Heartburn with gastritis

Many people are familiar with the uncomfortable feeling of irritation and burning along the esophagus: we are talking about heartburn. The problem can appear when eating spicy or fried food, fast food, after overeating, and even after excessive physical activity. However, heartburn most often occurs with gastritis - a disease that is associated with certain digestive problems.

What is gastritis and why is it accompanied by heartburn?

Before trying to understand the mechanism of heartburn in gastritis, it is important to get information about what gastritis is.

Gastritis is an inflammatory reaction affecting the mucous tissue of the stomach. Such inflammation is caused by a number of factors, such as:

• parasitic, viral or microbial infection, including the bacterium Helicobacter pylori;
• treatment with medications that have an ulcerogenic effect (non-steroidal anti-inflammatory drugs, steroids, etc.);
• frequent stress, chemical poisoning, alcohol abuse.

Heartburn with gastritis is not always a concern: its appearance most often accompanies gastritis with high acidity, but heartburn is also possible with low acidity. It occurs when the acid-base balance in the digestive system is upset. Part of the food or gastric juice gets back into the esophagus, which leads to unpleasant sensations.

Causes heartburn with gastritis

Heartburn with gastritis occurs mainly due to impaired acidity of gastric juice. Less often, its appearance is explained by excessive sensitivity of the mucous tissues of the digestive tract. Against the background of gastritis, heartburn can bother with errors in nutrition or after stress.

Doctors say that the most common causes of heartburn are dietary disorders and an unhealthy lifestyle.

• Well-known bad habits such as smoking, drinking alcohol, and frequently including fatty and spicy foods, soda, strong tea or coffee in the diet can lead to increased acidity in the stomach, as well as disruption of the gastric valve.
• Heartburn with gastritis can occur if a person eats several tomatoes, fresh baked goods, chips or fried foods on an empty stomach.
• Overeating is the main cause of heartburn: excess food in the stomach leads to excessive stretching of its walls and hypersecretion of acid.
• Taking certain medications, such as acetylsalicylic acid, diclofenac, ibuprofen, increases the production of acid in the stomach. When acid gets into the esophagus (even in small quantities), heartburn occurs.
• Too tight clothing in the abdominal and chest area, pregnancy, obesity - all these factors can increase the pressure in the abdominal cavity, which also provokes the appearance of heartburn.
• With gastritis, heartburn can be provoked if a person takes a horizontal position immediately after eating (for example, going to bed).
• Long-term stress or short-term but severe anxiety can also trigger heartburn.

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Foods that cause heartburn in gastritis

Heartburn with gastritis can appear after any food, if the patient regularly overeats, or adds hot spices to dishes, or eats “on the run”, “whenever necessary”, without following a regimen.

According to medical statistics, heartburn with gastritis most often begins to bother after consuming the following foods and drinks:

• alcoholic and carbonated drinks;
• coffee (especially instant), strong tea;
• sweets, fresh baked goods;
• spicy foods, fatty foods;
• fried foods;
• tomatoes with skin;
• sauces (fatty, with spices, with vinegar, garlic, mayonnaise, etc.).

We will tell you more about the principles of proper nutrition for heartburn and gastritis below.

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Risk factors

What accelerates the appearance of heartburn in gastritis?

• Eating a large amount of food in a short period of time.
• Frequent consumption of fatty foods, failure to follow the principles of proper nutrition.
• Overweight, obesity.
• The habit of taking a nap after eating.
• Smoking, drinking alcohol.
• Regular consumption of carbonated drinks.
• Drinking strong coffee and tea.
• Adding hot spices, garlic, chili peppers, horseradish, and mustard to food.
• Taking non-steroidal anti-inflammatory drugs, hypotensive drugs, as well as medications whose action is aimed at relaxing smooth muscle fibers.
• Pregnancy.

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Pathogenesis

The pathogenetic basis for the occurrence of heartburn in gastritis is gastroesophageal reflux, which is characterized by a pathologically increased frequency or duration of episodes of acidic contents from the stomach cavity into the esophagus. As a rule, reflux is caused by the failure of the cardiac safety mechanism (for example, with low pressure of the lower esophageal sphincter and a hernia of the esophageal opening of the diaphragm).

