Treating Severe, Chronic Heartburn

If you feel uncomfortable in the middle of your chest every time you finish a meal, you may have chronic heartburn. This is when the acid from your stomach leaks up into the tender tissue of your esophagus (food pipe), causing pain and burning. You need treatment. If you don’t control your heartburn, it could damage your esophagus and even lead to cancer. There are some simple ways to make sure this doesn’t happen to you.

Watch What You Eat, Drink, and Do

Making some changes to your lifestyle can go a long way toward easing the pain of heartburn.

Say goodbye to cigarettes. Smoking causes your body to make less saliva, a liquid that helps stamp out stomach acid. That can lead to burning in your esophagus. Tobacco may also cause your stomach to make more acid and relax the muscles at the lower end of your esophagus that can shut down the opening between the stomach and the esophagus. Chewing gum and sucking on lozenges can help you make more saliva.

Avoid trigger foods. For many people, these are spicy and high-fat foods, chocolate, peppermint and other mints, coffee, citrus fruits or juices, tomato products, carbonated drinks, and onions.

Don’t lie down after you eat. If you need an afternoon siesta, snooze upright (or almost upright) in a chair. Eat dinner at least 2-3 hours before you go to bed, and don’t make the last meal of the day your biggest one.

Raise the head of your bed. If the top of your bed is higher than the bottom, it’s harder for the acid to travel up. You can do this with a block of wood under the bed or a foam wedge under the mattress.

Be careful what medications you use. Aspirin, ibuprofen, and other medications, such as some sedatives and blood pressure drugs, can trigger heartburn. Ask your doctor if any of your medications might be causing your symptoms. There may be something else you can take.

Eat several small meals during the day. Your stomach produces acid based on how much food you eat. Less food means less acid. Don’t overload your stomach.

Limit alcohol. Alcohol can relax the muscles around the lower end of your esophagus, making it easier for acid to bubble up.

Stay slim. One study found that overweight people who lost weight were more likely to have their heartburn go away. Another reason to lose weight: You’ll respond better to heartburn medications.

Wear loose clothing. Tight clothing, including belts, can cause stomach contents to push upward.

Relax. Stress causes stomach acid to bubble up.

Treatments

If you have chronic severe heartburn, you may need medications. Both over-the-counter and prescription drugs are available.

Antacids are usually the first type of drugs doctors recommend for chronic heartburn. You can get them over the counter. They work by stamping out the acid in your stomach. Antacids work right away, but they don’t last long. They also don’t help a damaged esophagus heal. Look for products that have both magnesium and aluminum salts. They’re less likely to cause diarrhea and constipation.

h3 blockers are available over the counter and by prescription. Although they don’t kick in as quickly as antacids, they last longer. They work by slowing down how much acid your stomach makes. They include cimetidine (Tagamet) and famotidine (Pepcid). Ranitidine (Zantac) was removed from the market in 2020 after it was found to contain a cancer causing agent.

Proton pump inhibitors (PPIs) also block acid production. You can get them over the counter or with a prescription.

You may need more than one type of medication. Talk to your doctor about the best treatment plan for you. Make sure you’re aware of the side effects of all the medication you take.

Surgery

The most common surgery for extreme heartburn is fundoplication. The surgeon wraps the top of your stomach around the bottom of your esophagus to strengthen it and help keep the acid where it belongs. This often can be done laparoscopically — it involves only a small cut and typically lets you go home in 3 days or less.

Endoscopic Treatment

The goal of this treatment is the same as surgery. But instead, your doctor puts a thin tube called an endoscope down your throat and into your esophagus. They then use stitches or heat to create scar tissue to tighten the sphincter and stop stomach acid from leaking.

Newer treatments involve using implants (almost like a retaining wall) to keep acid from seeping out of the stomach. There’s not a lot of information yet on how safe they are or how well they work in the long run.

What to eat when you have chronic heartburn

Avoid spicy foods, and keep some dazzle in your diet with low-fat sauces and fresh herbs.

Image: bhofack2/Thinkstock

The fiery feeling of heartburn is the last way you want to remember a great meal. But when your doctor says you have chronic heartburn caused by gastroesophageal reflux disease (see “What is GERD?”), you may worry that a bland and disappointing menu is in your future. “That may not be true,” says Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital. “The foods that trigger heartburn are different for everyone.” He suggests keeping a journal to determine which foods cause symptoms.

Common culprits

Some foods and ingredients may intensify heartburn, such as spicy foods, citrus, tomato sauces, and vinegar.

Fatty and fried foods linger longer in the stomach. That may increase stomach pressure and force open the muscles that keep stomach acid out of the esophagus.

Other common heartburn triggers include chocolate, caffeine, onions, peppermint, carbonated drinks, and alcohol.

What’s for dinner?

You can still enjoy lean meats, fish, poultry, vegetables, legumes, fruits, and whole grains. The trick is making them flavorful.

If spices bother you, try using only small amounts, and be mindful of blends that contain cayenne or chili powder. Or use fresh herbs instead. “Fresh herbs are less concentrated and may be less irritating,” says Emily Gelsomin, a registered dietitian with Harvard-affiliated Massachusetts General Hospital. She recommends using fresh parsley, oregano, and basil.

Another tip: roast your food. “This makes vegetables sweeter. The natural sugars come out and caramelize,” says Gelsomin. Carrots, sweet potatoes, cauliflower, broccoli, squash, and Brussels sprouts work well. Broiling, sautéing, or grilling food also brings out intense flavor.

Eat vegetables raw. “Tomato sauce may bother you, but a fresh tomato may not,” says Gelsomin.

Use sauces but cut the fat. Blend low-fat yogurt with cucumber and basil, or sauté mushrooms in a little olive oil. “Or make a pesto. Blend basil, pine nuts, Parmesan cheese, and a dash of olive oil or water. Use a tablespoon of it on food,” suggests Gelsomin.

Breakfast and lunch

Avoid fatty meats like ham or bacon. “Oatmeal is a great option. Throw in bananas, raisins, and maybe a hint of cinnamon,” suggests Gelsomin. Other possibilities: low-fat yogurt with fruit or nuts, any kind of eggs, whole-grain toast, or a side of chilled whole grains like quinoa mixed with fruit or topped with a dollop of yogurt.

For lunch, think salads with protein such as chicken or beans. “But maybe use a yogurt-based dressing, to avoid vinegar and citrus,” says Gelsomin.

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Why Does Your Heartburn Always Seem Worse at Night? – Cleveland Clinic

You get it after you eat spicy food. You even get it when you wear tight pants and belts. If you suffer from heartburn, you know that burning sensation in your chest is always unpleasant. But you may wonder why it often seems worse when you’re trying to get some sleep. Why is it more likely to flare up at night?

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Blame it on the natural force of gravity. It doesn’t work in your favor when you’re lying down. When you sit or stand, gravity helps move your food through the esophagus and into the stomach where digestion occurs.

“When you’re lying down, you lose gravity’s help in allowing your esophagus to clear food, bile and acids,” says gastroenterologist Scott Gabbard, MD. “That can allow for heartburn to happen.”

While every person’s experience with heartburn is a little different, most people have heartburn symptoms during the day and at night. However, many find it tougher to control at night.

What causes this burning sensation?

When you eat, food passes down your throat and through your esophagus to your stomach. A muscle (the lower esophageal sphincter) controls the opening between the esophagus and the stomach. It remains tightly closed except when you swallow food.

When this muscle fails to close after food passes through, the acidic contents of your stomach can travel back up into the esophagus. Doctors refer to this backward movement as reflux. When stomach acid hits the lower part of the esophagus, it can produce a burning sensation. This is what we call heartburn or, more formally, gastroesophageal reflux disease (GERD).

“About one in 10 adults has heartburn at least once a week, and 1 in 3​ have it every month,” says Dr. Gabbard. “About 10 to 20% of adults have chronic heartburn.”

