Latest Catalogue Heartburn

Heartburn

DEFINITION

Acid reflux is when acid from the stomach leaks up into the gullet (oesophagus). This may cause a burning sensation in the chest (heartburn) and other symptoms. Heartburn that occurs more than twice a week may be considered Gastro Oesophageal Reflux Disease (GORD) that can eventually lead to more serious health problems.

 


DESCRIPTION

The oesophagus is the tube which all food passes down after being swallowed. This tube connects the throat to the stomach. A valve between the stomach and oesophagus usually prevents backflow of stomach contents. This is called the oesophageal sphincter. In certain individuals this valve may be weak, or there may be increased pressure within the stomach forcing acid upwards.

 

Most heartburn is only occasional. If Acid reflux is severe or chronic, it may suggest you have GORD. Complications of GORD include irritation and inflammation of the oesophagus (oesophagitis), narrowing of the oesophagus (stricture) and a slightly increased risk of oesophageal cancer.

 


RISK FACTORS

Some other factors that can worsen Acid reflux and the symptoms of heartburn include:

  • Certain foods, such as fatty foods, spicy foods, chocolate, caffeine, onions, tomato sauce, carbonated beverages and mint
  • Alcohol
  • Large meals
  • Lying down too soon after eating
  • Certain medications, including sedatives, antidepressants and calcium channel blockers for high blood pressure
  • Cigarette smoking

 

Conditions that cause difficulty with digestion can increase the risk of Acid reflux and the symptoms of hearburn. These include:

  • Obesity
  • Pregnancy
  • Asthma
  • Diabetes
  • Hiatus hernia

 


SIGNS AND SYMPTOMS

Acid reflux is generally experienced as a burning sensation around the stomach, in the centre of the chest or radiating up behind the breastbone. Other symptoms include; pain in the upper abdomen and chest, feeling sick, an acid taste in the mouth, bloating, belching, and a burning pain when you swallow hot drinks.

 

Less common symptoms include;

  • A persistent cough, particularly at night sometimes occurs. This is due to the refluxed acid irritating the trachea (windpipe). Asthma symptoms of cough and wheeze can sometimes be due to acid reflux.
  • Other mouth and throat symptoms sometimes occur such as gum problems, bad breath, sore throat, hoarseness, and a feeling of a lump in the throat.
  • Severe chest pain develops in some cases (and may be mistaken for a heart attack).


TREATMENT OPTIONS

As with all conditions your Doctor should be consulted to diagnose and treat this condition. Ask your Doctor about the latest advice for this ailment. Your Doctor will decide whether the symptoms are a sign of a more serious condition or if the Acid reflux is a result of prescribed medication. An antacid or H2- receptor antagonist may be prescribed.

 

This medication may be taken to reduce gastric acid and pepsin output. This can help to improve the symptoms of Acid reflux, decrease the need for antacids and aid in the healing of gastric damage to the oesophagus.

 


DIET HINTS

- Avoid eating within three hours of bedtime.
- Eat several small meals during the day. Large meals are associated with Gastric Reflux. Try to avoid physical exertion directly after eating, especially bending over and heavy lifting.
- Try to eat foods which are easily digested e.g., salads, chicken, fish and some wholemeal bread. Concentrate on lightly cooked greens and avoid roasts and fatty red meats that are hard to digest.
- Hot spicy food or food containing possible irritants, such as garlic and onion should be avoided. Citrus fruit juices and tomato products are also possible irritants.
- Avoid alcohol and citrus juices which stimulate gastric juices and acid in the stomach.
- Avoid drinking before meals and drink sparingly during the meal. Stomach acid (the aid to digestion) can be diluted with too much fluid.

- Certain foods, such as fatty and fried foods, spicy foods, chocolate, caffeine, onions, tomato sauce, carbonated beverages, peppermint and spearmint can worsen the symptoms of Acid reflux in some cases.

 


PREVENTION

- Research demonstrates that eating too quickly and not chewing food thoroughly increases the incidence and severity of Acid reflux.

- Avoid smoking. The chemicals from cigarettes relax the sphincter muscle and make Acid reflux more likely.
- Avoid large meals and foods and drinks that can worsen symptoms in some people. These include: peppermint, tomatoes, chocolate, spicy foods, hot drinks, coffee, and alcoholic drinks.
- Lose weight. Excess weight puts extra pressure on the stomach and encourages Acid reflux.
- Good posture. Lying down or bending forward a lot during the day encourages reflux. Sitting hunched or wearing tight belts may put extra pressure on the stomach which may make any reflux worse.

 

If symptoms are worse at night, the following may help:

  • Go to bed with an empty stomach. Avoid eating in the last three hours before bedtime, and do not drink in the last two hours before bedtime.
  • If you are able, try raising the head of the bed slightly (for example, with books or bricks under the bed's legs). This helps gravity to keep acid from refluxing into the oesophagus. Do not use additional pillows, because this may increase abdominal pressure.

 


VITAMINS/MINERALS/HERBS

- Slippery elm has a long history of traditional use in reducing gastric inflammation and ulceration
- Acidophilus helps rebalance gastrointestinal bacterial levels and improve digestion.
- Digestive enzymes help digestion and the breakdown of food. .

 


PHARMACIST'S ADVICE

Ask your Pharmacist for advice.
1) Follow the Diet Hints . Eat smaller meals more often. Avoid carbonated drinks, chewing gum and sucking lollies as these may increase the intragastric pressure.
2) Consider an antacid to help with the acidity. Ask your Pharmacist for the best brand suitable for you. Ask your Pharmacist for advice.
3) Never undertake exercise or lie down immediately after a meal as this may hinder digestion. Wait at least 2 hours to allow the food to digest.
4) Avoid smoking, tea, coffee, alcohol, chocolate, peppermint and spearmint which all relax the oesophageal sphincter. If you need help to stop smoking ask your Pharmacist for suggestions.
5) Try to minimise stress, especially around meal-times.
6) Certain drugs may aggravate reflux. These include asthma medication, sedatives, calcium channel blockers (prescribed for heart disease), anti-cholinergics (prescribed for depression and other illnesses), aspirin and other non-steroidal anti-inflammatory drugs. Always stay on prescribed medication and ask your Pharmacist about any possible side effects.

7) Raise the bed head; avoid wearing tight clothes around the abdomen. If necessary sleep propped up on a few pillows to reduce the exposure of the oesophagus to Acid reflux during the night.
8) Lose weight if necessary. Being overweight is associated with an increased incidence of Acid reflux.

9) If the diet is inadequate consider the nutritional supplements suggested in this topic.