Heartburn

Heartburn is a common ailment that almost all of us have experienced. This characteristic, unpleasant burning sensation in the chest, often radiating towards the throat, can effectively spoil your mood and interrupt the most pleasant moments. Although it is usually a temporary condition, related to diet or lifestyle, it should not be underestimated. Frequent or worsening episodes of heartburn can be a sign of more serious health problems, such as gastroesophageal reflux disease (GERD).

What exactly is heartburn? Mechanism of the problem

To effectively fight heartburn, it is crucial to understand what happens in our body when we feel a burning sensation in the esophagus. Heartburn is not a disease in itself, but rather a symptom whose source lies in the malfunction of the upper gastrointestinal tract.

The main culprit is regurgitation of gastric contents into the esophagus, i.e. gastroesophageal reflux.

Under normal circumstances, there is a muscle called the Lower Esophageal Sphincter (LES) at the border between the esophagus and stomach. It acts as a one-way valve – it opens to let food into the stomach and then closes, preventing the acidic stomach contents from flowing back.

Heartburn occurs when this mechanism fails. The lower esophageal sphincter relaxes at inopportune times or is weakened, allowing hydrochloric acid and digestive enzymes from the stomach to return to the esophagus. The esophageal mucosa, unlike the stomach, is not adapted to contact with such a strongly acidic environment. The acid irritates its delicate walls, which we feel as a painful burning.

Common symptoms of heartburn include:

• Chest burning: The most characteristic symptom, felt behind the sternum. It can intensify after eating, lying down or when bending over.
• Sour or bitter taste in the mouth: The result of gastric contents flowing back into the throat.
• Difficulty swallowing (dysphagia): Feeling like the food is stuck in the throat or esophagus.
• Empty bounce.
• Chronic cough or hoarseness: Especially in the morning, caused by irritation of the vocal cords by acid.

The most common causes of heartburn – what promotes reflux?

The causes of the malfunction of the lower esophageal sphincter are varied and can overlap. They can be divided into three main categories: dietary, lifestyle, and medical, which can affect the digestive system.

Reason No. 1: Your Diet and Eating Habits

What we eat and how we eat has a direct impact on the risk of heartburn. Some foods can relax the lower esophageal sphincter, others increase the production of stomach acid, and others simply linger in the stomach, increasing pressure.

Products that most often cause heartburn:

• Fatty and fried foods: Hamburgers, fries, doughnuts, fatty meats. They slow down gastric emptying and weaken the esophageal sphincter.
• Hot spices: Chili, pepper, curry can aggravate heartburn – causes. They can directly irritate the esophageal mucosa.
• Foods with high acidity can increase the burning and burning sensation in the stomach. Citrus fruits (oranges, grapefruits), tomatoes and their preserves (ketchup, sauces), pineapples.
• Chocolate: It contains methylxanthines, which relax the sphincter muscle.
• Onion and garlic: Especially in their raw form, they are common culprits of heartburn in many people.
• Mint: Although often seen as a remedy for digestive problems, the menthol in it can relax the esophageal sphincter.
• Drinks:
  • Coffee and strong tea: Caffeine weakens the LES, which can lead to heartburn – causes.
  • Alcohol: Especially white wine and beer, have an irritating and relaxing effect on the sphincter.
  • Sodas: Carbon dioxide increases pressure in the stomach, which promotes reflux.

Bad eating habits:

• Eating too large meals: An overfilled stomach exerts mechanical pressure on the sphincter.
• Eating in a hurry: Swallowing large bites and air promotes problems.
• Eating just before bedtime or lying down: The lying position facilitates the reflux of gastric contents.

Cause 2: Lifestyle and Esophageal Health

Our daily lifestyle plays an equally important role in the prevention of heartburn as diet, because heartburn is a common ailment.

• Overweight and obesity: Excess abdominal fat increases intra-abdominal pressure, which “pushes” gastric contents upwards. Losing even a few pounds can bring significant relief.
• Smoking cigarettes can lead to a burning and burning sensation in the esophagus. Nicotine has a multifaceted negative effect: it weakens the lower esophageal sphincter, reduces the production of saliva (which neutralizes acid) and can directly irritate the mucous membrane.
• Wearing tight clothes: Tight pants, belts or shapewear press on the abdomen, increasing pressure in the stomach.
• Stress: Although the mechanism is not fully understood, chronic stress can increase sensitivity to acid and affect gastrointestinal motility.
• Physical inactivity: Regular, moderate exercise helps to maintain a healthy weight and improves digestion. However, you should avoid intense exercise immediately after a meal so as not to exacerbate the symptoms of acid reflux disease.

Cause 3: Medical Conditions and Medications You Take

In some cases, heartburn is a symptom of a specific condition or a side effect of pharmacotherapy, including gastric juice.

• Gastroesophageal reflux disease (GERD): It is a chronic, severe form of reflux. If heartburn occurs twice a week or more and significantly affects your quality of life, you are likely dealing with GERD, which requires diagnosis and medical treatment.
• Hiatal hernia: A condition in which the upper part of the stomach moves above the diaphragm to the chest. This makes it difficult for the sphincter to function properly.
• Pregnancy: Hormonal changes (mainly progesterone) relax smooth muscles, including LES. In addition, the growing uterus presses on the stomach, which can lead to heartburn – the cause. Heartburn in pregnancy is very common, but it usually goes away after childbirth.
• Some medications: Heartburn can be caused by taking:
  • Non-steroidal anti-inflammatory drugs (NSAIDs), e.g. ibuprofen, aspirin.
  • Certain medications for high blood pressure (calcium channel blockers).
  • Anticholinergic and sedative medications that may affect the symptom of gastroesophageal reflux disease.
  • Antibiotics (e.g. amoxicillin) can affect the balance of gastric juice. tetracyclines).