Tips to reduce nighttime heartburn

Dr. Gabbard recommends these steps you can take to reduce heartburn:

• Lose weight. Body mass index (BMI) takes weight and height into account. People who are overweight (BMI of 25 or above) are at a greater risk for heartburn.
• Stop smoking. Quitting smoking is one of the most important things you can do to help reduce heartburn. One study found that when 141 patients quit smoking, their GERD improved by 44%. However, the 50 people who didn’t quit smoking only saw an 18.2% improvement in their GERD. Quitting tobacco not only does wonders to alleviate heartburn, but it also helps you in other areas of your health.  
• Eat smaller, less fatty meals, especially later in the day. For someone with chronic heartburn, a meal of less than 500 calories and 20 grams of fat is ideal.
• Wait at least three hours after eating to go to bed. It takes the stomach four to five hours to fully empty a meal, so give it at least three hours.
• Try acid-reducing medications. The most commonly prescribed medications for GERD are proton pump inhibitors. While thought to be generally safe, patients with long-term use of these medications should discuss potential risks with their doctors.
• Try alginate preparations. If you need a medication to take on-demand, consider trying a preparation containing alginate. Alginate has been shown to form a raft on top of the pocket of acid that sits in the stomach. It’s been shown to be an effective agent when taken on an as-needed basis.
• Keep food sensitivities in mind. Avoid foods that may trigger digestive problems like tomatoes, lemons, dairy products or even alcohol. 
• Use a body pillow at night. Dr. Gabbard recommends using a body pillow or sleep-positioning device that helps keep you on your left side with your head elevated. Lying on your left side allows acidic contents to pass through the lower esophageal sphincter into the stomach. Plus, elevating your head allows gravity to work.

Is Acid Reflux Bad for You?

You’re just getting home from a dinner date when it hits — that burning sensation in your chest that you always feel after eating spicy Thai noodles. You’re uncomfortable. You can’t sleep. And you can’t figure out how to make it go away.

You’re feeling heartburn, a symptom of acid reflux. According to the American College of Gastroenterology, 15 million Americans experience heartburn every single day. If you experience acid reflux more than two times a week, though, you may have the long-term, persistent gastroesophageal reflux disease, a.k.a. GERD.

We know the word “disease” sounds scary, so you’re probably wondering: Is acid reflux bad for you?

Our answer: Not necessarily. Once you understand acid reflux and GERD and the impact it can have on your health, you can better figure out how to treat your symptoms and keep yourself healthy.

What Is Acid Reflux?

Acid reflux is a condition wherein acid in your stomach escapes upward, back into the esophagus. It looks something like this:

Unlike your stomach, the esophagus is not designed to handle acid. So when acid makes contact with the soft muscle tissue of the esophagus, you might experience the common symptoms of acid reflux, namely chest pain, or a burning sensation behind your breastplate. That’s called heartburn, even though it has nothing to do with your heart (confusing, we know). Other symptoms include:

• asthma and/or shortness of breath (often confused with a heart attack, but heart attacks don’t come with other digestive issues)
• difficulty swallowing and/or sore throat
• dry cough
• dyspepsia or indigestion (recurring pain or discomfort in the upper part of your abdomen)
• nausea
• regurgitation, burping or vomiting
• sour or bitter taste at the back of your mouth (sometimes accompanied by bad breath)

So, what causes acid reflux? Well, a lot of times, it’s what you eat. It’s commonly known that spicy, fried, salty, or fatty foods, like beer and wings are linked to heartburn. But there are many other triggering foods that are often overlooked, like seafood, cheese, alcohol, coffee, and ice cream. Typically, you’ll feel symptoms of acid reflux 2-3 hours after eating these or other trigger foods. And it’s more common to experience acid reflux at night, when acid production peaks for the day.

If you’re experiencing these symptoms every once in a while, following a heavy meal — that’s pretty normal. But if you have chronic heartburn, more than twice a week, it’s a sign of gastroesophageal reflux disease, or GERD. And this means you’re at risk for other digestive diseases.

When Happens if You Don’t Treat Acid Reflux?

Your stomach contents are acidic, so if you have acid reflux on a regular basis, there’s potential for complications. You’ll want to keep an eye on your conditions and stay in touch with your doctor to understand your risk factors and how to keep your reflux in check.

It Can Lead to Tooth Decay

With acid reflux, sometimes acid can make its way into the mouth, which means people with GERD are at risk for tooth decay — the acid can eat away at the lingual (tongue-touching) parts of your teeth. Then there’s dry mouth, a symptom that enables dental bacteria to thrive, which increases your risk for cavities or decay. So be sure to visit your dentist regularly to keep on eye on your oral health.

It Can Interrupt Your Sleep

Because acid reflux is more common at night, it can interfere with sleep, which can be uncomfortable and have dramatic effects on your well-being. The NIH reports a 50% comorbidity rate, meaning that half the people they studied with sleep problems also experience acid reflux.

Why? Partly because laying down means the stomach acid has less gravity to fight to get into the esophagus, so it’s easier for acid to find its way there. On top of that, when you’re horizontal in bed, there’s a higher chance that the acid might stay there longer, increasing your risk for esophageal complications.

To relieve the discomfort, some people have found that it’s more comfortable to sleep on their left side, and/or at an incline (pro tip: put risers under the head of your bed to prop it up), so the stomach acid is less likely to make its way back up into the esophagus. Though it’s not quite clear why, it seems sleeping on one’s right side relaxes the lower esophageal sphincter, making reflux more likely, so patients prefer sleeping on their left side.

Some studies also have shown a correlation between acid reflux and sleep apnea. So in short, if you’re experiencing sleep problems that might be related to heartburn, talk to your doctor.

It Can Make Your Asthma Worse

Studies have also shown significant overlap between asthma and acid reflux — 75% of asthma patients also have GERD. While the relationship isn’t totally clear, it’s been observed that GERD makes asthma symptoms worse, and that asthma makes GERD symptoms worse — especially at night. It may be that acid reflux triggers a nerve that narrows one’s airways, or that damage to one’s esophagus makes breathing difficult.

Either way, if you’re experiencing asthma and acid reflux, it’s recommended that you eat smaller meals, stay fit, and sleep at an incline to mitigate symptoms and discomfort. We also recommend that you see a doctor to understand how to treat these conditions together.

It Can Cause Esophagus Damage and Lead to Esophageal Cancer

While acid reflux is more of a discomfort than a serious health risk, you do need to be vigilant about what’s going on in your digestive tract, especially if you experience frequent acid reflux. According to the NIH, 5% of people with symptoms of GERD may develop Barrett’s esophagus, a risk factor for developing esophageal cancer wherein the esophageal cells transform into cells akin to those in the intestines. And in general, GERD patients are more at risk for esophageal cancer, so it’s important to see your doctor regularly.

How Acid Reflux Interplays With Other Habits & Health Issues

If you experience acid reflux, there are other risk factors you should know about. Smoking has been linked to dysfunction in the lower esophageal sphincter, which means the acid is more likely to move into the esophagus, so it’s a good idea to quit smoking (for this and other reasons) to reduce your risk of reflux and other health problems.

Researchers have also uncovered a correlation between high blood pressure and GERD. Though we don’t understand whether the relationship is correlated or causal, studies show that taking antacids can help maintain normal blood pressure.

With acid reflux, there’s also risk for hiatal hernia, which happens when the upper part of the stomach moves up into the chest through the esophageal opening — it’s not known whether this is a cause or effect of acid reflux.

So what can you do?

There are several ways to treat symptoms and mitigate the effects of acid reflux, including over-the-counter medications (OTC) and prescription drugs.

• Over-the-counter antacids, which neutralize stomach acid (you’ve probably heard of Gaviscon® , Tums®, etc. )
• h3 blockers, which block histamine so your stomach produces less acid. (For example, Zantac® is an h3 blocker).
• Proton pump inhibitors (PPIs), which reduce how much acid your stomach produces, typically faster than an h3 blocker. (You might know them by their brand names: Prilosec®, Prevacid®, Nexium®.)

You can also make lifestyle changes, such as avoiding large meals, reducing your intake of fatty and spicy foods, quitting smoking, and wearing loose-fitting clothes (pressure on your stomach increases the risk of acid reflux).

We know this is a lot of information. Now that you know the symptoms and risk factors of acid reflux, we recommend speaking with a licensed physician, who can diagnose GERD, offer treatment, explain possible side effects, and inform you of other conditions you might be at risk for.

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

6 Symptoms Of Acid Reflux You Should Not Ignore

It’s estimated that 60 to 70 million people in the U. S. are affected by a digestive disease. While that includes everything from chronic constipation to inflammatory bowel disease and pancreatitis, research shows that acid reflux is the most commonly diagnosed of all. And whether it’s due to a physiological reason or the fact that women are more diligent about visiting the doctor, women are diagnosed with GI conditions—including acid reflux—more often than men.

