Heartburn – when and how to treat?

Heartburn - when and how to treat?

Heartburn not only causes a burning pain in the chest, but it can also be a significant psychological burden for those affected. This results from a Norwegian study in which more than ten thousand patients were interviewed. Early therapy prevents serious consequences. You can find out when and how heartburn should be treated below.

What is heartburn?

Heartburn occurs mainly after heavy meals or when you are stressed. If the sphincter muscle between the stomach and the oesophagus is not working optimally, the chyme can flow back out of the stomach. Stomach acid then enters the oesophagus. This is a mixture of hydrochloric acid and proteolytic enzymes produced in the stomach lining to help digest food and destroy germs in food.


The oesophagus can cope with occasional acid attacks. However, if the stomach acid regularly gets into the oesophagus, it burns the sensitive mucous membrane and causes inflammation ( reflux esophagitis ).



Heartburn: Take the symptoms seriously

Long-lasting heartburn, in particular, can trigger numerous complaints in those affected. The most common symptoms include:

  • a burning sensation that can radiate from the upper abdomen down to the throat
  • retching
  • frequent belching
  • stomach pain or pressure

In addition to the physical symptoms, the study in Norway also showed that the condition causes severe limitations in the quality of life. Those affected reported fears of hidden serious illnesses, permanent mental stress and reduced vitality.

Heartburn: when to see a doctor?

Many patients suffer, especially at night. The gastric juice can flow into the mouth and the respiratory tract when lying down. Heartburn can trigger chronic bronchitis and asthma-like symptoms. If the urge to cough interferes with deep sleep, the patient may feel tired in the morning.

Persistent irritation of the oesophagus can lead to the formation of scar tissue, which in turn narrows the oesophagus. In the long term, there is even a risk that the mucosal cells in the oesophagus will degenerate and cancer will develop. For these reasons, a doctor should always be consulted if symptoms persist. In addition to the family doctor, the right contact person is a gastroenterologist.

A doctor should be consulted immediately if the following severe symptoms occur:


Medicines for heartburn

If mild symptoms occur several times a week or last longer than two to three weeks, the doctor should be consulted. He can prescribe particular medications that almost wholly inhibit the production of acid in the stomach.

In particularly severe cases, it is possible to strengthen the gastric sphincter surgically. This “fundoplication” is used in specialized clinics.

Below, we present the most common remedies and medications for heartburn.

Proton pump inhibitor (PPI)

Proton pump inhibitors can be considered as a treatment for severe and persistent symptoms. They inhibit an enzyme in the gastric mucosa that is significantly involved in acid production. The medication works for about three to four days. Proton pump inhibitors should be taken for at most four weeks without medical advice. A doctor’s visit is also advisable if there is no improvement in symptoms within two weeks.

Acid-binding agents (antacids)

These drugs form a mash in the stomach that binds or neutralizes excess acid. They contain aluminium or magnesium compounds, for example. They are available in pharmacies without a prescription as chewable tablets, gels or drinking solutions for the short-term treatment of minor or occasional complaints.

The effect kicks in within a few minutes and lasts a few hours. They work best when taken two to three hours after eating and before bed. Some preparations can be used briefly during pregnancy after consultation with the doctor.

Preparations with aluminium compounds should not be taken with fruit juices, citrus fruits or vitamin C, as otherwise, more aluminium gets into the blood. If antacids are given simultaneously with other medications, such as antibiotics, they can interfere with their effectiveness.


Acid inhibitors (H2 blockers)

H2 blockers occupy the binding sites (H2 receptors) in the gastric mucosa for the tissue hormone histamine, which produces gastric acid. As a result, less acid is produced and released into the stomach. The tablets are available over the counter for short-term treatment.

Its effect occurs after a few minutes and lasts for several hours. Since stomach acid is mainly produced at night, taking the antacid in the evening makes sense.

Pregnant women should only take H2 blockers after consulting their doctor. These drugs are not suitable for children.

Calcium or sodium carbonate preparations

Although they bind to excess stomach acid, a large amount of flatulent carbon dioxide gas is produced, and acid release is instead stimulated. Therefore, these preparations should be used sparingly.

combination drugs

In addition to an acid-inhibiting agent, such medications contain, for example, anti-foaming agents that allow bubbles in the stomach contents to burst more quickly and relieve flatulence . However, defoamers such as dimethicone or simethicone do not work against heartburn. Other antacids also contain plant extracts, such as celandine or bismuth compounds, whose effect on heartburn is viewed critically.


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 pharmacy use for mild, occasional heartburn.

Baking soda (Sodium hydrogen carbonate)

Once used as a common home remedy for heartburn, baking soda is now discouraged. Although baking soda has been shown to neutralize stomach acid, it raises the pH level in the stomach too much. As a result, the stomach acid is less acidic, which is why the stomach counteracts this with an increased production of gastric acid. A so-called “rebound effect” occurs.

What else helps against heartburn?

Experts, therefore, warn against taking heartburn lightly. Acid-inhibiting or acid-binding medications, available in pharmacies without a prescription, help with minor symptoms. At the same time, one should:

  • avoid fatty and heavy meals
  • reduce stress
  • reduce weight
  • reduce coffee consumption
  • avoid alcohol
  • limit smoking

In addition to the medications mentioned, these behavioural changes often help alleviate or eliminate heartburn.

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