Heartburn after eating

Our digestive system begins with the mouth, where we chew food by processing it with saliva. Then it enters in portions into the esophagus – a hollow tubular organ that connects to the upper part of the stomach. The walls of the esophagus are muscular, it is necessary for food to be rhythmically pushed down, from the inside it is covered with a mucous membrane, a layer of cells that protect against irritants.

Between the esophagus and the stomach there is a sphincter, this is a section of circular muscles that relax in time when food passes from the esophagus, and must be closed when the stomach digests food, processing it with hydrochloric acid and pepsin (the main components of gastric juice). If the tone of the lower esophageal sphincter is disturbed (decreased) or the stomach is stretched too much, the hole opens slightly, and the contents, along with acid, are thrown back into the esophagus – this is called reflux. The mucosa of the esophagus, unlike the stomach, is not protected from the effects of acid, and when we reflux, we feel heartburn. If heartburn occurs frequently, the esophagus becomes damaged, inflamed, and GERD occurs, which means gastroesophageal reflux disease.

What is heartburn

In fact, this is a symptom that occurs when the sphincter opens and acidic contents are thrown into the esophagus. This is one of the most striking manifestations of GERD, signaling irritation and inflammation of the esophagus. Episodic heartburn due to overeating or eating acidic foods is not dangerous. But if reflux becomes almost daily, this is an alarming symptom. Most often, the problem occurs after eating, when the stomach begins to actively produce acid and pepsin to process incoming food.

Heartburn symptoms

Heartburn is described as an excruciating subjective sensation, accompanied by burning, pain and discomfort behind the sternum, spasm, pressure, nausea, and heaviness in the abdomen. With GERD, heartburn is one of many other symptoms. Pain can be localized in the epigastric region, in the throat area, may be accompanied by sour belching and an unpleasant taste in the mouth. Sometimes reflux that occurs at night provokes a sore throat and cough.

Increased heartburn after eating, especially when lying down or bending over, may be temporarily relieved by eating or drinking.

Causes of heartburn after eating

The main cause of heartburn, as we have already found out, is the ingress of hydrochloric acid from the stomach back into the esophagus due to the fact that the sphincter is not completely closed. Heartburn can be triggered by many factors:

• foods, medicines and various conditions that increase the production of hydrochloric acid in the stomach;
• damage or insufficiency of muscles in the sphincter area, due to which it does not completely close;
• a change in the position of the esophagus and stomach, contributing to the reflux of contents in the opposite direction.

Coffee and alcohol, spicy, sour foods, spices, carbonated drinks, chocolate are considered irritants and stimulants for acid secretion. Non-steroidal anti-inflammatory drugs, some painkillers are also dangerous.

The tone of the sphincter is negatively affected by fatty foods, overeating and smoking.

During pregnancy, the presence of a hernia in the diaphragm, obesity, especially if fat accumulates in the abdominal cavity, the stomach rises higher, taking a more horizontal position. This makes it easier for the acid to flow back into the esophagus.

In some situations, persistent heartburn is a sign of gastritis with high acidity, peptic ulcer disease, tumors and systemic diseases.

Treatment for heartburn after eating

In addition to discomfort, heartburn and GERD are dangerous serious complications. These are inflammatory lesions of the esophagus that can lead to ulcers and bleeding, scarring, and narrowing of the sphincter, causing problems with eating. In addition, frequent contact with acid leads to a change in the epithelium of the esophagus – the formation of a precancerous “Barrett’s esophagus”, and without treatment – even cancer.

And severe heartburn can simulate a heart attack, and the patient may even end up in the hospital. Therefore, it is important to find out the causes of heartburn as soon as possible and start treatment.

Diagnostics

The doctor will definitely take into account all complaints, in addition to heartburn, and will even ask you to keep a diary in order to assess what factors provoke deterioration. Additionally, you will need an x-ray of the esophagus and stomach with contrast, endoscopy (EFGDS) to visually assess the walls of the esophagus and stomach, as well as a number of tests. In order to assess the work of the sphincter, manometry is performed with pH-metry of the esophagus – they measure muscle tone and acidity in the lumen of the organ.

Modern treatments

Of course, lifestyle changes play a significant role in treatment. It is important to review the diet, removing irritating foods from it, and also not to transfer, to eat often, in small portions. It is important to stop eating 2-3 hours before bedtime. You should try to give up alcohol, smoking and take medications strictly as directed by the doctor, even if they are banal painkillers. After eating, you should not immediately lie down or bend over, you should be more physically active so that the food leaves the stomach sooner.

“The most common drugs that patients themselves use for heartburn are antacids,” says gastroenterologist, therapist Vera Samsonova. – They “extinguish” hydrochloric acid in the stomach and alleviate the condition, eliminating discomfort and pain. However, they do not affect the problem itself – excessive production of hydrochloric acid and weakness of the sphincter, these are symptomatic drugs. And their action is not very long, they bind the acid that has already been released, but do not affect the production of new portions.

Other drugs that are used are histamine H2 receptor antagonists. Their action is to block the activity of histamine, a substance that stimulates the stomach to produce hydrochloric acid.

Another group is proton pump inhibitors. These drugs also block the release of acid from the stomach cells, but in a different way. The very first of the drugs in this group is Omeprazole. A more modern PPI is Rabeprazole. When taken once a day, Rabeprazole is able to reduce the production of hydrochloric acid for a long time, helping to prevent heartburn.

Prevention of heartburn after eating at home

No less important is the prevention of heartburn, and this is the concern of the patient himself. Along with taking medications selected by the doctor, it is necessary to reconsider your attitude to nutrition, reduce the amount of fatty and fried foods, spicy foods, alcohol and carbonated drinks consumed. It is equally important to lose weight, often heartburn is aggravated by fat accumulated around the waist.

It is important to stop smoking, and take any medications, especially those that irritate the stomach, only when absolutely necessary and after consultation with your doctor.

Popular questions and answers

We discussed with gastroenterologist Vera Samsonova questions regarding ways to get rid of heartburn, including in expectant mothers, as well as tactics of action in the event of frequent heartburn.