The proper name for acid reflux is gastroesophageal reflux (GER). GER happens when your stomach’s contents move back up toward your esophagus, causing an array of uncomfortable symptoms. It’s extremely common for anyone to experience this on occasion, according to The National Institute of Diabetes and Digestive and Kidney Diseases. But if it happens regularly—more than twice a week for a few weeks—it could be a sign that you have a chronic condition called GERD, or gastroesophageal reflux disease. GERD affects 20 percent of the U.S. population. It’s caused by a malfunction in the lower esophageal sphincter (LES). The LES is supposed to close after allowing food to pass through to the stomach, but when it doesn’t, stomach acid can flow back up where it’s not supposed to be. Over time, GERD can cause damage to the esophagus, including precancerous changes, or lead to respiratory problems like pneumonia, laryngitis, and asthma, so it’s important to get treated.

Though some people are most at risk—pregnant women, smokers, and those who are overweight or obese—acid reflux and GERD can happen to anyone. Here are the most common signs to look out for.

1. Heartburn

This is the most common symptom of acid reflux. “Somewhere between 5 to 10 precent of the population suffers daily heartburn,” Felice Schnoll-Sussman, M.D., gastroenterologist and director of the Jay Monahan Center for Gastrointestinal Health at NewYork-Presbyterian and Weill Cornell Medicine, tells SELF. Heartburn is marked by a burning sensation in the chest, right behind your breastbone, that happens after eating. It can last a few minutes or several hours. Chest pain, especially after bending over or lying down, and burning in the throat are also signs you’re experiencing heartburn. If chest pain is ever paired with shortness of breath or jaw or arm pain, seek medical attention, as you could be experiencing symptoms of a heart attack.

2. Regurgitation

About 80 percent of people with GERD also experience regurgitation, when undigested food and stomach acid move back up from the stomach to the esophagus. You know, that feeling when you kind of burp and get a little taste of your last meal (but, like, mixed with puke). Eating large meals, exercising, or bending over after eating can trigger regurgitation. But it can also happen suddenly.

3. Sour taste in the mouth

“A fair number of people with acid reflux experience a sour taste in their mouth,” Schnoll-Sussman says. It may also seem bitter, and can cause bad breath. This commonly happens along with regurgitation.

4. Difficulty swallowing

This is called dysphagia. Dysphagia makes it take longer to get food down, and can feel like food is sticking in the esophagus. According to the Mayo Clinic, this is caused by GERD-induced damage to esophageal tissues, which can cause the lower esophagus to spasm, scar, and become more narrow.

5. Chronic cough

The reason many people with GERD develop a chronic cough is unclear, but there are two theories in the medical community. One is that cough happens as a protective measure when tiny amounts of acid reaches—and is slightly breathed into—the larynx, which acts as an air passage to the lungs. The other theory is that the cough is simply a reflex reaction to what’s happening in the upper part of your digestive tract.

6. Hoarseness or sore throat

When stomach acid moves up the esophagus, it can irritate the vocal cords. This is often worse in the morning, after lying down all night and may subside during the day. This constant irritation can also make the throat feel a bit sore.

Overview: Symptoms of GERD – About GERD

Is it Simple Heartburn or Is it GERD?

Nearly everyone has heartburn now and then. But heartburn is also the most common symptom of gastroesophageal reflux disease (GERD), so talk to your doctor if:

• Your heartburn happens 2 or more times a week
• Your heartburn gets worse
• Your heartburn happens at night and wakes you from sleep
• You’ve had heartburn now and then, but for several years
• You have difficulty or pain when swallowing
• Your discomfort or pain interferes with your daily activities

Symptoms and Characteristics of GERD

Gastroesophageal reflux disease, or GERD, is a very common disorder. Gastroesophageal refers to the stomach and the esophagus. Reflux refers to the back-flow of acidic or non-acidic stomach contents into the esophagus. There is no known single cause of GERD. It occurs when the esophageal defenses are overwhelmed by stomach contents that reflux into the esophagus.

A band of muscles at the junction of the stomach and esophagus called the lower esophageal sphincter (LES) normally acts, in conjunction with the diaphragm, as a barrier to prevent reflux of stomach contents into the esophagus. If that barrier is relaxed at inappropriate times or is otherwise compromised, reflux occurs.

GERD is characterized by symptoms and/or tissue damage that results from repeated or prolonged exposure of the lining of the esophagus to contents from the stomach. If tissue damage is present, the individual is said to have esophagitis or erosive GERD. The presence of symptoms with no evident tissue damage is referred to as non-erosive GERD.

GERD symptoms are often persistent, such as chronic heartburn and regurgitation of acid. But sometimes there are no apparent symptoms, and the presence of GERD is revealed when complications become evident.

Symptoms of GERD vary from person to person. The majority of people with GERD have mild symptoms, with no visible evidence of tissue damage and little risk of developing complications.

Periodic heartburn is a symptom that many people experience. If it occurs occasionally just after a meal and less than once per week, it is likely a “benign” condition.

Heartburn that occurs more frequently than once a week, becomes more severe, or occurs at night and wakes a person from sleep, may be a sign of a more serious condition and consultation with a physician is advised. Even occasional heartburn – if it has occurred for a period of 5 years or more, or is associated with difficulty in swallowing– may signal a more serious condition. People with long standing chronic heartburn are at greater risk for complications including stricture or a potentially pre-cancerous disease that involves a cellular change in the esophagus called Barrett’s esophagus.

Did you know – heartburn is not the only symptom of GERD

Chronic heartburn is the most common symptom of GERD. Acid regurgitation (refluxed material into the mouth) is another common symptom. But numerous less common symptoms other than heartburn may be associated with GERD. These may include:

• Belching
• Difficulty or pain when swallowing
• Waterbrash (sudden excess of saliva)
• Dysphagia (the sensation of food sticking in the esophagus)
• Chronic sore throat
• Laryngitis
• Inflammation of the gums
• Erosion of the enamel of the teeth
• Chronic irritation in the throat
• Hoarseness in the morning
• A sour taste
• Bad breath

Chest pain may indicate acid reflux. Nevertheless, this kind of pain or discomfort should prompt urgent medical evaluation. Possible heart conditions must always be excluded first.

Relief of symptoms after a two-week trial therapy with a proton pump inhibitor (a prescription medication that inhibits gastric acid secretion) is an indication that GERD is the cause. This can also be confirmed with pH monitoring, which measures the level of acid refluxing into the esophagus and as high as the larynx.

Barrett’s Esophagus

In a small subset of patients with GERD, a complication has been identified as a potentially pre-cancerous condition. The condition is called Barrett’s esophagus. It is a condition in which normal tissue lining of the esophagus has been replaced by abnormal tissue lining called specialized intestinal metaplasia.

Barrett’s esophagus is a risk factor associated with a type of cancer in the esophagus called esophageal adenocarcinoma. In a small number of people with Barrett’s esophagus cellular changes occur in the Barrett’s tissue that are considered pre-cancerous, or more likely to develop cancer than normal tissue.

The number of people who develop Barrett’s esophagus is relatively small. If Barrett’s esophagus is present, talk to your doctor about regular endoscopic screening. In the absence of Barrett’s esophagus, there is no strong evidence that GERD is a risk factor for developing cancer.

Learn more about Barrett’s Esophagus

Adapted from IFFGD Publication: GERD Questions and Answers. Revised 2010 by Ronnie Fass, MD, Chair, Division of GI and Hepatology, Metro Health Medical Center, Cleveland, OH. Original Contributors: Joel E. Richter, MD, Philip O. Katz, MD, and J. Patrick Waring, M.D. Editor: William F. Norton, International Foundation for Functional Gastrointestinal Disorders, Milwaukee, WI.

Frequent Heartburn: Causes and Symptoms

About one in every six adults – nearly 60 million Americans – experience symptoms of heartburn at least once a month. It’s important to really understand what heartburn is, what causes it, and how to avoid it.

Heartburn is usually felt in the chest just behind the breastbone. It’s the pain you feel when harsh stomach contents come into contact with the delicate lining of your esophagus, causing irritation.

It’s important to know that heartburn affects everyone differently. For some, it feels like a burning pain that begins in the chest and moves up towards the throat. For others, it feels like food is coming back up into the mouth, or it’s an acidic or bitter taste in the back of the throat.  

Heartburn pain usually starts soon after you eat and it can increase in severity if you lie down or bend over.

