How to deal with heartburn and stomach issues

Heartburn is a common issue associated with modern lifestyle.

Proton pump inhibitors are the medicines of choice for symptoms of GERD, also heartburn.

The modern lifestyle is often associated with unhealthy choices and may cause stomach problems. We talked to a general physician Damijan Gazvoda about the role of PPIs and the lifestyle changes required for the treatment of heartburn.

Why heartburn occurs

Heartburn occurs when the lower esophageal sphincter becomes too loose. Food mixed with gastric and bile acids as well as digestive enzymes flows back into the esophagus, which may cause inflammation. Some patients experience severe problems, though no physiological changes appear on the esophagus. In asymptomatic patients we suspect damage to the esophagus due to other issues.

Problems arise higher up in the throat and manifest as hoarseness, coughing or an asthmatic attack, or as a change in the mouth cavity that leads to the formation of ulcers on the tongue or damage to the tooth enamel. When no clear symptoms are present or the patient does not really experience them, we are talking about extraesophageal symptoms. Sleep apnea is one of them. It is caused by acid that reaches the vocal chords. Due to muscle contraction, intermittent pauses in breathing may occur during sleep.

When it comes to the quality of life what do patients complain about the most?

They are mostly bothered by reflux, i.e. the burning sensation they experience behind the breastbone right after a meal, particularly after heavy meals in the evening. The problems are more pronounced at night, during sleep. We also notice that the patients are – apart from coughing, which disrupts their sleep and scares them – more troubled by other things. Lately, there has been in increase in sleep apnea diagnoses. Sleep apnea is not as harmless as it seems – it may pose a grave danger to the patient’s health.

The role of PPIs in treatment

PPIs have become the first choice of treatment in patients with confirmed heartburn or other symptoms of gastroesophageal reflux disease (GERD). After 2 weeks, their problems usually go away. To protect gastric mucosa, long-term treatment with smaller doses of PPIs is recommended in older patients who often take various medicinal products, which may cause inflammation of the gastric mucosa.

Do you know any other myth in relation to heartburn treatment?

When self-medicating, patients often follow recommendations that have no basis in science.  One such popular recommendation is drinking lemon juice first thing in the morning. You have to understand that lemon juice relaxes the sphincter, which causes even more acid to escape into the esophagus.

What you can do to your help yourself

Nolpaza control* and Emozul control* are intended for short-term treatment of reflux symptoms (e.g. heartburn, regurgitation) in adults. If you experience such problems for two weeks or more, you might need to see a doctor.

Interesting facts

• If you often experience heartburn, it is advisable to go for a walk after a meal. Any kind of activity that increases the pressure on the intraabdominal tract (e.g. bending over at the waist) is not recommended.
• For a long time people believed that milk neutralized the gastric acid. The problem is that as soon as you drink it, it turns sour and does not help at all.
• Beer is a type of beverage that increases the secretion of gastric acid the most. Smoking is also a very common and harmful bad habit, which greatly contributes to heartburn.

Interview with Damjan Gazvoda, MD, spec. (07/12/2018). Heartburn and heartburn-related issues. Krka archives

* Krka has registered a wide range of products in different countries. There are differences in registration and availability of our products among the countries.

Some products may also have a different brand name in different countries. Please contact your local representative office for up-to-date details specific to your country or visit the available Krka’s local web pages.