All About Heartburn With Dr. Philip MacMahon
Monday, 15 December 2008
As the party season kicks off many of use will be overindulging over the next few weeks. A result of this can be heart burn . Today we'll be telling you about the signs and symptoms of heartburn and how to avoid it over the party season!
Heartburn or acid indigestion is a common complaint, especially during the holiday periods when we are more likely to over indulge in rich food, drink alcohol to excess and lie around on the sofa all day, all of which spells trouble for our digestive system.
What is heartburn?
Heartburn is a form of indigestion referred to by doctors as gastro-oesophageal reflux (GORD). It is caused by acid flowing back up from the stomach into the oesophagus (the tube that connects the throat to the stomach). Normally the muscle connecting the stomach and oesophagus (oesophago-gastric sphincter) closes and only allows food and acid down into the stomach.
However, when this sphincter is weakened, the reverse happens and the contents of the oesophagus and acid flow back up into the oesophagus causing heartburn. Children are also prone to heartburn; it may be responsible for recurrent chest infections in this age group as well as contributing to the occurrence of asthma. Reflux induced asthma may result from the contents of the oesophagus spilling over into the lungs, thus causing narrowing of the airways, giving rise to wheezing.
What causes heartburn?
Some factors that have been implicated in the development of heartburn include:
. Fatty foods
. Chocolate
. Pregnancy
. Smoking
. Alcohol
. Large Meals
. Obesity
. Lying down too soon after a meal
. Hiatus hernia - a condition whereby part of the stomach moves up through a small opening in the diaphragm (the muscle separating the stomach from the lungs)
. Drugs e.g. nitrates and calcium channel blockers (used in the treatment of heart problems); aminophylline and beta agonists (used in the treatment of lung problems)
What are the typical symptoms?
The main symptom of heartburn is a burning sensation in the chest that gets worse after eating, bending or lying down. This may sometimes be confused with chest pain (angina). However, there are some differences. Angina usually occurs on exertion and is relieved by resting. Heartburn is not usually related to exercise.
Other symptoms of heartburn include:
. Acid/bitter taste in the mouth;
. Hoarseness - the acid contents make contact with the lining of the throat thus causing inflammation of the throat (laryngitis);
. Difficulty swallowing;
. Coughing.
Occasionally complications can arise from chronic acid reflux including:
. Oesophagitis (inflammation of the oesophagus);
. Ulceration of the oesophagus;
. Narrowing (stricture) of the oesophagus;
. Barrett's oesophagus - this is a condition whereby the cells lining the oesophagus change. It needs to be monitored closely as it can be lead to oesophageal cancer.
Should I see my GP
A doctor should be consulted if heartburn is severe and frequently occurring; if antacids are used regularly for a period of three weeks or more or if you experience hoarseness, difficulty swallowing or coughing.
Your doctor may carry out certain tests such as:
. Gastroscopy. This is a camera test that looks for inflammation of the oesophagus and stomach. Sometimes a sample of tissue may be taken (biopsy) and sent to the laboratory for analysis.
. Special x-ray tests called barium studies may be done to look for narrowing of the oesophagus.
. Manometry tests. These look specifically at the pressure in the oesophagus.
. How can I get relief from heartburn?
How can I avoid Heartburn?
The most effective way to avoid heartburn lies with your lifestyle:
. Don't smoke
. Avoid alcohol
. Cut down on fatty foods
. Switch to decaffeinated tea and coffee
. Sleep with your head raised If you are overweight,
. Take steps to lose those extra pounds
Treatments
. If you do suffer from occasional bouts of heartburn, the most common treatment is over-the-counter antacids. These work by neutralising the stomach acid and provide rapid relief of symptoms. However, taking too many antacids can cause side effects such as diarrhoea and electrolyte abnormalities.
. H2 Antagonists such as ranitidine (available over-the-counter) and cimetidine (prescription only) give relief to heartburn by inhibiting acid secretion. Side effects are few but Cimetidine may interact with some drugs including warfarin.
. Proton pump inhibitors (prescription only) including omeprazole and lansoprazole ease heartburn by blocking an enzyme involved in the production of acid. They produce good symptom relief and also promote healing of oesophagitis (inflammation of the oesophagus). They are generally well tolerated but can cause diarrhoea, rash and headache.
. Surgery is occasionally necessary if medical therapy fails and involves a procedure called a fundoplication in which that part of the stomach is wrapped around the oesophagus.
What causes heartburn during pregnancy?
When you're expecting, the hormones coursing through your body make the muscles of the digestive system relax, which slows down digestion. The valve in your esophagus may open or leak, allowing acid from the stomach to flow upward. In addition, as your uterus grows, it pushes against the stomach, increasing pressure on the valve.
The slowdown in digestion can also cause more gas, which is the culprit in flatulence and bloating. Your stomach has less room due to your expanding uterus, and so feels fuller than normal.
Do's and Don'ts for the Christmas season
Do;
. Sit down to eat
. Eat slowly
. Take at least 15 minutes to eat
. Chew food well
. Try to sit for 20 minutes after eating
Don't:
. Drink excessive amounts of coffee, acidic or fizzy drinks, or alcohol
. Eat too much chocolate, fatty foods or tomatoes
. Fill your stomach - always leave some room
. Eat large meals or late in the evening
Source www.vhi.ie
Next Week:
Next week Dr. Philip will be taking your calls on common Christmas ailments.