What to do against heartburn?

What can you do for heartburn?

A causal therapy of reflux (heartburn) is usually not possible except in cases of anatomical changes (hiatus hernia). The conservative, drug therapy of heartburn must usually be continued for years, since only the symptoms, but not the cause of the disease itself is treated.

Behavior and nutrition

Conservative heartburn therapy is a symptom-related long-term therapy that also includes dietary and behavioral measures. In many cases, dietary measures and the observance of certain behavioral measures are completely sufficient for a successful therapy. These include all factors that prevent increased excretion of gastric acid, such as avoiding sweets, high-fat foods, alcohol and cigarettes.

A weight reduction (reduction of overweight) is also to be aimed at. It is also recommended to eat several small, protein-rich meals distributed throughout the day, in contrast to the classic and extensive morning, lunch and evening meals. Before going to bed, no more large quantities of food should be taken in order to keep the pressure on the lower esophageal sphincter low.

This is especially important before going to bed because the lying position per se increases the pressure on the lower esophageal sphincter. A sleeping position with slightly (20-30%) raised head and upper body also contributes to this. The abdominal position as a sleeping position should be avoided.

Drugs

In cases of mild reflux disease (heartburn), so-called acid-neutralizing drugs (antacids) are initially used (e.g. Talcid ®, Riopan ®, Maaloxan ®). These are chewable tablets or gel sachets (suspensions), which are taken when symptoms occur. A preventive taking of this kind of medication makes no sense, because neither the acid production nor the reflux is prevented.

In mild cases of reflux esophagitis, stomach and intestinal movement-enhancing drugs (prokinetics) are used (e.g. Domperidone (Motilium®)). These cause a faster passage of food through the stomach into the intestine. If an inflammation of the mucous membranes is already present, so-called H2-receptor blockers are used (e.g. Ranitidine (Sostril®), Cimetidine (Tagamed®)).

H2-receptor blockers are drugs that block the H2-receptors of the acid-forming stomach cells (document cells) and thus reduce the production of stomach acid. In severe forms of heartburn, proton pump inhibitors such as Omep® are prescribed. Their effectiveness does not decrease significantly even during prolonged administration.

This is a decisive advantage over H2-receptor blockers. In addition, the tolerability of these drugs is usually good even during long-term therapy. Proton pump inhibitors represent the gold standard for drug therapy of gastroesophageal reflux disease.

The proton pump blockers inhibit certain enzymes in the stomach cells and thus prevent the secretion of stomach acid. Since the blocking of these enzymes is irreversible, the necessary enzymes must first be produced again in order to resume the production of gastric acid. This usually takes 2-3 days (Possible side effects usually affect the digestive tract and are usually harmless.

These manifest themselves for example as flatulence, diarrhoea, abdominal pain, nausea or a feeling of fullness. Taking this medicine can also cause dizziness and headaches. A possible side effect of long-term administration over several months is a magnesium electrolyte deficiency.

Proton pump inhibitors are also used in the treatment of stomach ulcers, small intestinal ulcers and inflammation of the stomach lining. In addition, the acid blockers are prescribed as a protection for the stomach in the case of long-term use of certain painkillers.Proton pump inhibitors are also used in the treatment of stomach ulcers, small intestinal ulcers and inflammation of the stomach lining. In addition, the acid blockers are prescribed as a protection for the stomach when taking certain painkillers over a long period of time.