What Causes Heartburn

Heartburn occurs when the lower esophageal sphincter (LES), the natural valve that allows food into the stomach and not out, relaxes or stops functioning properly. When that happens, acidic stomach juices reflux, or flow backward into the esophagus. 

Other factors that can contribute to heartburn include eating acidic foods like tomatoes or citrus foods, drinking alcohol, smoking cigarettes, and certain medical conditions like diabetes or asthma.

In addition, excessive pressure on the abdomen can put pressure on the LES, allowing stomach acid to enter the esophagus or even the mouth. For that reason, if you’re pregnant or overweight, you might be especially prone to heartburn. Even tight fitting clothes can cause pressure that leads to frequent heartburn, as well as lying down or having too full a stomach.

Types of Heartburn

Generally, heartburn experts tend to use three categories to describe heartburn frequency: episodic, frequent, or persistent.

Episodic or occasional heartburn refers to infrequent flare-ups that are fairly predictable and occur less than once a week. For example, you could get episodic heartburn after overdoing it at an all-you-can-eat buffet. This kind of heartburn is usually treated with antacids.

At the other end of the spectrum is severe or persistent heartburn. These are painful, long-lasting episodes of heartburn that may occur most days if not all the time. Persistent heartburn should be treated by a medical doctor.

Frequent heartburn is the middle category problem. This means that you’re experiencing heartburn symptoms two or more days a week. If you’re having symptoms that often, you may want to take a proactive approach by reducing excess acid production that’s causing frequent heartburn, rather than waiting and treating your symptoms every time they occur.

How to Treat Frequent Heartburn

There are a number of heartburn medications to choose from that work differently. Antacids neutralize stomach acid on contact and they’re great for relieving symptoms immediately, but the relief is only temporary.

h3 blockers work by reducing excess stomach acid. h3 blockers begin working within an hour and last up to 12 hours, but they don’t provide the immediate relief of an antacid. Although preventative, h3 blockers might not avert heartburn as long with a single pill compared to a proton pump inhibitor, or PPI.

A PPI like Prilosec OTC is the most frequently recommended therapy to block heartburn for 24 hours with just one pill a day*.

How PPIs Work

When you eat, millions of tiny pumps in your stomach produce acid to break down food. h3 blockers inhibit a portion of the receptors and they last about 12 hours, while PPIs actually shut down some of the pumps, reducing the excess acid that causes heartburn while leaving enough behind to digest your food. PPIs don’t provide immediate relief but they can block heartburn before it starts, and they do it for a full 24 hours with just one pill a day*.

Be sure to talk to your healthcare professional if you think any other medications you’re taking might be contributing to your heartburn. Also ask about alternatives, but never stop taking any prescription medication before checking with your doctor.

90,000 causes and mechanism of development of the disease

Heartburn or a burning sensation along the esophagus, although not a life-threatening condition, can bring a sick person significant discomfort and reduce the quality of life. The answer to the question: “What can be heartburn and how to treat it?”, Is relevant for almost half of the population of Russia ¹ . According to domestic population studies ¹ , an episodic feeling of fever in the esophagus occurs in about half of adult sick Russians.About 10% feel it at least once a week ¹ . In order to find a therapeutic “key” to this condition, it is important to understand its nature and causes of its appearance.

Mechanism of heartburn development

When asked what may cause heartburn after a meal, then “blame” primarily on certain foods. But this is not entirely correct: GER is at the heart of the unpleasant sensations. This frightening abbreviation hides gastroesophageal reflux – the physiological failure of the sphincter that separates the esophagus and stomach.As a result, the acidic contents of the stomach are thrown back into the esophagus ¹ . Prolonged contact of acid, digestive enzymes and other components of gastric juice with the mucous membrane of the esophagus also causes that characteristic burning sensation or discomfort behind the breastbone, accompanied by a sour taste in the throat.

Under normal conditions, the lower esophageal sphincter is in good shape most of the time and does not allow stomach contents into the esophagus.With GER, relaxation becomes so frequent that stomach contents can flow back into the esophagus without hindrance. Typical for GER is the occurrence and / or intensification of unpleasant sensations with errors in the diet, physical stress, consumption of carbonated drinks and alcohol. Thus, heartburn can also be from beer. A number of European population studies have confirmed the relationship between overweight and GER ¹ .

Causes of heartburn

The main causes and factors that can provoke a burning sensation in the esophagus:

1. Diseases of the gastrointestinal tract (GIT).
2. Power supply errors.
3. Bad habits.
4. Pregnancy.
5. Overweight.
6. Side effects of medicines.

Gastrointestinal diseases

Frequent (2 or more times a week) occurrence of heartburn may suggest a full-fledged disease – GERD (gastroesophageal reflux disease) ⁴ . With GERD, discomfort occurs 15-30 minutes after each meal.In most cases, the question “What can cause heartburn every day after eating?” has one answer: GERD. In 75% of cases, the cause of esophageal discomfort is GERD ² .

A burning sensation in the esophagus is also associated with impaired motor function and increased sensitivity of the mucous membrane ⁶ . Hypersensitivity of the esophageal mucosa may be the result of increased psychoemotional stress, excessive stress, depression ⁵ .Therefore, heartburn can be “from the nerves” ⁵ .

Power supply errors

Abuse of fatty, fried, spicy foods can provoke a burning sensation in the esophagus in a susceptible person and in a healthy person . Can there be heartburn from tomatoes? – Most likely, yes ³ . And from coffee? – Probably yes again ⁶ . According to the American College of Gastroenterology, the first step to getting rid of episodic heartburn is to avoid fatty and spicy foods, chocolate, coffee and tomatoes ³ .Foods high in caffeine, such as tea, coffee, and chocolate, contribute to gastrointestinal discomfort. The same can be said about oranges and lemons if a person has a hypersensitivity to citrus fruits. Heartburn can be caused not only by certain foods, but also by a violation of the diet:

• irregular food intake;
• haste while eating;
• overeating (especially before bedtime) ³ .

Bad habits

It’s clear about alcohol, but why can there be heartburn from smoking? Smoking suppresses the secretion of saliva, which neutralizes gastric acid.In addition, tobacco can activate the production of acid by the parietal cells of the stomach and reduce the tone of the lower esophageal sphincter, causing GER ³ .

Pregnancy

During pregnancy, the growing uterus causes an increase in intra-abdominal pressure, which contributes to the development of GER and heartburn.

Overweight

With overweight, the same mechanism of heartburn occurs as during pregnancy. The reason is an increase in intra-abdominal pressure ¹ .

Side effects of drugs

Side effects can cause NSAIDs – non-steroidal anti-inflammatory drugs. They suppress gastrointestinal motility, contributing to the congestion of gastric contents and causing GER ¹ . Other drugs that can cause GER are steroid hormones, cholinomimetics, beta-blockers, nitrates, etc.

Heartburn Treatment

The first recommendation of a gastroenterologist for a patient with a burning sensation in the esophagus is to change the lifestyle:

1. Power supply mode correction.
2. Change in diet.
3. Change in sleep patterns (do not eat two or less hours before bedtime).
4. Weight loss.
5. Quitting bad habits.

If the lifestyle correction does not work, drug treatment is indicated. Here it is pertinent to cite curious statistics: among the residents of Moscow, experiencing a feeling of heat in the esophagus, who are indicated for pharmacotherapy, only 64% ² receive treatment.

So, if you have heartburn every time after eating, then you should consult your doctor for advice. The following drugs may help you:

1. Antacids.
2. Prokinetics.
3. H2-blockers of histamine receptors (H2-blockers).
4. Proton pump inhibitors (PPIs).

This information is for the attention of healthcare professionals:

Antacids neutralize increased stomach acidity.But this is only a momentary solution to a problem that may arise again as soon as the effect of the drug ³ stops.

Prokinetics increase the tone of the lower esophageal sphincter by preventing food backwash. They have been used for mild to moderate GERD,

H2-blockers suppress the production of hydrochloric acid in the stomach, reducing the acidity of the contents thrown into the esophagus, but are inferior in the strength of this effect to proton pump inhibitors.H2 receptor blockers are currently used in patients with PPI intolerance / tolerance ⁷ .

Studies meeting the requirements of evidence-based medicine have demonstrated that PPIs are superior to both H2 blockers and prokinetics in eliminating esophageal burning sensation ⁸ .

Modern therapy for GERD using PPIs allows to adequately control heartburn and improve the quality of life of patients ⁴ .