The effect on the mucous tissues of the esophagus is determined by the following factors:

• composition of the cast (enzymes, acids, etc.);
• duration of exposure;
• the mucous tissue's own protective abilities.

Reflux can occur due to increased pressure in the abdominal cavity (with excess weight, with difficulty with defecation, during pregnancy) or in the gastric cavity (with duodenostasis, gastric stasis).

Heartburn may occur due to a disruption of the motor functionality of the stomach: insufficient mixing of food causes the formation of an acid accumulation near the cardia. The formed "pocket" gives rise to reflux and heartburn.

As a rule, heartburn is considered one of the most characteristic symptoms of gastritis with high acidity.

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Heartburn with gastritis and the degree of acidity

The basic indicator of adequate stomach function is the degree of its acidity, or the concentration content of acid, which is measured in pH. The maximum acidity is defined as 1pH, neutral as 7pH, and the maximum alkaline environment as 14pH. To assess the state of the digestive system as a whole, the degree of acidity is determined simultaneously in several of its sections.

The number of parietal cells in men is approximately 1.5 times greater than in women. Therefore, men are more likely to develop gastritis with increased acidity.

The main direction of action of gastric acid is the breakdown of complex molecular structures to facilitate their absorption in the small intestine. In addition, the acid creates optimal conditions for enzymatic activity, antimicrobial treatment of food mass, and regulation of acid-base balance within the body.

A shift in acidity in one direction or another leads to the appearance of painful symptoms, and diseases develop, such as reflux disease, gastritis, etc.

When there is an excess of acid secretion or when it is not neutralized sufficiently, a state of increased acidity occurs. By the way, heartburn with gastritis with increased acidity is considered one of the leading symptoms. It is caused by the juice from the stomach entering the esophagus, either immediately after eating or after a person takes a horizontal position. The acid begins to irritate the mucous tissue, which leads to a burning sensation behind the breastbone.

A shift in pH to the alkaline side can also be characterized by similar signs, although heartburn with gastritis with low acidity is not a mandatory and typical symptom. Against the background of low acid content, enzymatic activity decreases, complex protein foods become difficult to digest. As a result, fermentation processes start in the intestines, bloating and "rotten" belching occur, and the contents of the stomach are partially thrown into the esophagus, which causes a feeling of heartburn.

An unpleasant sensation behind the breastbone can be detected not only with acute gastritis. Long-term and severe heartburn occurs with chronic gastritis, with ulcerative-erosive lesions, with gastroduodenitis. Therefore, if such a symptom occurs simultaneously with sour or bitter belching, with pain in the stomach, with a feeling of heaviness, flatulence, loss of appetite, then you need to urgently seek help from a doctor: in this situation, a gastroenterologist or therapist can help.

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Treatment heartburn with gastritis

To give clear and correct recommendations on the treatment of heartburn, you need to know why it appeared. In rare episodes, provoked by a change in the regime or diet, special medical intervention is not required: it is enough to adjust the lifestyle, improve nutrition, and the problem will go away on its own.

It's a completely different story if heartburn bothers you often and the cause is gastritis. In such a situation, complex treatment is used, the task of which is not just to eliminate discomfort, but also to affect the underlying pathology (in this case, gastritis).

The doctor selects the medications: as a rule, the therapeutic regimen is made up of drugs representing several categories at once (for example, antacids are prescribed simultaneously with enveloping and antimicrobial agents).

We can talk about a complete cure for heartburn only after successfully treating the underlying pathology – gastritis.

However, medications are only part of the therapy. Diet and lifestyle changes also play an equally important role.

It is absolutely necessary to stop smoking and drinking alcohol, and to decide on the correct diet. And medications will only be a reinforcement and part of the basic therapeutic scheme.

Heartburn Remedies for Gastritis

Medicines are prescribed by a doctor only if there are indications, based on the results of diagnostics. Before taking any medicine, you need to study the instructions carefully, weigh all possible contraindications and assess the likelihood of side effects.

Heartburn associated with gastritis is treated with medications from different pharmaceutical categories.

