Effect of Low-Dose Aspirin on Chronic Acid Reflux Esophagitis in Rats

Background:

Clinical role of low-dose aspirin (LDA) in pathogenesis of gastroesophageal reflux disease is by far controversial. This can be attributed to the paucity of basic research detailing the mechanism of LDA-induced esophageal mucosal injury (EI) on underlying chronic acid reflux esophagitis (RE).

Aim:

The aim of this study was to clarify the effect of LDA on chronic RE in rats.

Methods:

Esophagitis was induced in 8-week-old male Wistar rats by ligating the border between forestomach and glandular portion with a 2-0 silk tie and covering the duodenum with a small piece of 18-Fr Nélaton catheter. Seventy-eight chronic RE rat models were divided into five treatment groups, consisting of orally administered vehicle (controls), and aspirin doses of 2, 5, 50 or 100 mg/kg once daily for 28 days. EI was assessed by gross area of macroscopic mucosal injury, severity grade of esophagitis and microscopic depth of infiltration by inflammatory cells.

Results:

Area of esophagitis in animals with aspirin dose of 100 mg/kg/day showed a 36.5% increase compared with controls, although it failed to achieve statistical significance (p = 0.812). Additionally, the rate of severe EI was increased in animals with aspirin dose of 100 mg/kg/day as compared with controls (p < 0.05). The grade of severity correlated with the depth of inflammation (r _s = 0.492, p < 0.001).

Conclusions:

Maximal dose aspirin (100 mg/kg/day) contributed in exacerbating preexisting EI. LDA (2 and 5 mg/kg/day), on the other hand, did not affect chronic RE in this model. LDA seems to be safe for use in patients with chronic RE.

Keywords:

Aspirin; Chronic acid reflux; GERD; Gastroesophageal reflux; Low-dose aspirin; Rat.

Warning: Aspirin-Containing Antacid Medicines Can Cause Bleeding

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The next time you reach for an over-the-counter (OTC) product to treat your upset stomach or heartburn, consider whether you should use one of the many antacids that don’t have aspirin.

Why? Aspirin-containing medicines to treat heartburn, sour stomach, acid indigestion, or upset stomach can cause stomach or intestinal bleeding, especially in some people, warns the U. S. Food and Drug Administration (FDA).

Cases of bleeding are rare. In 2009, FDA issued a warning about serious stomach bleeding risk with aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). Despite that warning, when FDA reviewed its Adverse Event Reporting System database, it found eight new cases of serious bleeding caused by aspirin-containing antacid products since that 2009 warning. Some of those patients required a blood transfusion.

“Take a close look at the Drug Facts label, and if the product has aspirin, consider choosing something else for your stomach symptoms,” says Karen Murry Mahoney, MD, Deputy Director of the Division of Nonprescription Drug Products at FDA. “Unless people read the Drug Facts label when they’re looking for stomach symptom relief, they might not even think about the possibility that a stomach medicine could contain aspirin.”

Mahoney adds: “Today we’re focusing on bleeding risk specifically with antacid-aspirin products used to treat upset stomach or heartburn. We’re not telling people to stop taking aspirin altogether.”

How will you know what OTC medicine to take to get relief from indigestion? Again, it’s important to read the Drug Facts label. It will tell you if the product contains aspirin, and it lists the risk factors for bleeding. If the medicine has aspirin, consider looking for something else. There are plenty of stomach medicines that don’t contain aspirin.

Who’s at Higher Risk of Bleeding

Because aspirin thins the blood, FDA believes the aspirin in these combination medicines is contributing to major bleeding events. People with one or more risk factors have a higher chance of serious bleeding with aspirin-containing antacid products.

You are at higher risk for bleeding with these products if you:

• Are 60 or older.
• Have a history of stomach ulcers or bleeding problems.
• Take drugs that reduce the ability of your blood to clot (also known as anticoagulants or blood-thinning drugs).
• Take steroid medicine, such as prednisone, to reduce inflammation.
• Take other medicines containing NSAIDs, such as ibuprofen or naproxen.
• Drink three or more alcoholic drinks every day.

Warning signs of stomach or intestinal bleeding include feeling faint, vomiting blood, passing black or bloody stools, or having abdominal pain. These are signs that you should consult a health care provider right away.

What if you’ve been taking these products for a long time?

“Some people may have been taking aspirin-containing antacid products frequently for a long time. Apart from the bleeding risk, it’s not normal to have frequent or chronic upset stomach or heartburn. You should talk to a health care provider if that’s happening,” says Mahoney.

Take aspirin regularly? If your health care provider has advised you to take an aspirin a day to help prevent a heart attack or other condition, don’t stop without talking with your doctor first, Mahoney says. Make sure you discuss what kind of medicine you can take in case you get an upset stomach.

How to Settle an Upset Stomach

Consumers have many alternatives for treating heartburn, sour stomach, acid indigestion, and upset stomach. Read the Drug Facts label and look for products that contain an “antacid” or “acid reducer.”

For example, Mahoney says, there are numerous OTC medicines that contain only an antacid, such as calcium carbonate, magnesium hydroxide, or another antacid. These can be used to treat heartburn, sour stomach, acid indigestion, and upset stomach. For frequent heartburn, there are acid reducers, such as proton pump inhibitors (esomeprazole, lansoprazole, omeprazole), or h3 blockers (cimetidine, famotidine, ranitidine).