Thus, it is not so important what causes heartburn. The main thing is that modern medicine has all the means to carry out its treatment.

THERE ARE CONTRAINDICATIONS, PLEASE READ THE INSTRUCTIONS FOR MEDICAL USE OR CONSULT A DOCTOR.

References:

1. Heartburn: modern principles of examination and treatment of patients.Regular issues of “RMZh” No. 21 dated 09.12.2015 p. 1249-1252. Author: Pakhomova I.G. FGBOU VO North-Western State Medical University named after I.I. Mechnikov, Ministry of Health of Russia, St. Petersburg.
2. Heartburn Society. L. B. Lazebnik, D.S. Bordin, A.A. Masharova. Central Research Institute of Gastroenterology, Moscow.
3. Advice from the American College of Gastroenterology (ACG). Digestive Disease Specialists Committed to Quality in Patient Care. Is it just a little HEARTBURN or something more serious? (Digestive health professionals strive for quality patient care.Is it just heartburn or something more serious?) Source: https://www.gastroscan.ru/patient/tips/236/4728. Login from 11/12/2019.
4. Lapina T.L. Heartburn: prevalence, clinical significance, case management. Pharmateca. // Annual collection of selected scientific and medical articles. Gastroenterology. – 2006. – P. 96-103.
5. Lazebnik L.B., Bordin D.S., Kozhurina T.S., Masharova A.A., Firsova L.D., Safonova O.V. A patient with heartburn: tactics of a general practitioner // Attending physician.- 2009. – No. 7. – p. 5-8.
6. Innovative approaches to pharmacological correction of hypersecretory conditions. Authors: Zaichenko Anna Vladimirovna – Doctor of Pharmaceutical Sciences, Professor, Head of the Department of Clinical Pharmacology, Institute for Advanced Training of Pharmaceutical Specialists, National University of Pharmacy, Kharkiv, Bryukhanova Tatyana Aleksandrovna – Candidate of Pharmaceutical Sciences, Assistant of the Department of Clinical Pharmacology of the Institute for Advanced Training of Pharmacy Specialists, National University of Pharmacy, Kharkov.

7. Yurgel V.V., Dusheba E.E., Livzan M.A. Combined therapy proton pump inhibitor and antacid : when this is is needed. Therapist. 2010, 11
8. Shcherbakov P.L. The use of proton pump inhibitors in gastroenterology. // Medicine. – 2012. – No. 4. – P. 47–52.

90,045 90,000 causes, effects and treatment.How to get rid of heartburn?

Probably everyone has experienced this unpleasant state at least once in his life. Sometimes heartburn is a relatively harmless consequence of eating inappropriate food, but often it turns out to be a symptom of serious medical conditions that require urgent treatment.

How to recognize how great the danger is? When is it time to take action and what should they be? How to treat heartburn with medications? The answers to these important questions are in our article.

What is heartburn

A burning sensation in the esophagus as a result of irritation of its mucous membrane – this is how heartburn is manifested. But where do these sensations come from?

The environment of a healthy stomach is acidic, which is due to the action of hydrochloric acid – the main component of gastric juice. In the esophagus, the acidity is close to neutral. Normally, the circular muscle – the sphincter – prevents the reverse movement of food. When it weakens for one reason or another, the acidic contents of the stomach are thrown into the esophagus.This process is called reflux. The walls of the stomach are lined from the inside with a protective film of mucus. Thanks to this, they are not subject to the aggressive action of acid. But there are no glands in the esophagus that produce protective mucus. Therefore, acidic stomach contents erode the mucous membrane of the organ. In fact, nothing more than a chemical burn of the esophagus is observed. This is manifested by a burning sensation, sometimes pain in the chest area.

Most often, heartburn occurs about 15-30 minutes after eating.Sometimes she worries patients at night.

According to statistics, from 20 to 50% of the population of developed countries periodically experience heartburn, while 10–20% experience this condition more often than once a week.

Frequent heartburn not only greatly reduces the quality of life, but also indicates serious health problems, and in itself leads to rather serious consequences.

Causes of heartburn

The immediate cause, as already mentioned, is a weakening of the esophageal sphincter, leading to reflux.The increased content of hydrochloric acid in gastric juice is also important. And these processes, in turn, are observed in many diseases and physiological conditions.

• Gastrointestinal diseases:
• gastroesophageal reflux disease (abbreviated as GERD) associated with insufficiency of the esophageal sphincter. Heartburn usually occurs immediately or 20-30 minutes after eating, often accompanied by belching;
• gastritis with high acidity .The patient feels heartburn 15-30 minutes after eating. This is almost always accompanied by complaints of pain in the epigastric region;
• peptic ulcer . A burning sensation behind the breastbone occurs 15-30 minutes after eating in case of stomach damage and after 1.5-2 hours with localization of the process in the duodenum;
• cholecystitis and gallstone disease.
• Power supply abnormalities. Irregular meals, overeating, eating in a hurry – all this contributes to the weakening of the esophageal sphincter and provokes heartburn.
• Errors in the diet. Fatty, fried, spicy foods, fresh baked goods, tea, coffee, chocolate – the abuse of such food can cause heartburn even in healthy people.
• Taking certain medications , in particular NSAIDs, antihypertensive drugs, can also cause heartburn.
• Unhealthy lifestyle : bad habits (smoking, alcohol abuse), chronic stress.
• Pregnancy is one of the possible causes of heartburn in women.Reflux occurs due to increased intra-abdominal pressure. The same mechanism for the development of heartburn is observed with excess weight.
• Some external factors : tight clothing, heavy lifting and other similar circumstances sometimes provoke heartburn in healthy people.

Consequences of heartburn

The cause of persistent heartburn is most likely a serious medical condition. Therefore, the often arising burning sensation behind the breastbone requires urgent intervention: delay with medical assistance can cost a person health, and sometimes life.

Not only the causes of reflux are dangerous, but the condition itself. With prolonged exposure to acid on the unprotected mucous membrane of the esophagus, an inflammatory disease develops – esophagitis. In some cases, erosion and peptic ulcers are formed, fraught with bleeding. A complication can be cicatricial strictures (narrowing) of the esophagus, which make it impossible for the normal process of eating.

In a number of patients, chronic inflammation leads to degeneration of the epithelium of the esophageal mucosa.This condition is called Barrett’s esophagus (Barrett’s syndrome) and is considered precancerous.

Thus, we see that the consequences of heartburn, if ignored for a long time, can be truly tragic, up to and including adenocarcinoma.

In this context, timely and high-quality diagnostics is of paramount importance.

This is important!
In some cases, a burning sensation behind the breastbone is a medical emergency.Under the “mask” of heartburn, an attack of angina pectoris and myocardial infarction can be hidden. Therefore, for any unusual and alarming symptoms accompanying this condition, you should immediately consult a doctor.

Diagnostics

Diagnostics for heartburn is complex. Careful collection of anamnesis, analysis of patient complaints allow the doctor to choose one or several priority areas of research.

Laboratory tests

A wide range of laboratory methods are used to diagnose the causes of heartburn.

• A general blood test is carried out to determine the level of hemoglobin, erythrocytes, leukocytes, ESR, etc. Deviation of these indicators from the norm indicates violations in the patient’s body. For example, high leukocytosis and ESR are signs of an inflammatory process, and anemia is associated with many diseases of the gastrointestinal tract. A general blood test is not a specific study and allows only indirect conclusions to be drawn for further examination.
• Biochemical blood test determines the content of hepatic and pancreatic enzymes, bilirubin, trace elements, etc.The results help to assess the functions of the liver, pancreas, gallbladder. The study is carried out on an empty stomach.
• A blood test for Helicobacter pylori antibodies is performed on all gastroenterological patients. A positive result confirms the presence of gastritis or peptic ulcer disease associated with this microorganism.
• Analysis of feces (coprogram) is an informative, although not specific, research method that allows you to assess the state and function of the gastrointestinal tract. The presence of pathological inclusions, a violation of the composition of the microflora indicate a disorder of the functions of certain organs.

FGDS

Fibrogastroduodenoscopy allows you to visually assess the condition of the mucous membrane of the esophagus, stomach and duodenum, determine the presence of inflammatory changes, ulcers, tumors, etc.

The examination is performed using an endoscope, which is inserted into the stomach through the esophagus. The image is displayed on the screen. EGD can be combined with biopsy.