• For mild and rare attacks of heartburn, use agents that reduce the manifestations of reflux and protect the mucous tissue from the effects of acid:

1. Antacids are primarily intended to neutralize gastric acidity. Their effect is fast but short-lived. Typically, this category is represented by aluminum, magnesium, and calcium compounds. Long-term treatment with antacids can cause bowel movements (diarrhea, constipation), as well as cause signs of aluminum intoxication.
2. Alginates are high-molecular polysaccharides that can form a protective film on the walls of the stomach and esophagus. The most famous alginates are Gaviscon, Laminal, calcium alginate, etc. These drugs have virtually no side effects: they are obtained from brown algae. The main purpose of alginates is symptomatic relief from heartburn in gastritis.
3. Preparations that protect the stomach walls (gastroprotectors) – they create protection for the mucous membrane from an aggressive acidic environment. The peculiarity of such preparations is the ability to stay exclusively on damaged tissues. The main active substance of gastroprotectors is tripotassium dicitrate bismuth.

• In severe gastritis and frequent episodes of heartburn, therapy should be not only complex, but also long-term. In combination with antacids and gastroprotectors, medications from other categories are included in the treatment regimen.

1. Antisecretory agents (h2-histamine receptor blockers and proton pump inhibitors) – reduce the production of pepsin and mucus, strengthen the mucous membrane, inhibit the secretion of hydrochloric acid. The main representatives of the first group of drugs are Ranitidine, Cimetidine. The most common proton pump inhibitor drug is Omeprazole (Omez). As a rule, such medications are well accepted by the body, and side effects develop only with a long period of treatment (more than 3 months).
2. Prokinetic agents are drugs that improve the motor function of the digestive tract. In case of heartburn, their main purpose is to increase the tone of the esophageal sphincter and prevent the throwing of food and acid from the stomach cavity.

Tablets for heartburn and gastritis

Here we will present to your attention a small list of the most common tablets that can help if heartburn due to gastritis begins to bother you.

Rennie	An antacid and gastroprotective drug, with the active action of calcium and magnesium carbonate. The tablets are chewed or held in the mouth until dissolved, 1-2 pieces when heartburn occurs. The maximum daily dose of tablets is up to 16 pieces. Rarely, but allergy to Rennie may occur.
Gastal	This is a preparation of aluminum hydroxide, carbonate and magnesium oxide. The standard dose is 1-2 Gastal tablets up to 6 times a day (optimally 60 minutes after meals). When using large doses of the drug, hypophosphatemia and hypercalciuria may develop.
Pechaevskie tablets	The tablets are classified as biologically active supplements, and their action is based on the properties of magnesium and calcium carbonate. For heartburn, take 1 tablet three times a day, 30 minutes after eating, with a sufficient amount of water.
Gaviscon	Chewable tablets and suspension have an enveloping effect, soothe heartburn and prevent the development of reflux. The tablets are chewed with a small amount of water. The standard dose is 2-4 tablets 4 times a day, and the duration of treatment may not exceed seven days. Side effects are rare: allergies are possible.
Maalox	Tablets or suspension based on aluminum and magnesium hydroxide. Tablets are taken for heartburn in chronic gastritis, between meals, 1-2 tablets (dissolve in the mouth). With prolonged use of the drug, a lack of phosphorus in the body may occur.
Text control	The drug pantoprazole (sodium sesquihydrate) is taken on an empty stomach, 1 tablet per day, but not more than one month in a row. Treatment may be accompanied by side effects such as nausea, increased fatigue, allergies, swelling.

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Folk remedies for heartburn

The folk medicine recipes we have outlined are used to “calm” heartburn during gastritis, or for the combined treatment of the inflammatory disease itself.

It is important to remember that any means – traditional or folk – will only work if the patient adheres to certain nutritional principles. Without an appropriate diet, treatment will be ineffective. But we will discuss the diet a little later, and now let's talk about folk methods of therapy.