What Else FDA Is Doing

In 2009, a warning about the risk of serious bleeding was added to the labels of all OTC products that contain NSAIDs, including aspirin-containing antacid products.

FDA is continuing to evaluate this safety issue and plans to convene an advisory committee of external experts in 2017 to provide input regarding whether additional regulatory action is needed, such as adding warnings to the labeling or other actions.

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Is Medication Causing Your Heartburn?

If you get frequent heartburn, you may think that food or drink is to blame. But the culprit may actually be lurking in your bathroom: Certain pain relievers and other common medications can cause heartburn, the most common symptom of gastrointestinal reflux disease, also known as acid reflux.

Almost everyone has experienced heartburn at one time or another. In fact, almost 40 percent of Americans have heartburn symptoms at least once a month.

Heartburn and acid reflux occur when acid or other stomach contents back up into your esophagus, the long tube that carries food from your mouth to your stomach. Sometimes, acid reflux causes a sour taste in your mouth or a burning sensation that may begin under your breastbone before traveling up to your throat.

In some instances, the lower esophageal sphincter (LES), a ring of muscle that helps keep food in the stomach after you swallow, may also become weakened, allowing food and stomach acid to travel back toward the mouth.

If you generally follow a healthy diet but find that you’re experiencing heartburn, or if your heartburn symptoms coincide with starting a medication, you may want to look in your medicine cabinet for possible culprits.

Heartburn Causes: Common Medications

The following common medications can trigger or worsen acid reflux:

• Ibuprofen. This common pain reliever belongs to a family of medications known as non-steroidal anti-inflammatory drugs (NSAIDs). They are available over-the-counter (Advil, Motrin) and also by prescription. Heartburn, abdominal pain, and nausea are common side effects since these medications irritate the lining of the stomach and esophagus. Long-term use can even result in bleeding and stomach ulcers. The best way to avoid these effects is by following the dosage directions on the packaging and by not taking these medications on an empty stomach.
• Aspirin. The “wonder drug” is another NSAID that can cause heartburn and other digestive problems. If you take aspirin for pain relief, acetaminophen (Tylenol) is a good alternative because it has a minimal, if any, effect on the stomach lining. If you take aspirin to help protect your heart, however, be sure to tell your doctor if you experience any stomach trouble or bleeding. Again, most of these issues can be avoided by taking aspirin with food to help minimize its effects on the esophagus and stomach.
• Osteoporosis medications. Bisphosphonates, such as alendronate sodium (Fosomax), ibandronate sodium (Boniva), and risedronate sodium (Actonel), can cause heartburn, nausea, and other gastrointestinal problems. Make sure you take these pills as directed in the patient information insert. Report any new or worsening heartburn, chest pain, or trouble swallowing to your doctor right away.
• Iron supplements. This mineral can help your body to make more red blood cells and fight iron-deficiency anemia, but it can also cause acid reflux, upset stomach, and constipation. Try taking iron pills with food and avoid taking them at bedtime.
• High blood pressure medications. Calcium channel blockers such as nifedipine (Procardia) and beta blockers such as propranolol (Inderal) can also cause heartburn. Speak to your doctor if you are experiencing problems. There are many high blood pressure medications available, and a different type of drug might be just as effective and yet cause fewer side effects.
• Anti-anxiety drugs. Diazepam (Valium) or lorazepam (Ativan) can sometimes cause nausea and heartburn. If your heartburn symptoms persist, your doctor will likely be able to prescribe another anti-anxiety medication instead.
• Tricyclic antidepressants. Amitriptyline (Vanatrip, Endep), imipramine (Tofranil), and nortriptyline (Pamelor, Aventyl) are among the tricyclic antidepressants that can cause acid reflux. Ask your doctor if a drug in another class of antidepressants might have fewer gastrointestinal side effects.
• Antibiotics. The antibiotic tetracycline isused to treat bacterial infections, including pneumonia, but can cause diarrhea, heartburn, and other side effects.

If you suspect that a medication is triggering heartburn, don’t stop taking you prescription drugs on your own. Call your doctor before you take the next dose. Your medical team may be able to make a substitution or suggest ways to prevent heartburn symptoms. Sometimes, simply changing the time of day you take your medication can help.

Cool the Burn With Heartburn Medicine

It’s important to treat heartburn, especially if you experience frequent symptoms. Over time, acid reflux can actually damage your esophagus. Talk to your doctor about whether prescription or non-prescription heartburn medicine is right for you.

There are many over-the-counter heartburn medicines available:

Making lifestyle changes, including losing weight if you are overweight, avoiding late night meals, and quitting smoking may also help put out the fire and ease your heartburn.

GERD: Can certain medications make it worse?

I’ve heard that some medications can aggravate the symptoms of GERD. Can you tell me more?

Answer From Michael F. Picco, M.D.

Certain medications and dietary supplements can irritate the lining of your esophagus, causing heartburn pain. Others can increase the severity of gastroesophageal reflux disease (GERD). GERD is a chronic condition in which stomach acid flows back (refluxes) into your esophagus. This backwash of acid causes irritation and inflammation of the lining of your esophagus.