To reduce discomfort, the procedure is performed under local or general anesthesia.

Fibrogastroduodenoscopy is an informative and accurate method for diagnosing gastrointestinal diseases. With its help, it is possible with high reliability to make such diagnoses as “gastritis”, “esophagitis”, “peptic ulcer”, etc.

Esophagomanometry

Manometry measures the pressure in the esophagus using a catheter inserted through the mouth or nose.

This diagnostic method examines indicators such as peristalsis of the esophagus, the function of the upper and lower esophageal sphincters.

Esophagomanometry is used to confirm the diagnosis of a disease associated with a violation of the contractile activity of the esophagus, in particular, GERD.

The method is contraindicated in patients with aortic aneurysm, acute destructive esophagitis, in patients in serious condition.

PH-metry

Direct measurement of the pH level in different parts of the stomach, esophagus and duodenum is used to accurately diagnose disorders in diseases associated with changes in acidity.The method helps to choose an effective treatment tactics for GERD, gastritis, duodenitis, peptic ulcer, etc.

Depending on the duration of the procedure, there are short-term, daily and express pH-metry.

The examination is performed using a probe inserted through the mouth or nose. A few hours before the procedure, you need to stop taking food and certain medications.

Contraindications to pH-metry are the same as to manometry of the esophagus and EGD: severe diseases of the cardiovascular system and lungs, blood clotting disorders, old age.

Peculiarities of treatment

To understand how to get rid of heartburn, you need to know what caused it. Rare seizures caused by a violation of the regimen or diet in healthy people do not require special medical intervention and quickly disappear when lifestyle changes.

Another thing is if the patient is worried about frequent heartburn: the reasons for this, most likely, are in the gastrointestinal tract disease.

Treatment of heartburn in such cases is possible only with an integrated approach .Therapeutic measures should be aimed not only at removal of unpleasant symptoms , but also at correction of the underlying disease . Thus, the cause and treatment of heartburn are closely related.

The therapeutic effect usually involves drug therapy . The selection of medicines is carried out by a doctor, taking into account the diagnosis. Most often, drugs are prescribed simultaneously from several groups (at least antacids + gastroprotectors).

Complete relief from heartburn is possible with successful treatment of the underlying disease.

General therapeutic recommendations

In addition to taking medication, dietary adherence and lifestyle correction are of great importance in the treatment of heartburn.

It is necessary to stop smoking and drinking alcohol, establish the correct diet. Food should be taken 4-5 times a day in small portions, chewing thoroughly. It is not recommended to lie down immediately after eating.The last meal should be no later than 3 hours before bedtime.

Fatty and fried foods, hot spices and sauces, carbonated drinks, coffee and strong tea, chocolate, citrus fruits, tomatoes, sour fruits and other foods that provoke heartburn should be excluded from the diet. Good cereals, lean boiled meat, steamed vegetables and low-fat dairy products.

How to deal with heartburn with medication

Medicines for heartburn are prescribed by a doctor strictly according to the indications, based on the diagnosis.Before taking them, you must read the instructions and make sure there are no contraindications.

In diseases of the gastrointestinal tract, accompanied by heartburn, drugs of several groups are used (usually in combination).

Mild heartburn and / or rare attacks

If esophageal burning attacks are rare and mild, the main treatment is to relieve symptoms, reduce reflux, and protect the mucous membrane from acid exposure.

• Antacids
  Antacids are prescribed to eliminate heartburn and relieve stomach pain in acid-related diseases (chronic gastritis, peptic ulcer, GERD).
  The therapeutic effect of antacids is to neutralize the acid contained in the gastric juice. Their action is quick, but short-lived.
  The main active ingredients of this group of drugs are compounds of aluminum, calcium and magnesium, as well as their combinations.
  With prolonged use and overdose of antacids, side effects may occur: diarrhea (magnesium preparations), constipation, symptoms of poisoning (aluminum preparations), etc.
  Antacids are prescribed as symptomatic agents in addition to the main therapy for acid-related diseases.
• Alginates
  Alginates are indicated for use in GERD and non-gastrointestinal heartburn.
  Reacting with hydrochloric acid, the active component of the drug forms on the surface of the gastric contents the so-called “alginate raft” – a gel film with a neutral pH. This prevents reflux from occurring. If the contents of the stomach still enter the esophagus, the “raft” protects the mucous membrane from acid damage.
  The active ingredients of alginates are compounds of alginic acid obtained from brown algae with calcium or sodium.
  Alginates have practically no side effects.
  Drugs in this group are also prescribed as symptomatic treatment of heartburn in combination with other drugs.
• Gastroprotectors
  Symptomatic remedies are not always sufficient for effective treatment of heartburn. At the same time, it is recommended to take gastroprotective agents that affect not only the symptoms, but also the causes of their occurrence.
  Reception of gastroprotectors is indicated for both acid-dependent diseases and heartburn caused by functional disorders of the gastrointestinal tract.
  Gastroprotectors protect the damaged gastric mucosa from the aggressive action of hydrochloric acid and pepsin, forming a thin protective film on its surface. In this case, the drug is retained only in the affected areas. One of the active ingredients of such drugs is bismuth tripotassium dicitrate.
  Possible side effects of gastroprotective agents depend on the type of active ingredient. For example, sucralfate can cause constipation and dry mouth, and misoprostol can cause diarrhea. Bismuth preparations have practically no side effects.

Severe forms and frequent attacks

If the patient is concerned about frequent or severe heartburn, the causes are usually much more serious than the usual functional gastrointestinal disturbance. Most likely, there is an exacerbation of the disease, which requires complex and long-term therapy. In addition to antacids and gastroprotectors, drugs of other groups are prescribed.

• Antisecretory drugs
  Medicines of this group reduce the secretion of hydrochloric acid, are effective in the treatment of peptic ulcer and gastritis.
  There are two types of antisecretory drugs.
  h3-blockers of histamine receptors , in addition to antisecretory action, reduce the formation of pepsin, increase mucus production and increase the resistance of the gastric mucosa to aggressive factors. The active components of drugs in this group are cimetidine, ranitidine, famotidine.
  To prevent recurrence of peptic ulcer disease, h3-blockers are prescribed for long courses (treatment can last for several years). Side effects are rare at low doses.
  Proton pump inhibitors effectively inhibit the secretion of hydrochloric acid. The main active ingredient of this type of drug is omeprazole.
  Proton pump inhibitors do not cause side effects if the course of treatment does not exceed 3 months.
• Prokinetics
  Prokinetics are agents for improving the motor function of the gastrointestinal tract, often used in the complex therapy of peptic ulcer disease, GERD, and functional digestive disorders. This group includes drugs with various active substances and a mechanism of action.The main therapeutic effect of these remedies for heartburn is to increase the tone of the esophageal sphincter and, therefore, prevent reflux.
  Some types of prokinetics have serious side effects, so their intake must be approved by a doctor.

Heartburn is not as harmless as many who experience it are used to thinking. If the attacks are repeated systematically, this is a reason to suspect the disease. In such cases, it is impossible to hesitate, because the consequences can be very serious.With frequent or severe heartburn, you should consult a gastroenterologist for a diagnosis and appropriate medications.

GERD – how or how to overcome it? | Page 3

Do not bend over. Exercise without bending. Squats, pull-ups, deadlifts, lunges, etc. – so many great exercises without bending over. There would be a desire.
You shouldn’t feel like you’re full. And the gases are seething. Intra-abdominal pressure is created, presses on the organs, the organs rise, and hi reflux.

The liquid is drained from the stomach in 10 minutes. I ate an hour before bedtime.
With a headboard – do as you like.

Reflux provokes a cough due to burning of the esophagus with acid – a sore throat and cough.
I have had a cough with a sore throat.
Sputum is another song. Do you smoke? If so, quit.

You chew – chew. Saliva is the first step in digesting carbohydrates – saliva neutralizes the acid in your esophagus as the chewed crackers descend through it. The bread must be dry and not fresh.Otherwise, you will languish from the effect of yeast – they will provoke gases. You cannot eat gas-forming foods.

Yes, I did FGDS – the esophagus is burnt, the cardia is open.

other examinations: OK, biochemistry + liver parameters AST ALT, ultrasound of the abdominal cavity, ultrasound of the gallbladder with function, EGD, blood tests for sensitivity to lactose and sugars, perhaps something else was.

It got better in summer, in July.

