Heartburn: causes, diagnosis, therapy

Heartburn can have several causes, including reflux disease. The secondary diseases are sometimes bad

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One coffee too much: The burning sensation rises from the upper abdomen or lower chest to the throat

© W & B / Martin Ley

Heartburn - in a nutshell

  • Heartburn is the main symptom of reflux disease (gastroesophageal reflux disease): a burning sensation under the breastbone, especially after meals and when lying down. Around a quarter of people in Western countries have reflux symptoms once a month. Often there is also belching of acidic gastric juice. Belching without acid is also possible.
  • There are also other causes of heartburn. An irritable stomach, an inflammation of the esophagus or the stomach lining, a stomach ulcer or a diaphragmatic hernia are just a few of them.
  • If the symptoms persist after adjusting your diet, quitting smoking and a first drug test treatment, the esophagus must be checked with an endoscopy.
  • Therapy depends on the cause. Lifestyle changes and medicines - some of which are available in pharmacies without a prescription - can relieve heartburn. So-called antacids or H2-receptor antagonists help in mild cases. Proton pump inhibitors are used for more severe symptoms or symptoms that last longer than two weeks. In addition, a solution to protect and regenerate the esophageal mucosa can be useful. Surgery is rarely indicated.

Heartburn: overview

The fat Sunday roast and a glass too much - who does not know the symptoms afterwards: It presses in the stomach, burns in the sternum area, sometimes up to the throat. Often a little acid comes up with it, sometimes even part of the "half-digested" food, especially if the belt is too tight or if you bend over. The unpleasant heartburn that causes such reflux (Latin for "reflux") often subsides quickly. So the whole thing is a physiological reflux.

A digestive walk helps best, the afternoon nap is less helpful. Because lying down flat only increases the burning sensation and belching. If you follow a lavish meal for a few days with light food (low-fat, no alcohol), you usually no longer have any problems.

However, some people also experience heartburn when they have not eaten for a long time and are really hungry. Others, on the other hand, are fed up with stress and grief and encourage painful reflux. Some suffer less from burning pain, but are hoarse, have to clear their throat frequently or - especially in the morning - cough repeatedly. Heartburn is also a problem for many pregnant women when the child is pressing on the stomach, mostly in the last trimester of pregnancy. In addition, the increased hormone levels affect the elasticity of many tissues. The sphincter muscle in the esophagus becomes a little "looser".

What happens when gastric acid refluxes
When stomach acid flows back up the esophagus, it often results in acid regurgitation and heartburn. In extreme cases, acidic stomach contents can reach the throat. Irritation of the mucous membrane in the respiratory tract with breathing difficulties at night, a dry cough in the morning, sore throat and bad taste in the mouth are among the possible complaints (more on this below and in the chapter "Reflux disease").