You can get rid of heartburn due to gastritis in the following ways:

• Pour 1 teaspoon of flax seeds into 100 ml of boiling water and leave overnight. In the morning, add boiled water, bringing the volume to 200 ml. Take the remedy on an empty stomach every day for two weeks. If you need urgent help with heartburn, you can grind some flax seeds, take 1 teaspoon of the resulting powder, pour 200 ml of warm water and drink in small sips.
• Take 1 teaspoon of anise, fennel and dill seeds, pour 200 ml of boiling water over them, and cool. Take the remedy one small sip at a time until the heartburn “calms down”. Systematic use of such a remedy should not exceed two weeks in a row.
• In the morning, before eating, grate a peeled potato, squeeze the juice through cheesecloth. Drink about 100 ml of juice on an empty stomach, in small sips. Then rest for half an hour, and only then have breakfast. The entire course of treatment in this way can last 10 days. After a few days of break, the treatment can be repeated.
• Grind washed and dried oats, together with the peel, in a coffee grinder. For heartburn, take 1 tbsp of this powder, pour it into a thermos, add 300 ml of boiling water. Infuse the remedy for five hours, filter and drink ¼ cup (about 50 ml) 15-20 minutes before any meal, as well as before going to bed.

If you need to quickly eliminate heartburn, and there is no time to prepare juices and infusions, then you can take a simpler path, for example:

Take an almond and chew it in your mouth;

Chew a pinch of oat or barley grains, moistening them well with saliva and swallowing little by little.

Honey for heartburn and gastritis can also be a quick remedy. However, to get a positive effect, it is necessary that the honey is real, not store-bought. One teaspoon of the natural product is slowly dissolved in the mouth, washed down with warm water. Too much honey should not be eaten - this can only worsen the situation. It is optimal to eat 1 teaspoon 3-4 times a day, with water or warm herbal infusion.

Soda should not be used as a quick remedy for heartburn: immediately after taking the soda solution, it does become easier, but then the situation only gets worse. In the stomach, acid secretion becomes even more intense, which can be complicated by a stomach ulcer.

Milk is also not recommended for heartburn and gastritis. Despite the seemingly quick positive effect, whole milk subsequently stimulates acid production and contributes to increased heartburn. Moreover, whole milk is not recommended for inclusion in the diet of patients with gastritis.

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Herbs for heartburn and gastritis

• Take 3 tbsp. of chamomile flowers, pour 250 ml of boiling water and keep under the lid for 15 minutes. Then filter the infusion and drink in small sips. It is optimal to drink at least 3-4 glasses of such infusion daily.
• Take 1 teaspoon of ground rhizome, leaves and angelica seeds, grind everything to a powdery state. Then dilute ¼ teaspoon of powder in 200 ml of boiling water, leave for 15 minutes and take half an hour before meals, three times a day.
• Squeeze the juice from an aloe leaf and store it in the refrigerator. For heartburn, take 1 teaspoon of juice, dilute it in 50 ml of water and drink in small sips.
• Melissa leaves are brewed in the amount of 1 teaspoon in a glass of boiling water, I drink it instead of tea during the day between meals. Instead of lemon balm, you can brew acacia or linden flowers.

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Homeopathy: Complementary Effects

If a patient decides to use homeopathic remedies to get rid of heartburn or to treat gastritis, he or she should first consult a homeopathic doctor. Only a specialist has the right to prescribe a particular medicine, as well as determine its dosage and frequency of administration.

It is not recommended to combine homeopathic remedies with alcohol, coffee or tea, mint infusion, or vinegar, as these products can neutralize the effect of the drugs.

If the doctor prescribed homeopathic granules or tablets, they should be gradually dissolved in the mouth, and drops should also be held in the mouth for a few seconds before swallowing. Any such remedy is taken between meals.

To eliminate heartburn due to gastritis, the following homeopathic medications are used:

• Duodenoheel - take 1 tablet three times a day between meals. In the acute period, it is possible to take 1 tablet every 15 minutes, but not more than 2 hours.
• Gastricumel - taken sublingually, 1 hour after meals, three times a day.
• Quinine is prescribed in various dilutions, individually.
• Nux vomica-Homaccord – taken 30 drops/day, divided into three doses, in 100 ml of water.
• Conium - use medium doses, from the third to the twelfth dilution.
• Petroleum is taken in an individually selected dose, under the tongue, gradually dissolving.
• Robinia - use dilutions of 3x, 3, 6 and more.

