Heartburn - when and how to treat?

Heartburn not only causes a burning pain in the chest, it can also significantly burden those affected emotionally. This is the result of a Norwegian study in which more than ten thousand patients were interviewed. Early treatment prevents serious consequences. When and how treatment for heartburn should occur is explained below.

What is heartburn?

Heartburn occurs especially after rich meals or during stress. If the sphincter between the stomach and the esophagus is not functioning optimally, the chyme can flow back out of the stomach. Then gastric acid also enters the esophagus. This is a blend of hydrochloric acid and protein-cleaving enzymes that is produced in the gastric mucosa to digest food and destroy foodborne disease.

Isolated acid attacks can cope with the esophagus. However, if gastric acid regularly enters the esophagus, it will etch the delicate mucous membrane and cause inflammation (reflux oesophagitis).
Heartburn: take symptoms seriously
Many patients suffer especially at night. When lying down, the gastric juice can flow into the mouth and from there into the respiratory tract. Heartburn can even trigger chronic bronchitis and asthma-like symptoms.

And if the coughing stimulus affects deep sleep, the patient feels in the morning uneaten and bruised. In the long term there is even the danger that the mucosal cells in the esophagus degenerate and develop cancer .

In addition to the physical symptoms, the study in Norway has also shown that suffering causes severe quality of life . Those affected reported fears of hidden serious illness, mental stress and diminished vitality.

Heartburn: avoid alcohol and coffee
Experts warn against taking heartburn lightly. Acid-inhibiting or acid-binding drugs that are available over the counter in the pharmacy can help with mild symptoms . At the same time you should:

• Avoid fat and generous meals
• Reduce stress
• Reduce weight
• Reduce the coffee consumption
• Avoid alcohol
• Restrict smoking

Medicines for heartburn

At the latest, if the symptoms occur several times a week or last longer than two to three weeks, the doctor should be consulted. He can prescribe special medications that almost completely inhibit acid production in the stomach.

In particularly severe cases, it is possible to surgically strengthen the sphincter of the stomach. This "fundoplication" is used in specialized clinics.

Below we introduce the most common remedies and medicines for heartburn.

Acid-binding agents (antacids)

These agents form a kind of porridge in the stomach, which binds or neutralizes excess acid. They contain, for example, aluminum or magnesium compounds and are available for over-the- counter treatment of minor or occasional ailments as a chewable tablet, gel or drink solution without a prescription at the pharmacy.

The effect begins within a few minutes and lasts for several hours. They work best when taken two to three hours after eating and at bedtime. Some preparations may be used briefly after pregnancy after consultation with the doctor.

Preparations containing aluminum compounds should not be taken in conjunction with fruit juices, citrus fruits or vitamin C , as otherwise aluminum will increasingly enter the blood. If antacids are given at the same time as other medicines, such as antibiotics, they may affect their effects.

Acid inhibitors (H2 blocker)

H2 blockers occupy in the gastric mucosa the binding sites (H2 receptors) for the tissue hormone histamine, which is involved in the production of gastric acid. As a result, less acid is produced and released into the stomach. The tablets are available without prescription for short-term treatment.

Their effect occurs after a few minutes and lasts for several hours. Since gastric acid is mainly produced at night, it makes sense to take the acid-inhibiting agent in the evening.

Pregnant women should take H2-Blocker only after consulting the doctor. For children, these drugs are not suitable.

Proton pump inhibitors

Proton pump inhibitors may be considered for treatment in severe and permanent conditions. They inhibit an enzyme in the gastric mucosa, which is significantly involved in acid production. The drugs work for about three to four days.

Preparations with calcium or sodium carbonate

Although they bind the excess stomach acid, but it produces a large amount of expanding carbon dioxide gas and the acid distribution is rather stimulated. Therefore, these preparations should not be used in continuous use.

Healing earth (natural loess)

Healing earth is a mixture of quartz and clay minerals with an acid-binding effect and has been used since ancient times. The natural medicine is only available for internal use with mild, occasional heartburn in the pharmacy.

Combination preparations

Such drugs contain, in addition to an acid-inhibiting agent, for example, defoaming agents that break bubbles in the stomach contents faster and relieve flatulence . Defoamers such as dimethicone or simethicone, however, do not work against heartburn. Other antacids also contain herbal extracts such as celandine or bismuth compounds, whose effect is considered rather critical in heartburn.