Heartburn: causes, treatment and management

GI-Series:

My post this week is a part of a series that we will be examining over the next few weeks, and I call it the GI-series. In this series, I'm going to be reviewing common gastro-intestinal disorders that can affect our daily living and how to manage and treat them. I will also mention red flags and signs for worsening of symptoms that warrants doctor's assessment.

What causes heartburn?

Heartburn occurs as a result of excessive reflux of gastric content into the esophagus, causing a burning feeling in the stomach or lower chest rising up to the neck. Many people have experienced heartburn at one point or the other, actually about 40% of the population. There are many factors that may contribute to the etiology of this disorder. Gastro-esophageal reflux may be due to defective lower esophageal sphincter, the valve that connects the esophagus to the stomach. It could also be due to delayed gastric emptying or excessive gastric acid production. Exposure of the esophagus to gastric content may lead to damage, ulcers or even bleeding. Things that make heartburn worse include bending over, lying down, smoking, obesity, spicy or fatty foods, or certain medication so it would be best to avoid these.

Red flags

If you experience any of the following, please contact your doctor immediately

-chest pain in the left side of the breast, radiating to the left arm (may be heart related) instead of upwards

-chocking, coughing, shortness of breadth

-difficulty swallowing

-blood in vomit or stool

-pain upon swallowing

-unintentional weight loss

Treatment and management plan

>Reduce or eliminate symptoms

>Reduce or prevent recurrence of symptoms (frequency or duration)

>Induce healing of any damaged mucosa

>Prevent complications such as Barrett esophagus or esophageal adenocarcinoma

>Educate patients to recognize worsening symptoms of GERD

How to manage heartburn:

Management of heartburn include lifestyle modifications such as avoiding foods that trigger symptoms and other activities that may exacerbate symptoms and stress management

---Avoid exercising or bending on a full stomach

---Avoid tight-fitting clothes around the waist

---Avoid foods that delay gastric emptying or increase acid exposure: chocolate, onions, carminatives (spearmint, peppermint), high-fat meals

---Elevate head of bed about 10 cm

---Avoid large meals

---Avoid alcohol consumption

---Limit use of drugs that may cause or worsen dyspepsia (e.g., antibiotics, bisphosphonates, corticosteroids, iron, metformin, nonsteroidal anti-inflammatory drugs, opioids, potassium salts)

---Stop smoking if a smoker

---Avoid lying down following meals, or eating before bedtime

---Achieve ideal body weight if obese

Please note; do not take antacids at the same time as taking other medications such as antibiotics and iron to prevent interactions. If there is no improvement in your symptoms after 2 weeks, consult your physician.

Disclaimer: all health information provided on this platform represent my opinion only and are for educational purposes only. Reading my blog is not intended to be a substitute for a visit to your local pharmacist, physician, dietitian, and other healthcare providers. Be sure to seek proper care from your nutritionist, family doctors or specialists when needed.