Medications and dietary supplements that can irritate your esophagus and cause heartburn pain include:

• Antibiotics, such as tetracycline and clindamycin
• Bisphosphonates taken orally, such as alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel, Atelvia)
• Iron supplements
• Quinidine
• Pain relievers, such as ibuprofen (Advil, Motrin IB, others) and aspirin
• Potassium supplements

Medications and dietary supplements that can increase acid reflux and worsen GERD include:

• Anticholinergics, such as oxybutynin (Ditropan XL), prescribed for overactive bladder and irritable bowel syndrome
• Tricyclic antidepressants (amitriptyline, doxepin, others)
• Calcium channel blockers, statins, angiotensin-converting enzyme (ACE) inhibitors and nitrates used for high blood pressure and heart disease
• Narcotics (opioids), such as codeine, and those containing hydrocodone and acetaminophen (Norco, Vicodin, others)
• Progesterone
• Sedatives or tranquilizers, including benzodiazepines such as diazepam (Valium) and temazepam (Restoril)
• Theophylline (Elixophyllin, Theochron)

If you have GERD, ask your doctor if medications you take may affect your symptoms.

• What causes laryngospasm?
• Heartburn medicines and B-12 deficiency

Jan. 22, 2020

Show references

1. MacFarlane B. Management of gastroesophageal reflux disease in adults: A pharmacist’s perspective. Integrated Pharmacy Research and Practice. 2018; doi:10.2147/IPRP.S142932.
2. Mungan Z, et al. Which drugs are risk factors for the development of gastroesophageal reflux disease? Turkish Journal of Gastroenterology. 2017; doi:10.5152/tjg.2017.11.
3. Castell DO. Medication-induced esophagitis. https://www.uptodate.com/contents/search. Accessed Nov. 26, 2019.

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Combining heartburn drugs and aspirin could help prevent oesophageal cancer in people at high risk – Cancer Research UK

In the famous words of Benjamin Franklin: “An ounce of prevention is worth a pound of cure. ”

While he may have been talking about fire safety rather than disease, this sentiment rings true for cancer too. If there was a way to stop cancer from developing, then the stress, costs and side effects that come with a diagnosis and treatment could be avoided.

The challenge is that not all cancers are preventable, and there’s no elixir of life to help us get around the biggest risk factor for the disease – getting older. But some can be prevented – around 4 in 10 in the UK – meaning there’s an opportunity to act and help reduce the burden of the disease.

For cancers where survival remains poor, like oesophageal cancer, there’s potential to make the greatest difference for people. That’s why many of our scientists are working in this area, and new research showcases the progress they’re making.

A new Cancer Research UK-funded clinical trial has found that two over-the-counter, widely available drugs could help cut cases of oesophageal cancer in people at higher risk of the disease. And when these drugs – a stomach acid blocker and aspirin – were used together, their effects were even greater.

“We weren’t expecting such overwhelmingly positive data,” says lead author Prof Janusz Jankowski from the Royal College of Surgeons in Ireland, who is presenting the findings at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

“The drugs caused a reduction in overall death and oesophageal cancers. It really surprised us how big the effect was, the effect for strong acid prevention was 4 times higher than we expected.”

Questions remain, such as who might benefit most from these drugs, and can they specifically prevent deaths from oesophageal cancer? But the findings mark an important step towards progress against a disease that has lagged others.

Risk and reason

Oesophageal cancer begins in the food pipe (oesophagus). The disease often doesn’t cause clear symptoms during its early stages, meaning many cases are diagnosed late when they’ve spread and become difficult to treat. That’s one of the main reasons why survival for oesophageal cancer is stubbornly low, with just over 1 in 10 people surviving their disease for a decade or longer.

It’s time for this grim situation to be turned around, and our researchers are showing that’s possible.

This latest study centres on one of the risk factors for oesophageal cancer, a condition called Barrett’s oesophagus. This is where the cells that line the food pipe change from a layered, brick wall to looking more like a picket fence. Normally, this happens because of stomach acid making its way up the food pipe (acid reflux) and damaging the cells.

Over time, these cells can become so different to healthy cells that they turn cancerous. This only happens to between 1 and 5 people in every 100 with Barrett’s oesophagus, but with acid reflux on the rise, there’s an opportunity to intervene and make a difference.

Mining for gold

For the study, scientists wanted to find out whether giving people with Barrett’s oesophagus a drug – called a proton pump inhibitor (PPI) – to treat their acid reflux could prevent their condition from worsening, and cut cases of oesophageal cancer. They also wanted to test whether adding aspirin could have a beneficial effect too.

Working across the UK and Canada, the team recruited more than 2,557 adults with Barrett’s oesophagus and randomly assigned them one of four treatments every day:

• A high dose of PPI with aspirin
• A high dose of PPI without aspirin
• A low dose of PPI with aspirin
• A low dose of PPI without aspirin

These people were then followed for an average of 9 years, amounting to a mammoth 20,000 years of patient data.

“It’s the longest of its kind in terms of follow up,” says Jankowski. “And no one had ever looked at combining PPIs and aspirin before for cancer prevention. That’s meant it’s been building a real gold mine for data collection.”

When they dug into this data gold mine, they found that high dose PPI treatment not only reduced progression of people’s Barrett’s oesophagus, but cases of oesophageal cancer and the number of people dying from any cause were lower too. And when aspirin was added in to the mix, the effect was even greater.

“We were expecting PPI treatment to maybe reduce cases of oesophageal cancer by about 5%,” says Jankowski.

“But we found the reduction was more like 20% in people given a high daily dose, which took us all by shock.”

