Heartburn

Heartburn ( pyrosis Greek, in Switzerland, heartburn ) describes an ascending from the upper abdominal burning and painful sensation behind the breastbone that radiates sometimes to the neck and the throat, often with sour or bitter eructations. Heartburn is the symptom of reflux disease and reflux esophagitis. Etymologically, means the barely used word Sod ' boiling, the Seething ' and is from the Old High German SOD, as well as Middle High German gisōd sot ' the Wallen, boiling, boiling liquid, broth, fountains ' derive.

Causes and History

The pain is mostly caused by the reflux of stomach acid into the esophagus strongly acidic (esophagus). This results in irritation of the epithelium of the esophagus is stock tern chemo- nociceptors by H ions because of the acid caused by the loosening of the cell junctions of the mucosal epithelium and thus increased permeability in the intermediate range of cells. But bitter, bilious regurgitation may also indicate a reflux from the duodenum. It can occur in a weakening of the smooth gastric sphincter muscles as an accompanying symptom, especially with increased activity of the intestine ( motility ) and non-acid- related. Furthermore, heartburn by a non- acidic gastric reflux caused, eg, by food and beverages, including various mechanisms such as reflux induction, local irritation or stimulation threshold reduction are possible.

Not every event actually occurs reflux heartburn; the symptom generation is dependent on the extent and duration of the pH drop, the extent of the attacked by acid mucosal surface as well as an awareness of the receptors due to previous heartburn. Frequency and intensity can be strongly influenced by a different individual Säurempfindlichkeit as well as by psychosocial factors such as stress or physical comorbidities. Next appear to play a role in the formation such as by a Ösophagusdehnung interactions between the chemical and mechanical sensitivity of the esophagus. Furthermore, there may be inflammatory mediators to a hypersensitivity of chemotherapy pain cells, which can then be amplified via central mechanisms and spatially extended.

Prevention and treatment

Acid reflux can especially after fatty or spicy food, peppermint -containing foods, coffee, alcohol or nicotine consumption occur and reinforce lying down. It is therefore recommended to avoid these triggering factors before bedtime. Drug treatment options for short-term symptom reduction are at acidic gastroesophageal reflux antacids, which neutralize as buffer the stomach acid, and proton pump inhibitors that suppress the production of stomach acid on the inhibition of H / K -ATPase in the parietal cells of the stomach. Thus, the reflux will not be prevented, but the esophagus is irritated not by the acid gastric juice. Another treatment option is the ingestion of alginate that places itself as a tough foam over the stomach contents and in this way protects the esophagus.

Pregnancy

Are between 40% and 80 % of all pregnant women, usually in the last trimester of pregnancy affected by heartburn. Main cause of heartburn in pregnancy is the faulty locking mechanism between the esophagus and stomach. The pregnancy-related increase in the hormones progesterone and estrogen causes the lower esophageal sphincter is less tense than before or after a pregnancy. In addition, increased pressure in the abdominal cavity, which the closing ability of the lower esophagus sphincter also reduces due to the growing uterus. The interaction of these factors leads to an increase of stomach acid to flow into the esophagus. Can provide relief sleeping with elevated upper body, frequent small meals instead of a few rich and generally the avoidance of fatty food and sweets. For drugs should be used only in severe cases and in consultation with a doctor.