How To Deal With Heartburn?

Gastroesophageal reflux disease is the most common disease of the digestive system. It is essentially reflux - the return of gastric contents , including hydrochloric acid in the lumen of the esophagus, which is the cause of the corresponding symptoms - burning behind the sternum, intensifying after eating and lying down, regurgitation of ingested food. in the esophagus or in the mouth, dysphagia and odynophagia - difficulty and pain when swallowing, anginal pain - behind the sternum, sometimes mimicking cardiac oppression.

Normally, food passes after its absorption from the esophagus into the stomach, which is aided by the relaxation of the lower esophageal sphincter at their border . Various conditions such as a decrease in pressure in the lower esophageal sphincter - when consuming certain foods and beverages , an increase in pressure in the abdominal cavity - after eating a large amount of food , hiatal hernia with displacement of the gastroesophageal connection above the diaphragm and subsequent relaxation are the cause of easier return of gastric juice to the esophagus and the appearance of the corresponding symptoms.

How can we deal with unpleasant symptoms?

At first, it is appropriate to follow a certain diet and follow certain measures such as:

• Avoid overeating and increase the number of meals, but in smaller portions for the day;
• Avoid eating foods high in fat;
• Exclusion of citrus juices, tomato and tomato juice, coffee, alcohol, chocolate - cause transient "relaxation" of the lower esophageal sphincter and increase reflux;
• Smoking avoidance;
• Weight loss;
• Early dinner is recommended;
• Avoid eating 2-3 hours before bedtime;
• Sleeping on a higher pillow, etc.

Taking certain medications also helps control the symptoms of gastroesophageal reflux disease. The following groups of drugs are used:

• Antacids - are alkaline salts that neutralize hydrogen ions in stomach acid and increase the pH of gastric juice. This group includes the widely used baking soda - sodium bicarbonate. The antacid effect occurs very quickly but is short-lived - from 5 to 25 minutes. It causes an increase in the pH of gastric juice and the formation of carbon dioxide, which can lead to a secondary increase in the secretion of hydrochloric acid. The combination of non-resorbable salts - aluminum and magnesium hydroxide, etc .;
• Proton pump inhibitors - are most widely used in practice. They block the final phase of hydrochloric acid secretion in the stomach lumen. Their action is slower, so they are unsuitable for "on-demand therapy". They are most often prescribed twice a day, and the course of treatment is about 4-6 weeks with the transition to maintenance treatment in the same or lower dosage. The most widely used are omeprazole, lansoprazole, pantoprazole, esomeprazole and others;
• H2-blockers - they are competitive antagonists of histamine in its binding to H2-receptors. This leads to a suppression of the effect of histamine associated with increased gastric secretion. The preparations are suitable for controlling nocturnal acid secretion and have a lasting effect. The preparations ranitidine and famotidine and others are known;
• Prokinetic drugs - metoclopramide, domperidone, levosulpiride. Their action is to improve and accelerate the emptying of gastric contents in order to prevent its possible reflux;
• Endoscopic treatment - photo- and laser therapy, ablation therapy for severe gastroesophageal reflux and complications - stenosis, strictures, Barrett's esophagus, bleeding;
• Surgical treatment - indicated in cases of diaphragmatic hernia.

In case of systemic complaints of reflux, it is appropriate to consult a personal physician and gastroenterologist in order to find the cause and take measures to prevent the symptoms of gastroesophageal reflux disease.