing the lumen of its internal cavity. These contractions are called peristalsis. They push food and saliva into the stomach. However, with problems with peristalsis, acid that has entered the esophagus does not return to the stomach. Pay special attention to the fact that smoking also significantly reduces the reduction of the esophagus. This effect lasts for at least 6 hours after the last cigarette.
4. Medicines. Some medications can cause or increase heartburn. These are anticholinergics,
antihypertensive drugs, bronchodilators,
sedatives and tricyclic antidepressants.
5. Pregnancy. Heartburn can be a serious problem during pregnancy. A growing fetus increases pressure in the abdominal cavity, which causes fluid reflux from the stomach.
Heartburn - treatment and diet
If you are one of the millions of people who suffer from chronic heartburn, you, of course, need to choose the appropriate method of treatment. This may be a lifestyle change, medication, or surgery.
Lifestyle
Doctors advise those with heartburn to start treatment with lifestyle changes. This is due to the fact that approximately 94% of patients can associate her seizures with specific products. It is important that each person listens to his body, especially if he has heartburn. Diet usually helps in most cases.
Drug treatment
- Antagonists of histamine receptors are used to treat conditions when the stomach produces too much hydrochloric acid (the drugs Famotidine, Ranisan, Kvamatel suppress its production, due to which heartburn disappears).
- Treatment with antacids that neutralize acid in the stomach upon contact. The most popular drugs are "Rennie", "Fosfalugel", "Topalkan", "Maalox", "Almagel", etc.
- Proton pump inhibitors (PPIs) are a group of prescription drugs that inhibit acid secretion in the stomach and intestines. Doctors prescribe PPIs for people with heartburn, an ulcer of the stomach or intestines, as well as with excessive production of stomach acid (Omez, Omeprazole, Pariet).
- Stimulating agents are used in patients with slow gastric emptying. They (Raglan, Domstal, Metoclopramide, Gastrosil drugs) accelerate digestion, which prevents acid retention in the stomach, as a result, heartburn decreases or disappears.
Surgical treatment
- Fundoplication is a standard method of surgical treatment of heartburn, in which the bottom of the stomach is wrapped around the esophagus and form a kind of cuff.