Heartburn is a burning sensation located in the upper part of the abdomen (epigastrium). What are the symptoms? What to do and how to relieve it?
Definition: What Is Heartburn?
“The burning stomach is a symptom that can be associated with retrosternal burns upward and regurgitation, mainly acids (sometimes bilious or food). We then speak of heartburn as the clinical sign of gastroesophageal reflux (GERD) “.
It is a frequent symptom that affects approximately 10% of the French population with at least one weekly episode. GERD affects all age groups and especially infants, and generally occurs after food intake. It is often positional and favoured by the lying position. GERD can only present as a burning sensation or epigastric discomfort without heartburn or regurgitation.
Causes: Alcohol, Drugs, Pregnancy, Gastritis, Stress
There are many causes of heartburn. ” They can be caused by other organic diseases such as acute or chronic gastritis, peptic ulcer. Stress, pregnancy, alcohol consumption, being overweight and taking certain medications such as nonsteroidal anti-inflammatory drugs. are contributing factors “, lists the specialist. Before adding: ” other diseases unrelated to the digestive tract can be associated with heartburn such as heart or lung disease (pericarditis, myocardial infarction, pneumonia). ”
Symptoms: Nausea, Gas
Heartburn usually presents as a feeling of heat, cooking, sourness or acidity in the upper and middle part of the abdomen. They often happen after a food intake and can last from a few minutes to a few hours. They can be isolated or associated with heartburn.
“Other digestive symptoms are sometimes described in combination as nausea or vomiting, belching, bitterness in the mouth, pain located in another part of the abdomen, a feeling of poor digestion (heaviness or heaviness in the pit epigastric), abdominal bloating, transit disorders (constipation or watery stools) “.
Heartburn can be acute, for example, after taking anti-inflammatory drugs, or chronic. It is necessary to consult your doctor, especially in chronic forms, to make a diagnosis. The questioning is the critical stage of the diagnosis and will be completed by a clinical examination, particularly the abdominal examination (palpation, percussion, auscultation). The questioning will specify:
- The circumstances of the occurrence,
- The time of occurrence, in particular concerning food intake,
- Favouring or aggravating circumstances,
- Symptoms improving factors,
- Any irradiation of epigastric burns (route),
- The nocturnal character
- Signs of seriousness (weight loss, asthenia or fatigue, inappetence, bloody vomiting, food blockage in the oesophagus).
The questioning and the clinical examination may be supplemented by additional examinations, mainly when signs of seriousness or a change in symptoms. The doctor can then ask:
- A blood test,
- 24-hour pH measurement in atypical GERD
- An imaging test such as an abdominal ultrasound or an abdominal CT scan, and possibly an endoscopic examination (upper digestive endoscopy, colonoscopy).
Heartburn: What To Do, When To See A Doctor?
In the event of heartburn, it is always advisable to seek medical advice. Specific clinical situations or associated symptoms necessarily require a consultation with the attending physician and sometimes with the gastroenterologist:
- The onset of symptoms after 50 years,
- History of digestive tract disease (stomach ulcer),
- Heartburn more than twice a week, increased frequency or intensity, persistence for several days,
- Pain when swallowing, difficulty swallowing or blockage when swallowing,
- Violent epigastric pain accompanied by nausea and vomiting,
- Deterioration of general condition (weight loss, fatigue, loss of appetite),
- Chronic anaemia,
- Digestive bleeding such as bloody vomiting, blood in the stool or smelly black stools corresponding to digested blood
- Breathing difficulties,
- Atypical manifestations of GERD, i.e. without epigastric burns or heartburn (recurrent dry cough especially at night, asthma attack, hoarseness, ENT symptoms, severe chest pain mimicking heart disease),
- Atypical pain (cervical spine, shoulders, upper limbs, jaw),
- Frequent use of self-medication,
- Persistence or worsening of symptoms after a few days of treatment,
- Recurrence of symptoms on discontinuation of treatment.
Treatment: Relieve Heartburn With Medication
Treatment for heartburn depends on its cause if it has been determined. ” For example, if the diagnosis of GERD is made, gastric antisecretory treatment with proton pump inhibitors (omeprazole, esomeprazole, pantoprazole) may be prescribed by the doctor. The modalities of this treatment will then be specified (dosage, duration, sequential treatment on demand) H2 blockers are used much less”.
Symptomatic self-medication treatments, some of which are over-the-counter or prescribed by the doctor, can be offered, such as analgesics, antispasmodics, topicals, or gastric dressings (Gaviscon, Maalox, Moxydar, etc.). In case of partial effectiveness or ineffectiveness, a medical consultation is imperative.
“It will be necessary to be careful with the use of nonsteroidal anti-inflammatory drugs, particularly in self-medication which can induce acute gastritis or peptic ulcer. It is recommended to take them with meals and to combine them with proton pump inhibitors. The time of treatment “, recalls the specialist.
Food: What To Eat?
Generally speaking, foods that cause heartburn have been identified and avoiding them is a simple way to avoid symptoms. To limit the onset of heartburn, it is recommended to eat slowly and chew well. It is also advisable to eat the evening meal two to three hours before going to bed and not overeat food during a meal.
Other non-medical or hygiene-dietary measures that are less effective on heartburn and GERD can be implemented:
- Avoid wearing tight clothes,
- Avoid drinking alcohol, coffee and smoking as this increases the production of stomach acid,
- Elevate his head when sleeping.