What helps against reflux

The common ailment heartburn: Oesophagus “under fire”

Burning, pressure and acid regurgitation due to heartburn.

(Bild: Adiano/stock.adobe.com)

Many people are familiar with the stabbing pain in the stomach area: Heartburn (pyrosis) is a common ailment in this country. Around 20 percent of adults suffer from it regularly, which often leads to a significant reduction in quality of life. And the trend is rising sharply. If left untreated, the disease can even lead to cancer.

While some sufferers talk of a "burning sensation", for others it manifests itself in the form of a feeling of pressure or acid regurgitation. Sometimes the pain is so severe that some patients even believe they are having a heart attack during a severe attack. After all, heartburn is also called "heart burn" in English.

Complaints often dismissed
However, as many people are affected, the symptoms are often dismissed and not taken seriously. OA Dr. Andreas Tschoner, Head of the Reflux Outpatient Clinic at the Ordensklinikum Linz Barmherzige Schwestern (Upper Austria), urgently warns against this: "Someone who regularly has heartburn and leaves it untreated has a 40-fold increased risk of developing esophageal cancer. A gastroscopy is important so that carcinomas can be detected earlier."

Why it burns
"Stomach contents, or more precisely stomach acid, flow back into the oesophagus. The mucous membrane is not designed to withstand such pH values. This causes inflammation and that hurts," explains reflux specialist OA Dr. Andreas Tschoner.

Someone who regularly has heartburn and leaves it untreated has a 40-fold increased risk of developing oesophageal cancer.

OA Dr. Andreas Tschoner, Ordensklinikum Linz Barmherzige Schwestern

Bild: Ordensklinikum Linz Werner Harrer Fotograf

Fat and sugar cause problems
Reflux disease is promoted by large meals, dishes high in fat and sugar and carbonated drinks as well as hot and spicy foods. The stomach reacts to these foods with increased acid production. This actually helps to break down the food so that the body can absorb the various components properly.

With reflux, however, this system becomes unbalanced. The reflux occurs because the function of the sphincter, a so-called valve between the oesophagus and stomach, is disrupted. Unlike the stomach, the mucous membrane of the oesophagus has no natural protection.

When to see a doctor?
If you occasionally notice heartburn immediately after eating, there is no need to worry. "However, if the discomfort also occurs on an empty stomach or at night, it is an indication that the closure mechanism is no longer working. Then you should see a doctor," advises Dr. Tschoner.

Relieving the burning sensation

• The mildest form of therapy is a change in diet, such as avoiding highly acidic foods and drinks (tomato products, citrus fruits, coffee and alcohol), fatty, spicy and very sweet foods.
• Drink teas that soothe the stomach: Fennel, caraway or chamomile tea.
• In general, try to eat small meals that are less stressful on the stomach.
• The most effective way to do this is to lose weight.
• Quitting smoking also contributes to an improvement.

How is it treated?
Proton pump blockers are usually used as medication. These reduce stomach acid and usually make the symptoms disappear. "Stomach contents still run back. But because less acid is produced, those affected no longer feel it. Some patients also take a tablet before a barbecue or party to prevent heartburn," says Dr. Tschoner.

A gastroscopy is indicated every five years. "If the symptoms are persistent and keep coming back, we recommend a gastroscopy. During the examination, doctors can assess the damage to the mucous membrane and the extent of the inflammation," explains the expert. If gastroesophageal reflux disease is diagnosed, treatment can also take the form of surgery. The defective valve is reconstructed during the one-hour procedure.

Diaphragmatic hernia as a cause
"A hiatal hernia is also often the cause of heartburn. This is repaired at the same time as the operation: A sleeve is formed around the oesophagus from part of the stomach and the stomach bladder, thus restoring the function of the valve. However, you should pay particular attention to the quantities you eat afterwards. The new valve loses tension again if it is regularly overstretched," explains Dr. Tschoner.