Didn’t eat fresh herbs, spices, salt and sugar
Didn’t grind anything, chewed – it satiates better.But if it is convenient for you, grind it, so the food is absorbed faster
Vitamins bought at the pharmacy

Preparations for GERD: pariet 20 mg – 2 times a day, itomed and trimedad 30 minutes before meals and Gaviscon / maalox 15 minutes after meals – not more than 5 tabs per day.
Pariet was replaced by a beret a year later. The drug is weaker, but I was on the mend and there was enough of it. Nolpaza did not help me.

Does cancer scare you? Cancer of the esophagus, as a consequence of the esophagus of the bartet, which can develop as a consequence of GERD.
What’s scarier? I don’t need an answer, I go through this examination once a year, swear and go through. The cardia is closed, the esophagus has healed. I’m healthy

Click to expand …

Gastroenterologist Kovalevich told when heartburn can cause esophageal cancer

Give up fractional meals and snacks

– What foods can provoke an exacerbation? What exactly should be abandoned?

– First of all, from spicy and sour foods. Secondly, from foods that increase gas production (vegetables and fruits with a high fiber content, legumes, carbonated drinks, including kvass, which is loved by many).It is recommended to limit the diet to baked goods, rye and just fresh bread with yeast, black coffee, chocolate, as well as alcohol, especially dry and sparkling wines, beer. Foods that are too hot and too cold also trigger aggravations.

– Also, doctors always advise such patients to eat fractional meals – they eat often, but in small portions.

– According to the latest data, eating 5-6 times a day for GERD has not been proven to be effective. It is now recommended to eat 3-4 times a day in standard portions and refuse snacks.

The fact is that food has a buffer function – mixing with acid in the stomach, it takes part of it on itself and removes it further along the digestive system. Whatever we eat, be it a small nut, acid will still be produced in the stomach. But the nut will obviously not be able to “take it upon himself” – he will leave, but the acid will remain. The same thing happens when we are hungry, thinking about food, or looking at something delicious. That is, we look forward to it. Through different channels of perception, the body receives a signal to prepare, stimulation of the production of acid and other substances promoting digestion begins.Snacks every half hour also “cheer up” the process. In order for food to fulfill its buffer functions, you need to eat in normal portions, not to starve, but also not to overeat.

– Are there foods that lower acidity or can tone the cardia so that it closes better?

– The products do not increase the tone of the cardia and, by and large, do not reduce the acidity in the stomach. In principle, each person has their own rhythm of production of hydrochloric acid in the stomach, if we do not reduce it with special medications.It’s just that some products act more aggressively on the mucous membrane or, using different mechanisms, stimulate secretion more. Therefore, with GERD, it is advised to give up including spicy dishes and spices.

– What is better to eat?

– For breakfast, it is very good, for example, oatmeal, on water, but it is also possible on milk, if the patient tolerates it. It gently “binds” the acid, envelops the mucous membrane, does not irritate it. Buckwheat porridge is also suitable. From vegetables, cauliflower, pumpkin, zucchini are recommended.From the “milk” without exacerbation – everything in small quantities. Sweet fruits and berries are best eaten in the form of jelly, jam, compotes. Kissel is generally the “favorite” drink of gastroenterologists.

– Are there any special recommendations for sleeping too? For example, sleeping on a high pillow?

– A high pillow will not help in any way, it will only cause inconvenience. The position of the upper body matters – the esophagus should be higher than the stomach. Some of our patients put additional bases under the mattresses to lift the body.But this is a recommendation for especially severe cases of GERD.

1/9 Every day is a new day

Maria Trashko

Every day is a new day

01/27/2019

It all starts with awareness.

Someone is now living the life of my dreams. Saturated with events, experiences, interesting people, meetings with these people, trips, accomplishments and whims.

This someone’s desires are projected onto reality.You can call it the power of thought, explain this through a connection with the cosmos, interpret God’s help in this way, or you can simply admit: a person takes full responsibility for the realization of his desires. So they come true.

I seem to have grown to understand the word “responsibility”, and even ready to take it upon myself. If it is insipid to me – I live with this insanity. Or live without it, but for this you need to make an effort.

Whether this effort is effective or environmentally friendly will become clear after a while.

(Under two conditions, necessary and sufficient: I will not be disappointed in the chosen method of rebooting my attitude and I will not forget to keep daily reports (the latter is very likely!))

I declare this year – new. I declare this day new. I declare every day a new day!

28.01.2019

So, a start has been made!

The essence of the experiment on myself (and on whom else to conduct such experiments?) Is as simple as possible: every day, until the pages in my diary run out, I will do one new thing.Every single day. Regardless of mood, employment, health, anticyclones and magnetic storms. It would seem, what could be simpler? Yesterday, for example, I started keeping a diary. I don’t remember that I led him in a disciplined way at a conscious age. I could once a month or two pour on paper everything that had accumulated and had already simply ceased to fit … But so that day after day, methodically, scrupulously … This is the first time with me.

In 365 days, I have to confirm or refute the theory that the acquired new experience has a direct correlation with the level of human well-being and a genuine feeling of happiness.

Over the past day, I have read a billion articles that prove this statement. But these are all theoretical calculations, which are subject to the census of empirical verification.

Today is my second day of creative endeavors. It seemed that so many new things would immediately burst into my life, like a stream of the strongest wind that flies into the room before a thunderstorm, which opens wide the barely opened window and raises the heavy curtain fabrics, but it turned out that the introduction of unusual tasks into everyday life has nothing in common with a momentary, abrupt change.This is more like a healthy habit that you need to persistently instill in yourself every day, stepping over a physiologically debugged wheel that previously worked without interruption. Apparently, inventing an unusual activity for yourself is as difficult as working on early morning wakes day after day or trying to quit smoking.

I find an excuse for myself that both the brain and the body obey the earthly law of conservation of energy. The “new” is interpreted in my head as obviously “complex”, but the mind does not want to work on the “complex”, the energy costs are unprofitable.

In general, I didn’t work with the new one today. At the beginning of the eighth evening, returning home, I had already accepted the fact that my poor overworked head would not give anything constructive today, and, either from lack of ideology, or from despair, I went to the nearest coffee shop for everyone’s adored green matches. And what was my surprise when, instead of a pleasant tea tint, an obsessive, harsh taste of Philadelphia with salmon remained in my mouth! I don’t know how my gastronomic habits brought me to such an associative array, but, for my taste, there was no trace of green tea in my disposable paper cup.

Such are the “radical” innovations. Universe, please, give me at least a teaspoon of fantasy for tomorrow!

01/29/2019

The answer from Space was not long in coming. A new bakery was inaugurated in a nearby neighborhood today, with music, balloons and red ribbon cutting as expected.

Of course, this is not how I drew in my imagination the first meeting with a trdelnik … But, I will indulge myself with hopes that one day, wandering through the Prague streets, I will accidentally wander into a quiet home coffee shop hidden from the eyes of an obsessive tourist and there I will taste a real Czech trdelnik with thick custard and almond petals.

01/30/2019

Family dinners are a disaster!

No, of course I adore my relatives. And mom, and dad, and countless aunts with their beautiful, restless offspring, I love my grandma and grandpa more than life! As a decent daughter and granddaughter, I regularly, twice a week, dial the memorized digits of their mobile numbers and get excited when I see a couple of missing ones from them. We have a great time together, chatting, laughing, supporting each other.But as soon as we gather ALL at one table, a complete mess begins! I don’t remember who exactly said this, but: “If you want to receive a couple of unflattering words in your address, feel free to talk about politics, sex and religion.” And how, well, how does it happen that every time at family dinners we begin meetings with warm hugs and discussions on the topic of work / home / hobbies, and all ends with passionate polemics, the subject of which becomes just one of the three forbidden topics ?!

Okay, anyway, Mom finally let me help her prepare a cream for her signature Napoleon.Now I own a recipe that can seduce anyone! And the whole secret was in whipped cream … Such is the new business.

01/31/2019

Which morning can start better than the one that starts with mom’s sweet cake and a cup of espresso?

Yes, of course, had it been a day off, I would have lazed in bed until twelve, having hammered all the alarms, traffic jams and deadlines, but, alas, the news will not offer itself.

I ordered coffee capsules with sweet cereal notes for the first time.

DO NOT FORGET: the courier will arrive after 20:00!

