Therapy of heartburn

The first step in the treatment of heartburn should be to consider the risk factors for the occurrence of heartburn. These include consumption of alcohol, nicotine, coffee, fatty, spicy, sweet foods, overweight and excessive stress. First the concerning should try thus to eliminate possible factors of risk as far as possible.

This is not always easy – for example in the case of stress, but also in the case of addictions such as nicotine consumption and overweight – but if the risk factor persists, the probability of heartburn recurring is very high. Many affected persons who complain about heartburn, especially at night, sleep with a slightly elevated upper body. In addition, large meals shortly before going to bed should be avoided.

There are numerous household remedies that are supposed to help against heartburn. However, none has a proven benefit, so you should try out individually what helps you. Here there are numerous tips, from stomach-friendly teas to chewing gum chewing to eating a handful of nuts, drinking milk or taking sodium bicarbonate.

If heartburn cannot be sufficiently contained with the above-mentioned measures, an effective treatment for heartburn can be achieved by taking so-called proton pump inhibitors. These are drugs that significantly inhibit acid production in the stomach. Typical examples are pantoprazole and omeprazole.

In the case of heartburn without actual inflammation of the stomach lining, it is often sufficient to take one tablet if necessary. If an inflamed mucous membrane of the esophagus is already present, regular intake over a period of several weeks can provide relief. If heartburn recurs, it may be necessary to have a gastroscopy performed.

However, this is by no means necessary for every patient with heartburn. Persistent or greatly increasing symptoms, vomiting of blood, black stools and the presence of unclear anemia may indicate that further diagnosis may be helpful or necessary. Riopan ® (an antacid) is often advertised as an acute therapy for heartburn.

This is an agent that is intended to neutralize stomach acid, i.e. to make it less acidic. The effect should be rapid and last for several hours. Riopan ® is available as a tablet or as a gel for swallowing.

However, the most effective medication against frequent heartburn with inflammation of the mucous membranes of the esophagus is proton pump inhibitors such as pantoprazole or omeprazole. The effect occurs relatively quickly and lasts for a long time. Since heartburn is due to increased production of stomach acid, it is recommended to consume foods whose digestion does not depend on much stomach acid.

The acid-producing cells in the stomach react mainly to fats and simple sugars, but also slightly to proteins. Those affected should therefore avoid fatty meals (e.g. fatty steak with gravy) and avoid sugary drinks. Coffee and alcohol should also be avoided because they potentiate the acidic environment inside the stomach.

It is advisable to eat alkaline foods such as low-fat dairy products (caution, often extra sugared!) and potatoes, rice and wholemeal pasta. The total amount of a meal should also be reduced.

Patients with heartburn should eat frequent small meals rather than large, opulent portions. If the pain is caused by stomach movements, it is also beneficial to eat mushy foods, as they do not strain the stomach activity too much (mashed potatoes, soft noodles, rice pudding, soups). It is also advisable to ban hot spices from the menu, as they can further damage the already irritated stomach lining.

When it comes to heartburn and the consequential damage caused by it (for example, inflammation of the esophagus), there is one group of active ingredients that is said to be very effective with relatively few side effects: The proton pump inhibitors. They attack certain cells and there at certain pumps and reduce so the acid production in the stomach. The stomach acid becomes thus less sour and thus also less “corrosive”.

The two main representatives of this group of drugs are pantoprazole and omeprazole.For occasional heartburn, one intake is sufficient when needed. In case of regular complaints and already existing inflammation of the esophagus, daily therapy over a few weeks is recommended. If the symptoms persist, the treating family doctor should be consulted.

Pantoprazole and omeprazole are available without prescription from pharmacies. There are numerous household remedies which are said to help against heartburn. Overall, however, there is no reliable proof of effectiveness for any of these household remedies.

In the end, one remedy is more effective than the other; it is best for those affected to try out which one gives the best results. Possible home remedies for heartburn include warm tea (for example chamomile), a handful of nuts, chewing gum, milk, bicarbonate of soda dissolved in warm water and others. More important than these home remedies, however, is ultimately preventing BEFORE the symptoms occur by avoiding alcohol, nicotine and, for sensitive people, coffee.

In addition, sleeping with a slightly elevated upper body and eating only a small meal with dinner can be helpful. Milk is one of the household remedies that is said to have a positive effect on heartburn. Allegedly it is said to neutralize the stomach acid.

Altogether one must say that the therapeutic use of milk for the treatment of Sodbrennen is rather questionable, concerning can try however naturally, which helps them, that is individually very different. The wrong diet can lead to a more frequent occurrence of heartburn. Especially spicy, fatty and very sweet food can stimulate acid production in the stomach and thus trigger a backflow into the esophagus.

Alcohol also increases the secretion of gastric acid, but at the same time lowers the tone of the lower oesophageal sphincter muscle, which makes it easier for the acid to flow back into the oesophagus. One teaspoon of baking soda dissolved in a glass of lukewarm water is said to work wonders against heartburn. The reason for this is that sodium bicarbonate is alkaline, but stomach acid is acidic, so sodium bicarbonate is said to help neutralize stomach acid.

This is not scientifically proven. However, many affected people notice a positive effect. Surely, the intake of sodium bicarbonate should not be permanent in the case of heartburn, so if heartburn occurs repeatedly, the treating physician should be consulted if necessary, who can then decide whether further diagnostics are necessary.

Since the art of homeopathy is based on empirical medicine and includes the entire organism in its considerations, no general recommendation from the viewpoint of conventional medicine can be given here. However, the following are some of the homeopathic remedies that are used particularly frequently: Nux vomica D6, Robinia pseudoacacia, Arsenicum album, Bismutum subnitricum, Chamomilla and Lycopodium. The effect of the Schüssler salts is based on the theory that diseases are caused by an imbalance of the acid-base balance of the body.

However, since the body has an excellent system (kidneys and lungs), a systemic imbalance only occurs in severe diseases, e.g. renal insufficiency. Only then does a systemic therapy with certain salts make sense. If a certain Schüssler salt is exclusively alkaline, it can be helpful to compensate for the acidic environment of a symptomatic stomach in the short term.

Similar to homeopathy, these are empirical values outside of conventional medicine. The Schüssler salt No. 9 Sodium phosphoricum is frequently used.

Also during pregnancy, remedies such as Riopan and Omeprazol are allowed in principle, but every intake of medication should be weighed and first clarified with the treating gynecologist. Pregnant women should therefore focus on other options, such as sleeping with a raised upper body and avoiding large meals in the evening. Home remedies can also be tried, such as a warm chamomile tea or a handful of nuts.