Do you feel a burning sensation in the chest (behind the breastbone) and throat ? Do you ever happen to regurgitate liquid or food in the mouth ? Do these symptoms appear more intensely after meals ? Do you feel an unpleasant, bitter or acid taste in your mouth ? Most likely you have gastro-esophageal reflux or heartburn.
The people who suffer most from heartburn are those who have a hiatal hernia, pregnant women during the last month of pregnancy, diabetics, the elderly, infants and the obese.
What are the causes and complications of heartburn ? Which drugs are used as conventional medicines ? Are there effective natural remedies ?
In medical terms, what is commonly called ‘heartburn’ or ‘reassembled acids’ are actually gastro-esophageal refluxes or GERD. By ‘reflux’, we mean the passage of gastric contents from the stomach (gastro : stomach in ancient Greek) and esophagus (the part of the digestive tract that lies between the stomach and entered the pharynx).
This liquid consists of the bolus and gastric juices (especially hydrochloric acid) that are highly acidic and therefore cause irritation, inflammation and burning of the esophageal mucosa tube (which, unlike the stomach, is not designed to withstand such a low pH of 1.5!)
The lower esophageal sphincter (LES) is a muscular ring comparable to a valve located between the lower part of the stomach and esophagus. When the bolus is swallowed, the sphincter opens to let in the stomach. At rest, on the other hand, its function is to seal the entrance to the stomach, preventing gastric contents into the esophagus.
Malfunction or muscle weakness of the sphincter is the main cause of symptoms associated with GERD (80% of cases). It relaxes outside the moments of food ingestion and exposes the lining of the esophagus to the reflux of corrosive gastric liquid. These acid regurgitations are more common after a meal or during the night. Hiatal hernia (the rising of part of the stomach from the abdomen toward the thorax) is also responsible for GERD in 20% of cases.
GERD can lead over time to esophagitis (the presence of chronic inflammatory lesions on the lining of the esophagus which makes swallowing painful), a peptic stricture or SPO (narrowing of the esophagus), to dental problems and to Barrett’s esophagus (part of the lining of the esophagus changes into a kind of gastric mucosa) that can promote the development of a cancer.
Conventional medicine relieves patients according to the severity of heartburn by offering three different medical strategies:
► The first is to neutralize the acidity with an antacid drug (Maalox ®, Gaviscon ®, Topaal ®, etc.).
► The second family of drugs used are H2 blockers (histamine) that act as gastric antisecretories (Tagamet ®, Azantac ®, Raniplex ®, etc.).
► The third family of drugs that treat the most severe forms are inhibitors of the proton pump or IPP ( Lanzor ®, Nexium ®, Mopral ®, Protonix ®, Pariet ®, etc.).
This type of drug treatments are symptomatic solutions that certainly relieve, but can in no way permanently cure heartburn!
Surgical treatment is performed only if drug treatment fails and in cases of serious complications.
1) The drugs in question
It must be recognized that, in many cases, some drugs (nitro derivatives, calcium channel blockers, combined hormonal contraceptive pills, theophylline …) may be responsible for heartburn. How? They lower the strength of the lower esophageal sphincter and promote GERD.
A specialist said that nearly 70% of cases of gastro-oesophageal reflux are related to the use of anti-inflammatory drugs (aspirin and non-steroidal anti-inflammatory drugs). Since their introduction a few decades ago, there has been a significant increase in cases of GERD in our populations.
If you are taking these medications, it would be good to talk with your doctor that he may substitute other drugs which do not contribute to the development of GERD.
2) Foods to avoid
Among the list of foods that cause gastro-oesophageal reflux, there are foods or beverages containing caffeine or theobromine such as coffee, tea and chocolate. Indeed, these molecules have the effect of reducing the muscle strength of lower esophageal sphincter (LES).
Also, avoid eating fruits and acidic foods such as tomatoes and citrus (orange, lemon and grapefruit).
It is not recommended to consume spices (most irritating), onions, salad dressings, sparkling drinks (which cause bloating), milk, peppermint and spearmint.
Do not eat fatty or fried foods. Lipids also tend to trigger relaxation of the LES and to increase stomach acid secretions.
3) Healing foods to eat
Taking natural honey contributes somewhat to protecting the lining of the esophagus and regenerating the damaged tissues of the lower esophageal sphincter. Before you go to bed, take also a spoonful so it can work during sleep.
Eating apples (non-acidic) are excellent to use in case of gastro-oesophageal reflux. Whenever you feel acid reflux coming, eat one or two slices of apple.
Eat more ripe fruits (pears, peaches, papaya, figs) and vegetables (asparagus, leeks, zucchini, beets, salads) non-acidic.
Prefer the consumption of starchy cereals such as pasta and bread. The fibers are also recommended. Eat rice more often, especially brown rice. Lentils and beans are excellent natural pulses for neutralizing gastric acidity.
As for meat and fish, be sure to cook them grilled, roasted or boiled, but especially not in sauce or fried!
4) Basic rules of health
To avoid heartburn, do not overload your stomach. It is better to eat smaller amounts more often. Take your time to eat. Make an effort to chew food.
Do not eat just before you go to sleep (wait at least two to three hours). Indeed, if the lower esophageal sphincter of your lacks energy, once in a supine position, the stomach contents will be easier to escape by entering the esophagus.
In general, make sure that no pressure is exerted on your stomach (clothes too ‘fitted’, a belt too tight).
At night, do not lie flat on the mattress, it is preferable to have the bust tilted upwards (using perhaps several pillows or putting something under the mattress at the top)
5) Stress, alcohol, cigarettes and overweight
Some studies indicate that stress contributes to the symptoms of GERD. If you feel stressed, opt to follow a stress therapy (see page ‘ How to manage and reduce stress ‘ in this web site).
It has been reported that smokers are 70 % more likely to have heartburn than nonsmokers. Nicotine is a substance which would tend to relax the lower esophageal sphincter muscle and increase gastric acidity.
Drink less alcohol (alcohol weakens the esophageal mucosa and modifies its permeability).
Clinical studies have revealed that the degree of GERD increases with the degree of excess weight, fat intake and a delayed gastric emptying. If you are overweight or obese, be resolved, then, to lose weight, as it will help greatly to reduce or eliminate GERD.
Author : Alexis ROGER
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