How to effectively fight heartburn? Best practices and tips

The fight against heartburn includes both short-term measures that bring quick relief, and long-term strategies that aim to prevent recurrence.

Heartburn remedies – immediate help and home remedies

When you get burning, you can reach for simple home remedies:

1. Drink a glass of water: It will help to “rinse” the acid back into the stomach and dilute its contents. However, avoid drinking large amounts at once.
2. Reach for herbal infusions: An infusion of chamomile, licorice root (be careful with hypertension) or marshmallow can have a soothing and protective effect on the esophagus. A warm but not hot ginger infusion can help to empty the stomach.
3. Milk or natural yogurt: Although they act temporarily, neutralizing the acid, the effect may be short-lived. In some people, the fat and calcium in milk can stimulate acid production (known as acid rebound) over time.
4. Chew gum (without sugar and mint): It stimulates the production of saliva, which is alkaline and helps neutralize acid in the esophagus.
5. Change position to relieve pressure in the lower esophageal sphincter. Get up, straighten up. Gravity will help keep the stomach contents in place. Avoid lying down and bending over.
6. Sodium bicarbonate: Dissolving half a teaspoon of baking soda in half a glass of water is an old way to neutralize acid quickly. However, it should be used very rarely and with caution, as it can lead to electrolyte imbalances and cause rapid gas secretion in the stomach.

Long-term strategy: Diet and Lifestyle Change

The most effective method of fighting heartburn is prevention. Making lasting changes to your daily habits can eliminate the problem at the source.

• Keep a food diary to better understand what could be causing heartburn is a symptom of a disease that often manifests itself as a burning and burning sensation. Make a note of what you eat and when heartburn appears. This will help you identify your personal “triggers”.
• Eat less and more often: Instead of 3 large meals, eat 5-6 smaller ones. This will prevent your stomach from overflowing.
• Eat slowly and chew thoroughly: You give your stomach time to prepare for digestion and avoid swallowing air.
• Eat your last meal 3-4 hours before bedtime: This is an absolute must. Going to bed with a full stomach is a simple way to nighttime reflux.
• Lift the head of the bed: Place blocks or books 15-20 cm high under the legs of the bed on the head side. Using extra pillows is less effective because it causes a bend in the waist, which can increase pressure on the stomach.
• Reduce body weight: If you are overweight, losing pounds is one of the most effective ways to get rid of heartburn.
• Quit smoking and limit alcohol.
• Choose looser clothes.
• Learn to manage stress: Relaxation techniques, yoga, meditation or even regular walks can bring relief.

Heartburn medications – when and what to use?

When home remedies and lifestyle changes are not enough, pharmacology comes to the rescue. Heartburn medications are available both over-the-counter (OTC) and prescription.

1. Antacids (antacids):
   • How do proton pump inhibitor drugs work in the treatment of heartburn? They neutralize excess hydrochloric acid in the stomach. They work very quickly (within a few minutes), but their effect is short-lived (1-3 hours).
   • Examples: Magnesium, calcium, aluminum compounds can affect the pressure in the lower esophageal sphincter. They are often in the form of lozenges or suspensions (milk).
   • When to use: Temporarily, with occasional episodes of heartburn.
2. H2 receptor blockers (H2 antagonists):
   • Here’s how they work: They inhibit the production of hydrochloric acid by blocking histamine H2 receptors in stomach cells. They start to work slower than antacida (after about an hour), but their effect is much longer (up to 12 hours).
   • Examples: Famotidine.
   • When to use: With more frequent, but still not very severe symptoms. They can be taken preventively before a meal that can potentially cause heartburn.
3. Proton pump inhibitors (PPIs):
   • Here’s how they work: This is the strongest group of drugs. They directly and for a long time block the mechanism (the so-called proton pump) responsible for the secretion of hydrochloric acid. The full effect of their action is achieved after a few days of regular use.
   • Examples: Omeprazole, pantoprazole, esomeprazole.
   • When to use: In the treatment of gastroesophageal reflux disease (GERD), with very common and bothersome symptoms, medications can be used to alleviate the symptoms. They are usually used once a day, in the morning on an empty stomach. Self-treatment should not last longer than 14 days. Long-term PPI therapy should be supervised by a doctor.

When does heartburn become an alarm signal? Time to see a doctor

Occasional heartburn is not a cause for concern, but it is worth observing whether it is not a symptom of the disease. However, there are symptoms that should prompt immediate consultation with a doctor, as they may indicate serious medical conditions, including esophageal or stomach cancer.

Alarm signals (“red flags”):

• Heartburn that occurs more than 2 times a week, persisting for several weeks.
• Pain or difficulty swallowing (dysphagia).
• Pain when swallowing (odinophagia).
• Unintentional weight loss.
• Vomiting, especially with an admixture of blood (“coffee grounds”).
• Black, tarry stools may indicate bleeding from the upper gastrointestinal tract, which is a serious symptom of the disease.
• Iron deficiency anemia (anemia).
• Feeling of a lump in the throat.
• Severe chest pain, especially radiating to the shoulder, neck or jaw – this may be a symptom of a heart attack that requires immediate medical attention!

Summary

Heartburn is an ailment that can significantly reduce the quality of life, but in most cases it is manageable. The key to success is an integrated approach: understanding the mechanism of the problem, identifying individual causes, and implementing appropriate dietary and lifestyle changes. Over-the-counter home remedies and medications can provide temporary relief, but with frequent and persistent symptoms, it is necessary to consult a doctor. Remember that your health is the most important thing, and ignoring chronic heartburn can lead to serious complications. Listen to the signals your body sends you and act consciously to enjoy your well-being every day.