As a painful burning sensation manifests itself mostly heartburn, which usually extends from the upper abdomen to the neck. The cause of heartburn is a reflux of gastric acid from the stomach into the esophagus, which then provides irritation by the stomach acid in the course.
What is heartburn?
Schematic diagram showing the anatomy involved in reflux disease or heartburn. Click to enlarge. A mild, sometimes unbearable burning sensation, an annoying pressure behind the breastbone indicates heartburn. This discomfort is caused by the reflux of stomach acid into the esophagus. Occasional heartburn is harmless, although not exactly pleasant. However, if the discomfort occurs more frequently or even becomes chronic, it is referred to as reflux disease or reflux esophagitis. Reflux means flowing back, i.e. the corrosive stomach acid keeps flowing back into the esophagus. The heartburn can then cause considerable damage. Untreated reflux disease can lead to ulcers, which in the worst case can degenerate into esophageal cancer. So heartburn should not be taken lightly.
Causes
So what are the causes of heartburn? As mentioned earlier, in heartburn, instead of remaining in the stomach, the stomach acid flows back into the esophagus. This is a pathological disorder that can have various causes. Normally, the backflow of stomach acid is prevented by the sphincter muscle, which ensures that the stomach is sealed off from the esophagus and thus no extremely corrosive acid that causes heartburn can escape. People beyond the age of 40 are more likely to suffer from heartburn because the slackening of the sphincter muscle with age is a cause of reflux disease. Eating too fatty or sweet foods, smoking cigarettes, or stress can also lead to heartburn. Since alcohol consumption reduces the tension of the sphincter, it can also be blamed for heartburn. Being overweight creates more pressure in the abdomen and therefore on the stomach. Stomach acid can therefore flow back into the esophagus more easily. Similarly, pregnancy belly can be one of the causes of heartburn.
Diseases with this symptom
- Reflux disease
- Gastritis
- Gastric ulcer
- Esophageal cancer
- Irritable stomach
- Achalasia
- Obesity
- Hiatal hernia
- Diabetes mellitus
Complications
Heartburn is very common. As a rule, it is also not problematic. Especially with very sugary and fatty foods, the acid formation in the stomach increases. However, after a change in diet, heartburn usually disappears quickly. However, there are diseases that are associated with chronic heartburn. It is particularly common with gastric ulcers or gastritis. Here, the focus is on the possible complications resulting from the stomach diseases. In the long term, it can lead to stomach cancer. In the case of severe gastric ulcers, there is also a risk of gastric rupture. However, long-lasting heartburn itself can also lead to serious complications and secondary diseases. If the esophagus is constantly irritated by refluxing stomach acid, inflammation forms there permanently and never heals completely. The first symptoms are burning pain in the chest and difficulty swallowing. The pain intensifies especially when eating. Chronic heartburn is also referred to as reflux disease. One of the long-term complications of reflux disease is Barrett’s esophagus. This involves cell changes that can lead to ulcers or even cancer in the esophagus. Once esophageal cancer has developed, it grows very quickly and, in the final stage, completely closes the esophagus, making it impossible to eat. Chronic heartburn may also be associated with a rare pancreatic tumor that stimulates stomach acid production.
When should you see a doctor?
Heartburn can occur in many people and does not necessarily need to be treated by a doctor. If the heartburn occurs very rarely or after eating certain foods, then a visit to the doctor is not necessary. Even a simple diet or food change can help to reduce or completely avoid heartburn.As a rule, the affected person should take it easy on the stomach and avoid sweet and fatty foods. There are also various self-help remedies available for occasional heartburn. However, a doctor should be consulted if the heartburn is permanent and associated with severe pain. This may be a serious condition. Likewise, heartburn can irreversibly damage the body in the long run. Therefore, to avoid secondary damage and further complications, a doctor should be consulted in case of severe heartburn. As a rule, the first visit is to the general practitioner. He or she may prescribe medication to treat the heartburn. If the symptom does not disappear even with taking the medication, a visit to a specialist is necessary.