Importantly, the drugs seemed to be safe too, with very few people experiencing side effects. But this is an important concern with using drugs to prevent cancer in this way, particularly aspirin, which is linked with bleeding risks when used long-term.

A case for change

So, what is it about this combination that seems to be so effective? While PPIs work by taming the cells’ environment, making it less hostile from the stomach acid, aspirin is thought to have a calming effect on growing cells.

“If we imagine a cell as a car careeing down a motorway, aspirin is like a speed regulator. It slows down cell metabolism and generally dampens down ‘go’ signals that could accelerate growth,” explains Jankowski.

There’s no question of whether this study will be practice-changing.

– Professor Jankowski

“Whereas PPIs are like the truck that sprays grit on the road surface, making it less likely that the car will skid out of control when conditions become unfavourable.”

And with such encouraging results, Jankowski doesn’t think it will be long before the findings will hopefully start helping people outside of clinical trials.

“There’s no question of whether this study will be practice-changing,” he says. “We found low dose PPI therapy isn’t as effective as high dose, so the results could alter their use.”

But there are other questions remaining. How long do patients need to take these drugs for them to have a beneficial effect? Who is most likely to benefit from taking them? And importantly, can they prevent deaths specifically from oesophageal cancer?

These will be the focus of future research. And Jankowski says the researchers are already drawing up plans to extend the study and begin answering these questions. With that clarity, hopefully this work can begin making an impact on people’s lives.

Justine

More on this topic

Aspirin: low dose to prevent heart attacks and stroke

Take low-dose aspirin once a day. Don’t take it on an empty stomach. It’s best to take it with or just after food. This will make it less likely to upset your stomach.

How much should I take?

Your doctor will discuss what dose is right for you. It’s important to take low-dose aspirin exactly as recommended by your doctor.

The usual dose to prevent a heart attack or stroke is 75mg once a day (a regular strength tablet for pain relief is 300mg).

The daily dose may be higher – up to 300mg once a day – especially if you have just had a stroke, heart attack or heart bypass surgery.

Different types of low-dose aspirin tablets

Low-dose aspirin comes as several different types of tablet:

• standard tablets – that you swallow whole with water
• soluble tablets – that you dissolve in a glass of water
• enteric coated tablets – that you swallow whole with water. These tablets have a special coating that means they may be gentler on your stomach. Do not chew or crush them because it’ll stop the coating working. If you also take indigestion remedies, take them at least 2 hours before or after you take your aspirin. The antacid in the indigestion remedy affects the way the coating on these tablets works.

You can buy low-dose enteric coated aspirin and low-dose soluble aspirin from pharmacies, shops and supermarkets.

What if I forget to take it?

If you forget to take a dose of aspirin, take it as soon as you remember. If you don’t remember until the following day, skip the missed dose.

Do not take a double dose to make up for a forgotten dose.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicine.

What if I take too much?

Taking 1 or 2 extra tablets by accident is unlikely to be harmful.

The amount of aspirin that can lead to overdose varies from person to person.

Aspirin Low Strength and Heartburn Antacid Extra Strength Drug Interactions

This report displays the potential drug interactions for the following 2 drugs:

• Aspirin Low Strength (aspirin)
• Heartburn Antacid Extra Strength (alginic acid/aluminum hydroxide/magnesium carbonate)

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Interactions between your drugs

Using aluminum hydroxide together with aspirin may decrease the effects of aspirin. Contact your doctor if your condition changes. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Using magnesium carbonate together with aspirin may decrease the effects of aspirin. Contact your doctor if your condition changes. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Citrate, or citric acid, can increase the absorption of aluminum hydroxide. This may lead to elevated blood levels of aluminum, particularly in individuals with reduced kidney function, since aluminum is primarily eliminated by the kidneys. Excess aluminum may deposit and cause problems in various tissues including bone, brain, heart, liver, muscles, and spleen. Over time, weak bones, bone pain, fractures, skeletal deformity, brain disorders, and anemia may develop. Talk to your doctor before using aluminum hydroxide if you have kidney impairment or are on hemodialysis. You should avoid or limit the consumption of citrate-containing foods and beverages (e.G., soft drinks, citrus fruits, fruit juices) during treatment with aluminum hydroxide. Be aware that some effervescent and dispersible drug formulations may also contain citrate and should be restricted as well. Even if you do not have kidney problems, it may be best to separate the dosing of aluminum hydroxide and citrate-containing products by 2 to 3 hours. Talk to a healthcare professional if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

When aluminum hydroxide is taken during enteral nutrition therapy (tube feeding), the tube may get clogged. Therefore, aluminum hydroxide should not be mixed with or given after high-protein tube feedings. The dose should be separated from the feeding by as much as possible, and the tube should be thoroughly flushed before administration of the dose.

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major	Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate	Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor	Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown	No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

How to get rid of heartburn

In a big city, everything is at hand: round-the-clock pharmacies, clinics with doctors and paid examination centers. But sometimes there are health problems far from the familiar world. For example, heartburn can catch a person on a hike. Or an annual two-week trip to a grandmother who lives far from civilization turned into an unpleasant surprise – the same heartburn.

How to deal with this situation? There are some simple tips to help you deal with these difficulties.

Where insidious heartburn awaits you

Before moving on to describing how to deal with heartburn at home, let’s remember when it can appear. This symptom can occur in the following cases.