02/01/2019

Before, I did not understand anything in dreams. Perceived them as a random movie in the TV schedule grid. But, having superficially studied the main theories of dreams and discarding the most absurd from them, I began to decipher the veiled desires of the subconscious, focusing more on the emotional background of sleep than on objects, forms and interior. Very interesting, I advise everyone.

Frankly, it also happens that the conscious part of me completely refuses to perceive the dream and look for any secret meanings in it.And it also happens that all the secret meanings are not so secret.

As in today’s dream, for example. It was a nightmare. I dreamed about how I woke up in the middle of an endless gloomy barn, filled up and down with refrigerators. I open one, and there are snacks: salads, sandwiches, baked eggplants, Korean carrots. The refrigerator is full, as if on the morning of the first of January. And I start to eat. I open another refrigerator – there is seafood: butter cocktails from mussels and shrimp, caviar, cod, trout, there were even jars of sprats! I stuff everything into myself, at least a piece – but I’ll try.The next one is cakes, pastries, pastries. I have nowhere to go, but I still eat. Nauseous – I seize. Vomiting – I vomit and then thrust another piece of eclair through disgust. So I staggered from refrigerator to refrigerator, periodically emptying the contents of my stomach. Heartburn, shortness of breath, colic, cramps, but I still eat and cannot stop.

Sorry Universe. Sorry, I’m absolutely stupid to eat up all the new cases. I will correct, honestly, I will come up with a thousand other new cases, but please, no more mocking my subconscious!

P.S .: Today, for the first time, I counted all the calories I had eaten.

02.02.2019

Once upon a time, a wise and noble king ruled in one kingdom. His people followed him, heeded him, truly loved and were ready to fall for the sake of their ruler. Only one thing was wrong with him: his appearance was as ugly as his soul was beautiful. Many years passed, some generations were replaced by others, but only one thing did not change: the royal descendants were pure in heart and rich in mind. Ugliness was transmitted not to everyone, but only to a few, and the more years passed, the less often a boy with ugly features appeared in the family.But once this fate befell the newborn princess. The girl grew up merciful, mischievous, healthy and did not know about her ugliness. The parents made sure that there were no mirrors left in the kingdom at all, and the people fell in love with the young princess so much that they did not dare to hint to her about the external ugliness. By chance, she found a mirror shard and realized how ugly she really was. In all her life, the princess has not met a girl ugly herself. Something inside trembled, a lump in her throat and tears flowed down her unfortunate face …

Jubilee – Every Single Day Lyrics

[Lyrics of the song “Every single day”]

[Verse]
I have not turned off Playstation for two weeks in a row
Rain in the window is classic Peter, I cannot even go to the store
I don’t go to parties anymore, I don’t answer my friends
Every evening I eat pills and update your contact
Brains fucked all my acquaintances, I told about you
I check your Insta Stories pack twenty times a day
And I hear conversations: “What is this psycho doing there?”
On the iPhone there are ten times more of your photos than mine (So)

[Chorus]
Every single day (I) think of you (Wow)
Every single day (Day) pills and the Internet (Wah-wow)
Everyone every single day stupid TV shows (Wow)
Every single day (Melts away) smoke from cigarettes (Wah-wow)
Every single day (I) think about you (Wow)
Every single day (Day) pills and the Internet (Wah- wow)
Every single day stupid TV shows (Wow)
Every single day (Melts away) with cigarette smoke (Wah-wah)

[Go]
(Every single day) Wow
(Every single day) Wah-wah
(Every single day) Wah
(Every single day) Wah-wah
(Every single day) Wah
(Every single day) Wah-wah
(Every single day) Wow
Wah-wah (So!)

[Chorus]
Every single day (I) think about you (Wow)
Every single day (Day) pills and the Internet (Wah-wow )
Every single day stupid TV shows (Wow)
Every single day (Melts away) with cigarette smoke (Wah-wow)
Every single day (I) think about you (Wow)
Every single day (Day) pills and the Internet (Wow)
Every single day stupid TV shows (Wow)
Every single day (Melts away) cigarette smoke (Wah wah)

[Skeet: Vanessa , Jubilee & Ernesto Shut up ]
* Emoji FM! You will understand us without words *
– And we have a call
– Can you hear me?
– You are on the air, we are listening to you
– Hello, yes.I’m right now … I’m near the lake, and here, right in the center of the lake, there is a huge funnel and it is constantly growing, hello?
– Oh, sounds creepy …?
– Ah, sounds like a prank
– B … You mean? Shouldn’t you do something? I don’t know … you are ma … media, you must have some methods. What do reporters do?
– We are not reporters. This is entertainment radio, man. Entertaiment
– What? You have a responsibility to all of us.You … you influence the minds. You must do something. You … You must have some responsibility!
– All we can do now is advise not to leave the house and warn all your people
– Yes, yes, yes, and keep warm with the warm music Emo … Emoji FM. I heard it all, I heard it all! Therefore, we, therefore, we are all in the ass, because everyone has it that “If only, if only not me,” because everyone does not care about each other and no one cares.All s-s-keep warm with warm music!
– Hello, hello, I can’t hear you well
– Can you hear me? Nobody cares!
– Oh, how hard it is to hear! Psh-psh-psh-psh, ahah, you disappear, oops, oops, the connection seems to be cut off, what a pity, what a pity …
– Back to the music!

90,000 Lifestyle changes helped me stop taking heartburn medication

Courtesy of Amanda Tiberi

I have always struggled with digestive problems, but it was in my sophomore year of college that I got serious heartburn.I often have a burning sensation in my chest or vomiting after taking certain foods.

I ignored it at first, thinking it was just a little indigestion from what I was eating. Eventually I went to a gastroenterologist and started self-medicating with over-the-counter drugs like Tums, except I needed to take at least five pills at the same time for the burning sensation to go away. (The instructions say to take two to four at a time.)

Once I had such a sharp pain in my upper abdomen that I could not get up off the bathroom floor. I finally realized that my problem is serious. My parents immediately took me to the hospital, where my gastroenterologist decided that I needed to have an endoscopy to check for damage to my stomach and esophagus.

During the procedure, a tiny camera was connected and attached to a thin, illuminated tube. went through my esophagus so the doctor could see what was going on.He diagnosed me with a hiatal hernia, which meant that part of my abdomen was bulging through the diaphragm into my chest. This is not uncommon, but it usually does not occur in 19-year-old girls – which is partly why I was not diagnosed earlier. I was shocked and scared that heartburn had damaged my body at such a young age.

When my doctor saw the hernia, he immediately prescribed Nexium, a proton pump inhibitor that prevents the stomach from producing too much acid.I asked if changes could be made to my diet to relieve symptoms, but he advised me to continue to eat the foods I usually eat and the medication should work fine.

Next page: Diet and exercise changes. big difference

Changes in diet and exercise played a big role
The medication really worked great, but I still didn’t really want to take pills every single day for the rest of my life – especially since I was not yet 20 years old.So I started doing my own research and learned about other ways to reduce heartburn symptoms. I began to cut back on foods that cause heartburn – sour or fatty foods like tomato and buffalo sauce, and everything fried.

I was also tested for celiac disease, a condition in which the body doesn’t feel it’s properly processing gluten. The test results were negative, but I still believe that I have an increased sensitivity to gluten, which is causing heartburn.Therefore, I completely gave up bread, pastries and pasta.

Avoiding these foods was an emotional struggle even more than a dietary or dietary one: I spent so many years of my life eating them and in the society situation I still feel bad about not being able to eat what everyone else is eating … But in everyday life, it’s not that difficult, and when I remind myself of how bad these products feel to me, I don’t miss them at all.

I also started to exercise regularly and I have lost 20 pounds since my diagnosis.As I became a healthier diet, I got into jogging and kickboxing. Now I train at least five times a week, and last year I ran 10 km – my first (but definitely not the last) major fitness achievement.

I’m 23 now, but I don’t. I had to take heartburn medication for almost four years. (Until my hernia gets bigger, I won’t need surgery either.) Now I pay a lot of attention to what I eat and try to be as healthy as I can.There are times when I can be wrong and food does affect me, but now I know what I did to cause it.

Before I knew what was happening to my body, I was so disappointed with my constant heartburn. I would go for something as simple as soccer and wings with friends and felt sick for two days after that.

I want people to know that they should not feel trapped in this situation, and this medicine is not always the best or only answer.They can change their lifestyle and forget about it. Once you begin to understand what these changes are for you, you will become a happier and healthier version of yourself.