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Diet for heartburn and gastritis

If heartburn with gastritis has bothered you more than once, but appears regularly, then you cannot do without radical changes in nutrition. The most important principles of such changes are considered to be the following:

• avoiding overeating;
• eliminating foods that can irritate the stomach (smoked foods, fatty and spicy foods).

A properly formulated diet for heartburn and gastritis should be both gentle and at the same time complete, with sufficient content of vitamins, minerals and other useful components.

When following a diet, it is important to follow these recommendations:

• for heartburn and gastritis, eat little by little, at approximately equal intervals - optimally up to six times a day;
• You should not lie down immediately after a meal, so it is better to plan dinner 2.5 hours before going to bed;
• It is better to replace any drinks with ordinary clean warm water - it will smooth out the symptoms of heartburn and improve the motility of the digestive tract;
• Immediately after eating, you need to rest - for example, read a book or listen to music, but do not immediately begin physical work.

To prevent heartburn during gastritis, the following foods should be included in the diet:

• low-fat cottage cheese, low-fat and non-acidic kefir, fermented baked milk;
• lean meat parts (chicken fillet, veal);
• rice, oatmeal porridge;
• dried bread, crackers;
• boiled, baked or stewed vegetables (potatoes, cauliflower, broccoli, carrots);
• non-acidic fruits (ripe bananas, apples);
• weak tea, herbal tea, jelly.

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Menu for heartburn and gastritis

The main thing with any manifestation of heartburn is the correct changes in nutrition. You should not think that from now on the sick person will have to eat only monotonous and bland food: this is not true. There are many tasty and healthy dishes that can be successfully included in the menu for heartburn and gastritis. Here is a simple example of a three-day diet that you can take into service and stick to, making changes and replacing products at your discretion.

• Day one.

1. Breakfast: rice porridge, chamomile tea.
2. Second breakfast: babka made from low-fat cottage cheese, or baked fruit with cottage cheese.
3. Lunch: pureed vegetable soup, stewed meat with vegetables, jelly.
4. Afternoon snack: fruit jelly, rusk.
5. Dinner: stewed fish with buckwheat, tea.

• Day two.

1. Breakfast: steamed cheesecakes, rosehip tea.
2. Second breakfast: dry biscuits, compote.
3. Lunch: homemade noodles with chicken, vegetables, chamomile tea;
4. Afternoon snack: a cup of yogurt with honey.
5. Dinner: steamed potato cutlets or cabbage rolls, tea.

• Day three.

1. We have breakfast: a couple of soft-boiled eggs, a rusk, tea.
2. Second breakfast: banana, pear or apple.
3. Lunch: chicken soup with oatmeal, baked potatoes, compote.
4. Afternoon snack: fruit pudding.
5. Dinner: dumplings with cottage cheese, manna pudding, a glass of yogurt.

Meals should be frequent, but without overeating, in small portions: for convenience, you can buy a plate, the volume of which is smaller than usual. This will make it easy to control the amount of food eaten.

To make it easier for yourself to follow the diet, it is recommended to make an approximate menu for a week or several days in advance. You should not "drive" yourself into excessively strict limits: sometimes you can allow yourself, for example, sweets that are not strictly prohibited by doctors - these are marshmallows, marmalade, a little juice diluted with water.

What should you not eat if you have heartburn and gastritis?

A complete list of foods and drinks that are prohibited when heartburn occurs frequently with gastritis can be obtained from a doctor during an individual appointment. In general, experts advise to especially refrain from consuming the following products:

• Vegetable crops such as radishes, turnips, onions, white cabbage, cucumbers, spinach or sorrel.
• Mushrooms.
• Sour and coarse fibrous fruits.
• Cranberries, gooseberries.
• Peanuts, almonds.
• Corn and barley porridge, pearl barley.
• Pasta, horns, spirals (large pasta products).
• Whole milk, fatty dairy products, sour kefir or yogurt, fatty and salty cheese, spread, margarine.
• Sausage, lard, smoked meat, fried or fatty meat and fish, offal.
• Scrambled eggs, fried omelette.
• Sweets (candies, cakes, pastries).
• Pastries, puff pastries, fresh bread.
• Ice cream, any cold foods from the refrigerator, drinks with ice.
• Canned products (stewed meat, preserves, pickles, salted products, marinated vegetables).
• Any spices, sauces (like mayonnaise, ketchup, mustard sauce), vinegar, etc.
• Carbonated drinks, kvass, packaged juices, alcoholic drinks, strong coffee or tea.