1. After a hearty meal during a feast.
2. With a sharp physical exertion after the next meal.
3. If breakfast, lunch or dinner was oversaturated with spicy and fatty dishes, sweets with strong natural coffee (and smoked more than one cigarette after).
4. When you have had to eat 1-2 times a day for the last few days.
5. Taking certain drugs that irritate the stomach and esophagus.

In this case, you are a potential contender for the appearance of burning pain in the epigastrium (the area under the sternum). They appear due to the action of the hydrochloric acid of the stomach on the lower esophageal sphincter (the muscle that restricts the passage from the esophagus to the stomach). The situation can be complicated by the long distance from the city or pharmacy, where you can buy medicines. In this case, you will have to find a way to treat heartburn at home. Below are some of them.

Right food is the best antacid for heartburn

Antacids are drugs that neutralize hydrochloric acid in the stomach. All doctors know that the best antacid is food. To correct your heartburn situation, it is important to know a few nutritional tips.

1. Excess hydrochloric acid must be somehow “neutralized”. It is for this that frequent meals in small portions are recommended.Build your daily routine so that every at least 2 hours, there are at least minor snacks. In this case, it is advisable to exclude raw vegetables and fruits. Compared to the usual portions, they will now have to be halved.
2. Drinking water before or immediately after a meal is undesirable, a large volume in the stomach will lead to the production of acid, which provokes the appearance of heartburn. It is better to have a tea party one hour after a meal.
3. If you have to eat on the go, as in the case of driving, try to stock up on moderate temperatures rather than hot drinks.
4. Sometimes it is difficult to change your habits. It is almost impossible to fight with avid coffee lovers. Then it is recommended to drink coffee with milk, it slightly smooths out the irritating effect of caffeine.
5. The surest home remedy for heartburn is to give up poor quality food. Stale, stale, sour food will cause heartburn.

What you need to completely eliminate with heartburn

There is a group of medicinal substances united by a common name – non-steroidal anti-inflammatory drugs (NSAIDs).They are used for colds, joint and muscle pain. This is the most commonly used group of medicinal substances, since they are dispensed without a doctor’s prescription. These are the following drugs:

• “Nimessulide”;
• “Diclofenac”;
• Aspirin or acetylsalicylic acid.

If there are burning pains behind the breastbone while taking such substances, they should be either completely canceled, or taken after meals, and their intake should be minimized. One way to get rid of such heartburn at home is with a minimal course of NSAID treatment.

In case of heartburn, it is strictly forbidden to eat fruits or vegetables immediately after the main meal. These products have a pronounced sokogonny effect (promote the production of hydrochloric acid), which renews heartburn with renewed vigor.

You should also exclude foods that relax the sphincter between the esophagus and the stomach, and those foods that increase the acidity of gastric juice.

What will help with heartburn at home

1. Against the background of general well-being, heartburn may appear after some specific foods.Then the way to get rid of it is to make a food diary and exclude those foods that cause a burning sensation. It is very simple to do everything: you need to write down in time those dishes that were in the diet. When heartburn occurs, note which product most likely worsened the state of health.
2. How to get rid of heartburn at home if it does not go away for a long time? Heartburn appears with an excess of hydrochloric acid in the stomach, provided that it acts on the lower part of the esophagus (in case of failure of the esophageal sphincter). Stomach acid can be easily neutralized: about half an hour after eating, drink something alkaline. Milk has a weak alkaline reaction – 100-200 ml will help you feel better.
3. There are unforeseen situations, for example, intolerance to milk or dairy products in general. In this case, still mineral water can save you. Drinking it in small sips an hour after eating, it can significantly reduce heartburn or get rid of it completely. The main thing is not to drink any drinks before bed!
4. Powdered egg shells are also alkaline.A pinch of crushed shells with water will help relieve an attack of heartburn.
5. Fruit gum can help relieve heartburn. It stimulates salivation, thereby reducing the concentration of acid in gastric juice. But chewing gum should be fruity, not mint, as mint relaxes the lower esophageal sphincter.
6. Aloe juice. Usually, this herb is used to soothe burns, but it can do the same for the stomach. Aloe vera juice will soothe any inflammation of the esophagus and stomach, but it can also have a laxative effect.
7. Everybody in the house has raw potatoes. Drink raw potato juice to relieve heartburn. Place the potatoes in a juicer, then mix the resulting potato juice with any other juice to make it tastier, and drink right away.
8. Warm green tea not only tones, but also helps digestion, has a calming effect on the stomach.

The worst is when any of the above means are powerless. In this case, there is no need to hesitate, as soon as possible, consult a doctor and undergo a full examination.After all, frequent heartburn can cause serious complications!

Source

90,000 Heartburn: How to Fight It?

Usually, the esophageal sphincter is closed and only a small amount of the contents enter, but during pregnancy, the muscles of the lower esophagus are more relaxed, which contributes to worsening heartburn.

In addition to the peculiarities of development, heartburn of pregnant women requires special features in treatment – not all drugs and alternative methods of treating heartburn are suitable for expectant mothers.

Medicines for heartburn from the pharmacy

Usually, with persistent heartburn, doctors, in addition to treating the cause of heartburn, prescribe a number of medicines to patients to help alleviate its manifestations. First of all, antacids are used. This is a group of drugs that neutralize hydrochloric acid produced in the stomach due to their chemicals.