Treatment and therapy
How to treat heartburn? If heartburn occurs only occasionally, one should not worry. Perhaps a compact, too fatty meal is to blame for the discomfort. These can be relieved relatively quickly by an over-the-counter remedy containing sodium bicarbonate. It neutralizes the stomach acid and can be taken without hesitation. Of course, it would still be desirable to consult your doctor or pharmacist in detail. However, if heartburn becomes more frequent, it is time to review your dietary habits. Fatty and rich meals should be avoided in the evening. Four to six meals spread throughout the day are recommended. Likewise, sweets and sugary drinks should be limited as much as possible. And stay away from excessive alcohol consumption. Corpulent people who suffer from heartburn should reduce their excess weight. If heartburn occurs frequently, a specialist in gastrointestinal diseases should be consulted.
Outlook and prognosis
For mild and moderate heartburn, the outlook for recovery is good. Provided that drug treatment is given promptly and before major injury to the esophagus has occurred, reflux disease can usually be cured within a few days. However, the cause is not eliminated, so the disease can recur again and again. Those affected can alleviate the symptoms by following certain behavioral and dietary rules. Until recovery, hoarseness, mild sore throat and other typical symptoms will occur at most. In rare cases, however, heartburn can develop into Barret’s esophagus, which can lead to esophageal cancer if severe. Moreover, chronic disease can lead to severe esophageal inflammation, which can also damage the mucosa. Rarely, specific inflammations such as laryngitis gastrica or pneumonia may also occur. Chronic bleeding as a result of mucosal damage can lead to anemia and also worsen the prognosis. In the case of chronic symptoms, heartburn should therefore be clarified by a doctor in any case. He can determine the degree of the disease and thus give an accurate prognosis regarding the recovery process. A gastroscopy will be essential in the case of pathological heartburn. This diagnostic procedure reveals possible pathological changes in the esophagus. A biopsy, i.e. a tissue sample, is necessary to demonstrate the degree of damage to the esophageal mucosa. The doctor can usually get heartburn under control through long-term medication with prescription acid blockers.
Prevention
So how can heartburn be prevented? A healthy lifestyle is always a good prevention against quite a few diseases, including heartburn. Eating natural foods that are low in calories and fat will help prevent the production of excess stomach acid, which is responsible for heartburn. Many small meals eaten with relish and at rest can prevent stomach acid from flowing back into the esophagus. The unpleasant, painful heartburn is stopped. Plenty of exercise through sports, walking or dancing prevents obesity, one of the main causes of heartburn. Since with a reflux disease the stomach acid has the habit to rise upward, one should sleep at night with the help of an additional pillow somewhat more elevated. This way, no uncomfortable heartburn will disturb your night’s rest.
This is what you can do yourself
In case of heartburn, the patient should definitely avoid unhealthy food. This includes especially fatty, sweet and sour food.Hot and pungent spices should also be avoided, as they can promote heartburn. Likewise, the affected person must avoid sweet drinks and alcohol. Juices can be drunk in the mild form with less acidity. Likewise, coffee should be avoided. To reduce heartburn acutely, a little warm water can be drunk. This should not contain carbonic acid. Bread and milk can also counteract heartburn. Nuts not only help against heartburn, but are very healthy for the body and an optimal source of energy. But home remedies such as chamomile tea can also help. When sleeping, the patient should sleep with his head elevated so that the gastric juice can flow back while lying down. Also, no more food should be taken before going to bed itself about two to three hours before. When eating, the affected person must take care to chew the food well and not swallow it in large bites. Also, smaller meals should be taken rather than one large meal. To prevent heartburn, a heartburn diary can also be kept. There, the patient always notes when the heartburn occurred and which foods or drinks were taken beforehand. This can prevent heartburn in the long term.