Causes and tips: heartburn as a common disease

Heartburn is certainly a common complaint: In Germany, one in two people suffers from it. Most only from time to time, others frequently – and some even chronically. Pregnant women and older people are affected more often than others. We reveal what helps against heartburn.

Heartburn is the leading symptom of reflux disease (gastroesophageal reflux disease):

A burning sensation under the breastbone, especially after meals and when lying down. Around a quarter of people in Western countries have to deal with reflux symptoms once a month or more frequently. Often accompanied by belching of acidic gastric juice. And burping without acid is also possible.

Heartburn usually manifests itself as a burning sensation in the throat and a sour taste in the mouth

Many heartburn sufferers are also familiar with sour belching and a feeling of pressure in the chest area. The burning pain in the chest is caused by the reflux of stomach acid (medically expressed: gastroesophageal reflux) into the esophagus. The symptom itself, i.e. the actual heartburn (medical term: pyrosis) can be quite harmless, but on the other hand it does not always have to be. So do not panic, but if the complaints are severe, frequent or occur permanently, the following applies: To clarify the cause should see the doctor or seek initial advice at the pharmacy.

In order to understand how heartburn develops, it is worth taking a look at how digestion works

Every day, our body produces about two to three liters of gastric juice, the task of which is to process the food pulp and eliminate harmful microorgasnisms. Therefore, the gastric juice with a pH value of 0.8 to 1.5 is also very acidic – i.e. deadly for most germs.

The esophagus is a muscular tube about 25 centimeters long and one centimeter in diameter, covered with mucous membrane. It connects the throat with the stomach. There is a sphincter muscle (esophageal sphincter) at the entrance to the stomach. This resembles a valve that slackens during the swallowing process and opens to the stomach. The contents of the esophagus may flow into the stomach.

Normally, this path is a one-way street. The aggressive and highly acidic gastric juice is no danger to the stomach thanks to its resistant mucous membrane. The esophagus, however, is very sensitive. If the valve leaks and no longer closes properly, the stomach acid can flow back and enter the esophagus. This is quite unpleasant and causes the described symptoms of heartburn, in addition, the esophagus can be irreparably damaged over time.

Heartburn can have various causes:

These include stress or certain dietary habits, such as eating too much fat or too late in the day. Among others, the following reasons can cause a disturbance of the sphincter muscle and thus cause heartburn:

Psychologically stressful situations such as stress excessively stimulate stomach acid production and often trigger heartburn. And certain foods also influence the pressure of the sphincter muscle. Likewise, medications (including some painkillers) may be involved.

Sometimes, however, there are also tangible organic causes:

Possibly a diaphragmatic hernia (a so-called hernia) has occurred. This causes part of the stomach to move through the diaphragmatic opening into the chest cavity. In pregnant women, on the other hand, the hormone progesterone causes the sphincter to slacken, and the greatly enlarged uterus presses against the stomach and, as a result, its contents enter the esophagus. People who are overweight may also experience increased leakage of stomach contents into the esophagus. Heartburn may possibly be a warning signal of an organic disease such as a stomach ulcer or gastritis. For this reason alone, persistent heartburn should be clarified by an examination by a doctor.

Occasional acid regurgitation is initially no cause for concern

If the mucous membrane of the esophagus is regularly confronted with the corrosive gastric juice, it can lead to irritation of the mucous membrane and damage (reflux esophagitis). Under certain circumstances, the mucous membrane is even completely destroyed, internal bleeding or a narrowing of the esophagus can occur. The upper respiratory tract, teeth and gums can also be affected by the refluxing acid. If left untreated, heartburn can lead to a disease such as esophagitis. In the worst case, an ulcer or cancer may even form.

Below we have listed some tips and home remedies that can help against annoying heartburn:

Eat several (five to six) small meals a day. Large meals are very bulky and lead to overfull stomach contents. The risk of gastric acid being forced into the esophagus is increased.

Especially in the evening, avoid rich meals and don't eat too late.

Do not lie down for a digestive nap immediately after eating, but wait until the stomach has had time to digest – at least half an hour. It is also helpful to sleep with the upper body slightly elevated.

Reduce your weight if you put too many kilos on the scale.

Avoid stress, as this is a common trigger of heartburn. Relaxation exercises, sports, meditation and rest can help to reduce stress and thus heartburn as well.

Don't wear tight clothing and loosen your belt.

Avoid highly acidic beverages such as grapefruit or lemon juice, as well as other juices made from citrus fruits – by the way, many wines also have a significant acid content.

Proven home remedies are teas with chamomile, fennel or caraway seeds.

Many people describe experiencing heartburn after eating highly seasoned, spicy foods

However, the nature of the active ingredients in herbal spices varies considerably, so it is not possible to make a uniform assessment. Studies have shown that the active ingredient capsaicin, which is responsible for the spiciness in chili peppers, increases the sensitivity of the esophagus to gastric juice and thus intensifies the burning sensation.

Again and again one reads recommendations,

to drink milk in case of heartburn. This results from the assumption that the protein in the milk buffers the stomach acid. In the past, patients with this clinical picture were fed exclusively with milk.

Whether this has ever helped, however, is questionable. On the one hand, such a one-sided diet is not to be recommended to anyone, and on the other hand, scientists have proven that milk can even stimulate acid production in the stomach.

Help can be found in many cases already in the pharmacy:

Because heartburn can often be successfully treated with the help of suitable preparations as well. Antacids, which neutralize the gastric juice, or proton pump inhibitors, which inhibit the formation of an enzyme that is needed for acid secretion, are mainly used for treatment. However, if the complaints do not decrease quickly and significantly, the doctor should be consulted.

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