Usually drugs for heartburn are salts of calcium, aluminum or magnesium, which form neutral and not harmful salts in reaction with hydrochloric acid.Then the contents of the stomach do not irritate the walls of the esophagus. These substances do not treat the causes of heartburn – they only alleviate its symptoms. The disadvantage of such funds is their effect on the stool – they often strongly strengthen, and also bind fatty acids and parts of vitamins. It is not recommended to use them constantly.

This group includes Gastal, Rennie, Gaviscon forte.

Antisecretory drugs cause the walls of the stomach to secrete less hydrochloric acid, and this, in turn, leads to a decrease in the aggressiveness of gastric contents, but negatively affects digestion.

These include Omeprazole or Famotidine, they are used in therapy, for example, peptic ulcer disease, gastritis, and they affect the cause of heartburn. They cannot be taken on their own, they have a number of side effects and contraindications, are prescribed in severe cases of heartburn, and are prohibited for pregnant and lactating women.

In addition, for heartburn, prokinetics are sometimes used, which increase the peristalsis of the digestive tract and increase the tone of the muscles of the digestive system.This allows the contents of the stomach to leave it more quickly and more securely locks the muscle between the esophagus and the stomach.

These include Cerukal and Motilium .

Traditional medicine help

Many popular folk remedies are not as good as they seem at first glance, and have very limited use. For example, a well-known remedy – baking soda for heartburn: this is the most extreme and unsafe remedy. It, of course, neutralizes hydrochloric acid, but by irritating the walls of the stomach with the resulting air bubbles, it stimulates its production even more.

Belching from soda is no less discomfort than heartburn. In addition, the systematic intake of soda leads to alkalization of the blood (the environment changes from neutral to alkaline), which leads to impaired blood clotting, headaches and nausea.

Milk intake is also not a very effective and useful remedy.First, not all adults can tolerate milk, and taking it can cause diarrhea. Then it is not clear which was better – heartburn or diarrhea. Secondly, lactic acid, formed when milk is curdled in the stomach, itself provokes the production of new portions of hydrochloric acid and irritates the esophagus.

causes of occurrence, what is the danger, treatment

What is heartburn?

Food passes through the esophagus in about 10 seconds, and then “knocks” on a special valve in the stomach. It opens for a short time, and the food “falls” into the stomach. Sometimes the valve malfunctions and relaxes, ejecting some of the gastric juices back into the lower esophagus. Because of this, the pH balance is disturbed – power Hidrogen, which shows the activity of hydrogen ions (H +) and hydroxide ions (OH−) in a liquid in values ​​from 0 to 14 units. If the concentration of these two elements is equal, then the pH will be neutral, equal to 7 units. An increase in the concentration of hydrogen ions and a decrease in pH values ​​are called acid shift, and a high activity of hydroxide ions is called alkaline.The normal pH for the esophagus is 6-7 units, but when gastric juice is ejected into the esophagus, it drops to 4 and below. The alkaline environment of the esophagus becomes acidic, burning sensation and discomfort appear. This is heartburn.

Why does it arise?

Didn’t have time to have breakfast, dined on semi-finished products or fast food, overeat at dinner and felt a burning sensation behind the breastbone? Improper diet is the first cause of heartburn. Others include stress, being overweight, pregnancy, smoking and alcohol abuse, taking blood pressure medications, aspirin, and even lying down after eating.

What is the danger of heartburn?

If you experience discomfort in the esophagus a couple of times a year, there is nothing to fear. But if heartburn lasts for weeks, it’s time to sound the alarm. A burning sensation in the esophagus is one of the symptoms of almost every disease of the gastrointestinal tract. Gastritis, peptic ulcer, cholecystitis, hernia of the alimentary opening, inflammation of the duodenum, gastroesophageal reflux disease (GERD) and early stage stomach cancer are an impressive list of possible companions of heartburn.

How to treat heartburn?

If a burning sensation in the esophagus is rare for you, then folk remedies can also solve the problem:

• Add a few spoons chamomile petals to a glass of boiling water and wait half an hour. Drink the resulting infusion in small sips three times a day. Alternatively, chamomile tea is suitable.
• If you know that certain foods cause heartburn, limit your intake.Drink a small amount of mineral water with food: it will help cleanse the walls of the esophagus from acid.

If traditional recipes do not help, contact the pharmacy for special drugs:

The most popular and harmless remedies for heartburn are antacids. They contain aluminum, magnesium and calcium, which neutralize the acid in the esophagus. These drugs are known to everyone: Rennie , Gaviscon , Almagel .

If these funds do not cope with constant heartburn, there is only one way – to the doctor. The specialist can prescribe antisecretory drugs , which reduce acid production, or, in extreme cases, stimulants of gastrointestinal motility. We do not recommend taking these drugs without a doctor’s prescription. For example, one of the side effects of antisecretory drugs can be dementia (dementia), an increased risk of heart attack, and kidney failure.

Heartburn is only a signal that we receive as a result of poor nutrition and lifestyle.Listen to your body and do not treat a burning sensation in the esophagus as something completely not worthy of attention.

CardiASK – reliable protection for your heart!

Acetylsalicylic acid is a universal medicine that was invented about 100 years ago by a pharmacologist from England, John Wayne. Now in every home medicine cabinet you can find aspirin or acetylsalicylic acid. Such a wide distribution of the drug provided its versatility – the drug has anti-inflammatory, antipyretic, analgesic and anticoagulant effects.The last of the listed effects is extremely important in the prevention of heart attack and stroke, since it allows acetylsalicylic acid to improve blood rheology, namely, to protect the body from the formation of blood clots and blockage of important vessels of the heart and brain.