It is necessary to restrain yourself in consuming products that can stimulate appetite, as they increase the secretion of acid in the stomach. Such dishes include seasonings, broth. The possibility of consuming salt, and its daily amount is discussed with the attending physician at a personal meeting.

Mineral water for heartburn and gastritis

There are several known types of mineral waters, in particular:

• hydrocarbonate;
• chloride;
• sulfate.

Additionally, each of these options differs in the number of individual ions – for example, sodium, magnesium, calcium.

Heartburn during gastritis is not relieved by any mineral water. For example, chloride and sulfate waters are not suitable for this purpose. But hydrocarbonate or alkaline waters are just the thing. They normalize the production of hydrochloric acid, remove the "aggressiveness" of gastric juice, relieve not only heartburn, but also sour belching, flatulence and a feeling of heaviness in the epigastric region.

However, you cannot just buy alkaline mineral water and drink it. You should follow certain important rules:

• The water should be freed from gas bubbles (you can leave it without a lid for a while, or warm it up a little).
• You also shouldn’t heat the water too much, as the salts it contains will settle and the product will lose its benefits.
• To relieve heartburn, drink water between meals (approximately one and a half hours before the next meal).
• What waters are most often used for heartburn and gastritis with high acidity:
• Borjomi, Polyana Kvasova, Luzhanskaya, Nabeglavi, Polyana Kupel, Svalyava;
• Arshan, Bagiati, etc.

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Is it possible to drink kefir if you have heartburn and gastritis?

The advisability of using kefir to relieve heartburn in gastritis is a controversial issue. After all, every patient with gastritis knows that the basis for improving the condition of the stomach is diet, and not all fermented milk products are suitable for consumption, especially during an exacerbation of the disease.

If the kefir is fresh, one or two days old, low-fat and not sour, and at room temperature, then drinking it for heartburn can really help.

It is not recommended to drink sour products, kefir from the refrigerator, or those that are more than three days old, when you have heartburn, so as not to worsen your poor health.

If gastritis worsens during the first three days, it is better to avoid kefir altogether: the product can temporarily "suppress" heartburn, but after a while it will become even more painful. Instead of fermented milk products, it is better to use other, harmless and proven methods.

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Prevention

The main point for preventing heartburn with gastritis is to establish a diet. Proper nutrition should be done fractionally, limiting the consumption of foods with a high percentage of carbohydrates, as well as initially unhealthy food (semi-finished products, fast food, chips and snacks, etc.).

It is advisable to exclude from the diet foods that promote relaxation of the smooth muscle sphincter - we are talking about mint, menthol, carbonated drinks, chocolate and coffee.

Dinner should be planned no earlier than a couple of hours before going to bed. Sleep itself should be comfortable: the room should be ventilated, and the head of the bed should be slightly raised - about 15 cm. This will prevent accidental reflux of stomach contents into the esophagus.

Physical activity should not be excluded, but overloads and overfatigue should not be allowed.

If you have a tendency to heartburn with gastritis, overeating is strictly prohibited - this is one of the most common factors that can worsen the prognosis of the disease. It is equally important to acquire the habit of chewing food thoroughly.

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Forecast

If heartburn with gastritis bothers you, then the prognosis for life is considered favorable. In patients with atrophic gastritis and existing metaplasia zones in mucous tissues, as well as with polyps, the prognosis worsens, since the risk of malignancy of the process increases.

In case of chronic pathology, patients should be registered with a dispensary. Particular attention is paid to patients suffering from polypous, erosive, rigid gastritis: for them, diagnostics are recommended every 6 months.

In general, heartburn with gastritis is not a harmless symptom, as many people think. If the problem occurs regularly, then it is necessary to see a doctor to diagnose and treat the underlying cause of the problem.

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