Juliet Cohen asked:


Heartburn or pyrosis is a painful or burning sensation in the esophagus. Heartburn is a form of indigestion. Heartburn is a burning feeling in the lower chest, along with a sour or bitter taste in the throat and mouth. It usually occurs after eating a big meal or while lying down. Heartburn is also identified as one of the causes of chronic cough, and may even mimic asthma. Heartburn is linked to eating habits and posture. It happens when acid from your stomach gets forced upwards into the oesophagus ,This is called acid reflux. About 30% of adults experience occasional heartburn, while 10% experience heartburn every day.

About 25% of pregnant women have heartburn or related symptoms. Heartburn is an irritation of the esophagus caused by acid that refluxes from the stomach. Some other factors that can make heartburn worse 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 and certain medications, including sedatives, antidepressants and calcium channel blockers for high blood pressure. Cigarette smoking is main cause of heartburn.The primary symptom of heartburn is a burning pain in your chest, under your breastbone.

This pain may decay when you bend over, lie down or eat. It may also be more frequent or worse at night. Most people can control the irritation of heartburn with lifestyle modifications and over-the-counter medications. Several kinds of medicine can be used to treat heartburn. H2 blockers (Pepcid, Tagamet, Zantac) reduce the amount of acid your stomach makes. Other medicines, such as omeprazole (Prilosec) and lansoprazole (Prevacid), also reduce how much acid the stomach makes. Metoclopramide (Reglan) reduces acid reflux. If the heartburn continues, you may need prescription surgery.

Heartburn Treatment and Prevention Tips

1. Smoking may increase stomach acid.

2. Antispasmodic drugs and motility stimulants may be prescribed.

3. Alginates are useful when there is reflux of stomach acid.

4. Eat smaller meals reduces pressure on the lower esophageal sphincter.

5. Acid suppressants, such as histamine H2-antagonists also helpful.

6. Antacids, such as maalox, rolaids and Tums, neutralize stomach acid and can provide quick relief.



Beverly

Heather Colman asked:


Do you suffer from acid reflux or frequent heartburn? The burning sensation at the back of your throat or down by the breat bone can be quite painful. Most physicians will first recommend lifestyle modifications for treatment of acid reflux. Preventative measures are the preferred method of relief.

Lifestyle Modifications

* Avoid soft drinks that contain caffeine. Other foods to avoid are chocolate, peppermint, spicy foods, acidic foods like oranges, canned tomatoes, onions, cabbage, cauliflower, broccoli, Brussels and sprouts.

* Milk and milk-based products contain calcium and fat, so should be avoided before bedtime.

* Avoiding food for 2 hours before bedtime and not lying down after a meal are frequently recommended lifestyle modifications.

* Elevation to the head of the bed is the next-easiest to implement. Products are also available as seen on tv that will elevate the head of your bed through the use of an inflatable mattress lifter. This is an ideal low cost solution for relief from acid reflux.

You can also accomplish the correct elevation by placing cinder blocks as noted above or with other items: plastic or wooden bed risers which support bed posts or legs, a bed wedge pillow.

The height of the elevation is critical and must be within the range of 6 to 8 inches in order to be as effective as possible in hindering the backflow of gastric fluids. Elevating the bed is also known as “positional therapy”.

Drug treatments

A number of drugs are registered for the treatment of acid reflux, and they are among the most-often-prescribed forms of medication in most Western countries. They can be used in combination with other drugs, although some antacids can impede the function of other medications.

* Antacids before meals or symptomatically after symptoms begin can increase the pH and reduce gastric acidity. Alginic acid may coat the mucosa as well as increase the pH and decrease reflux.

* Gastric H2 receptor blockers such as ranitidine or famotidine can reduce gastric secretion of acid. These drugs are technically antihistamines. They relieve complaints in about 50% of all acid reflux patients.

* Proton pump inhibitors such as omeprazole are the most effective in reducing gastric acid secretion, as they stop the secretion of acid at the source of acid production, i.e. the proton pump.

To maximize effectiveness of this medication the drug should be taken a half hour before meals. Prokinetics strengthen the lower esophageal sphincter and speed up gastric emptying. Cisapride, a member of this class, was withdrawn from the market for causing Long QT syndrome.

If one implements pharmacologic therapy in combination with food avoidance before bedtime and elevation of the head of the bed over 95% of patients will have complete relief.

Surgical treatment

The standard surgical treatment, sometimes preferred over longtime use of medication, is the Nissen fundoplication. The upper part of the stomach is wrapped around the lower esophageal sphincter to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. The procedure is often done laparoscopically.

An obsolete treatment is vagotomy, the surgical removal of vagus nerve branches that innervate the stomach lining. This treatment has been largely replaced by medication.

Disclaimer The information presented here should not be interpreted as medical advice. If you or someone you know suffers from acid reflux, please seek professional medical advice for the latest treatment options.



Samantha