What is the difference between CardiASK and ordinary acetylsalicylic acid?

Acetylsalicylic acid is taken for a long time for the prevention of stroke and heart attack, both as a monopreparation and as part of antiplatelet therapy.Therefore, unlike conventional aspirin, CardiASK is covered with a special enteric coating that does not irritate the stomach and protects it from the development of stomach ulcers and heartburn.

There are standards for the prevention of strokes and heart attacks in the world, and acetylsalicylic acid in a dosage of 50 mg and 100 mg is one of the first places. It is in these dosages that CardiASK is produced.

Features of receiving CardiASK

Despite cardiac protocols that recommend continuous use of cardiac aspirin for all people over 40 years of age for the prevention of cardiovascular events, you should consult with your doctor before taking it.

There are contraindications for taking CardiASK, like all aspirins, and first of all it is erosive and ulcerative lesions of the gastrointestinal tract and gastrointestinal bleeding in the active stage and hypersensitivity to acetylsalicylic acid

It is recommended to take CardiASK daily and regularly with plenty of fluids. The duration of taking the drug is determined by the doctor; daily intake of acetylsalicylic acid will be more likely to protect the heart and blood vessels.

As an advertisement

Scientists have named the drug against heartburn as a remedy for the treatment of COVID-19 :: Society :: RBC

Taking the drug famotidine, which is used for heartburn, may improve treatment outcomes for patients with COVID-19 coronavirus infection. This was reported by a group of scientists whose study is published in the journal Gut.

During the study, ten patients with coronavirus infection took 80 mg famotidine three times a day. The median treatment period was 11 days, but ranged from five to 21 days. Scientists assessed the severity of five main symptoms of the disease: cough, shortness of breath, fatigue, headache, loss of taste and smell.

All ten patients noted that after starting famotidine, their well-being improved within one to two days.

Ministry of Health recommends another drug for the treatment of coronavirus

However, the researchers emphasize that it is not yet possible to confirm the effectiveness of famotidine in the treatment of coronavirus due to the lack of available data.

Acetaminophen, Aspirin, and Caffeine | Memorial Sloan Kettering Cancer Center

This document, provided by Lexicomp ^® , contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

Trade names: USA

Excedrin Extra Strength [OTC]; Excedrin Menstrual Complete [OTC] [DSC]; Excedrin Migraine [OTC]; GoodSense Headache Relief [OTC]; GoodSense Migraine Formula [OTC]; Headache Formula [OTC]; Headrin EX Strength Pain Rel [OTC] [DSC]; Pain Reliever Extra Strength [OTC]; Pain Reliever Plus [OTC]; Pain-Off [OTC]

What is this drug used for?

• Used to treat migraines.
• Used to relieve pain.
• This medicinal product may also be used for other indications. Consult your doctor.

What do I need to tell my doctor BEFORE taking this drug?

For all patients taking this drug:

• If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
• If you have had nasal polyps or inflammation in the mouth, face, lips, tongue or throat, unusual hoarseness or shortness of breath while using aspirin or NSAIDs.
• If you have bleeding.
• If you are taking another drug that contains the same drug.
• If you are taking other non-steroidal anti-inflammatory drugs (NSAIDs).
• If you are pregnant, plan to become pregnant, or become pregnant while taking this drug.If you take this drug after 20 weeks of pregnancy, it can cause fetal harm. If you are between 20 and 30 weeks pregnant, take this drug only as directed by your doctor. Do not use this drug after 30 weeks of pregnancy.

Children:

• If your young or adolescent child has signs of flu, chickenpox or other viral infections, or is recovering. There may be an increased risk of developing a very serious condition called Reye’s syndrome. Do not give this drug to a child or teenager who has a viral infection or is recovering from it.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all the medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems. You need to make sure that this drug is safe for your medical condition and in combination with other drugs you are already taking.Do not start or stop taking any medication or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

• Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• Do not take the drug in higher doses than the doctor prescribed. Taking more than the prescribed amount of the drug increases the risk of serious side effects.
• Do not take this drug for longer than your doctor prescribed.
• If you are allergic to tartrazine, consult your doctor. Some products contain tartrazine.
• It is not recommended to use other medicinal products containing acetaminophen. Read the instructions for medicines carefully. Taking too much acetaminophen can lead to liver problems.
• This medicine contains acetaminophen.Liver disorders have been reported during acetaminophen use. In some cases, these disorders required liver transplantation or resulted in death. In most cases, liver problems have occurred in patients taking more than 4,000 milligrams (mg) of acetaminophen per day. Often, patients used not one, but several drugs containing acetaminophen.
• Follow the instructions exactly. Do not exceed your prescribed daily dose of acetaminophen.If you are unsure of the daily dose of acetaminophen, ask your doctor or pharmacist for it. Some patients may take this drug in doses of up to 4,000 milligrams (mg) per day as directed by a healthcare practitioner. Some patients (such as those with liver disease and children) require a lower acetaminophen dose. If you have exceeded your daily dose of acetaminophen, contact your doctor immediately, even if you do not feel worse.
• Consult a physician before drinking alcohol.
• If you are a smoker, consult your doctor.
• There is an increased likelihood of bleeding. Be careful and avoid injury. Use a soft toothbrush and electric shaver.
• Caution should be exercised in G6PD deficiency. Anemia may occur.
• Limit caffeine (such as tea, coffee and cola) and chocolate. When taken with this drug, it can cause nervousness, tremors and tachycardia.
• If you are taking aspirin to prevent myocardial infarction, consult your doctor.
• This drug may interfere with some laboratory tests. Tell all healthcare providers and lab staff that you are taking this drug.
• If you are 60 years of age or older, use this drug with caution. You may have more side effects.
• Tell your doctor if you are breastfeeding. It is necessary to consult if the drug poses any risk to the child.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, some people with this drug can have serious and sometimes deadly side effects. Call your doctor or doctor right away if you have any of the following signs or symptoms, which may be associated with serious side effects:

• Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
• Signs of liver problems such as dark urine, feeling tired, lack of appetite, nausea or abdominal pain, light stools, vomiting, yellowing of the skin and eyes.
• Signs of bleeding such as vomiting or coughing up blood; vomiting like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; non-cyclic vaginal bleeding; bruising that occurs or increases for no reason; bleeding that you cannot stop.
• Confusion of consciousness.
• Movement disorders.
• Feeling extremely tired or weak.
• Severe dizziness or fainting.
• Ringing in the ears.
• Hearing loss.
• Severe headache or inability to relieve pain after the first dose.
• Possible severe skin reaction (Stevens-Johnson syndrome / toxic epidermal necrolysis). This can lead to serious and permanent health problems and sometimes death.Get immediate medical attention if you experience symptoms such as redness, skin swelling with blistering or scaling (with or without a high fever), eye redness or irritation, or ulceration in the mouth, throat, nose, or eyes.
• Very bad stomach ulcers or very bad bleeding can happen with this drug. Taking the drug in high doses or for a long time, smoking or drinking alcohol increases the risk of these side effects.Taking this drug with food does not reduce the risk of these effects. If you have very severe abdominal or back pain, black, tarry stools or blood in your stool, vomit with blood or coffee grounds, weight gain, or unusual inflammation, seek immediate medical attention or medical attention.

What are some other side effects of this drug?

Any medicine can have side effects.However, many people have little or no side effects. Call your doctor or get medical help if these or any other side effects bother you or do not go away:

• Abdominal pain or heartburn.
• Nausea.

This list of potential side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner. Read all the information provided to you. Follow all instructions strictly.

All forms of issue:

• Take with or without food. Take with food if the medicine causes nausea.

Tablets:

• Take this drug with a full glass of water.

Powder:

• Place the powder on your tongue and drink with a full glass of water or other liquid. You can also mix the powder with water and drink.

What should I do if a dose of a drug is missed?

• This drug should be taken as needed.Do not take this medicine more often than prescribed by your doctor.

How do I store and / or discard this drug?

• Store at room temperature in a dry place. Do not store in the bathroom.
• Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so.If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

General information on medicinal products

• If your health does not improve or even worsens, see your doctor.
• You should not give your medicine to anyone and take other people’s medicines.
• Some medicines may have different patient information sheets.If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
• Some medicines may have different patient information sheets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
• If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention.Be prepared to tell or show which drug you took, how much and when it happened.

Use of information by consumer and limitation of liability

This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are appropriate for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient.Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. Check with your doctor for complete information on the possible risks and benefits of taking this drug.Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.

Copyright

© UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.

90,000 Heartburn from pills: what are the causes

5 DAY CLEANING PROGRAM INCLUDES:

1. Consultation of specialists (family doctor, ozone therapist, functional diagnostics doctor)

2. Accommodation in 1 or 2-bed superior rooms.

3. Examination (ultrasound of the abdominal cavity and kidneys, ECG, general blood test, general urine analysis, blood sugar).

4. Analysis of the state of the organism at the Medical Expert Complex by the method of spectral analysis, which allows to reveal: the presence of more than 250 types of parasites, fungi, viruses, bacteria; identify food, household, infectious allergens; pick up the necessary food products; missing vitamins and minerals.

5. Vegetarian diet.

6. Taking herbal teas , which have anti-inflammatory, diuretic, anti-hemorrhoidal and laxative effects, which helps to cleanse the liver and the whole body.

7. Reception of ozonized water , which has anti-inflammatory, anti-Helicobacter effect, increases the activity of gastrointestinal enzymes.

8. Orthograde lavage of the entire alimentary canal with “mountain crystal” will restore absorption processes in the small intestine.The uniqueness of this procedure lies in the fact that 200 m2 of the villi of the small intestine can be cleaned in a short time.

9. Daily enemas, microclysters with ozonized olive oil

10. Therapeutic gymnastics, back and neck massage

11. Ozone therapy is a new non-drug method of treatment, the effect of which is that when therapeutic doses of ozone are introduced into the patient’s body, ozonides are formed in the lipid layer of erythrocyte membranes. This leads to improved microcirculation, activation of immunity, improved oxygen supply to tissues and blood purification. In the basic program, they are used in the form of rectal insufflation with an ozone-oxygen mixture, ozonized water, microclysters with ozonized oil)

12. The process of cleansing the body ends with the procedure of hepatic dyubage.

13. Recommendations for separate nutrition and further improvement with an individual selection of the necessary food products according to the missing vitamins and microelements in the body.

RECOMMENDED COURSE: preventive – 5 days, therapeutic – 10 days!

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