Heartburn with gastritis

Many people are familiar with the uncomfortable feeling of irritation, burning along the esophagus: it is about heartburn. The problem may occur when eating spicy or fried foods, fast food, after overeating, and even after excessive physical activity. However, most often there is heartburn with gastritis - a disease that is associated with certain problems with digestion.

What is gastritis, and why is it accompanied by heartburn?

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

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

• parasitic, viral, or microbial infections, including Helicobacter pylori;
• treatment with ulcerogenic drugs (nonsteroidal anti-inflammatory drugs, steroids, etc.);
• frequent stress, chemical poisoning, alcohol abuse.

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

Causes of the gastritis heartburn

Heartburn in gastritis occurs mainly due to impaired acidity of gastric juice. More rarely, its appearance is due to excessive sensitivity of the mucous tissues of the digestive tract. Against the background of gastritis, heartburn can be disturbed when there are errors in nutrition, or after stress.

Doctors call the most common causes of heartburn nutritional disorders and poor lifestyle choices.

• Well-known bad habits in the form of smoking, drinking alcohol, and the frequent inclusion in the diet of fatty and spicy foods, soda, strong tea or coffee can lead to an increase in acidity in the stomach, as well as a violation of gastric valve abutment.
• Heartburn in gastritis can occur if a person eats on a empty stomach a few tomatoes, fresh pastries, chips or fried foods.
• Overeating is the main cause of heartburn: an excess amount of 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 gastric cavity. When acid enters the esophagus (even in small quantities), heartburn occurs.
• Too tight clothing in the abdomen and chest, pregnancy, obesity - all these factors can increase the pressure in the abdominal cavity, which also provokes the appearance of heartburn.
• In gastritis, heartburn can be triggered if a person assumes a horizontal position immediately after eating (for example, goes to bed).
• Long-term stress, or short-term, but strong anxiety can also trigger heartburn.

[1], [2]

Foods that cause heartburn during gastritis

Heartburn during gastritis can appear after any food, if the patient overeats regularly, or adds spicy seasonings to the dishes, or eats “on the run”, “when it is necessary”, without observing the regimen.

According to medical statistics, most often heartburn during gastritis begins to bother after eating such dishes and drinks:

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

In more detail about the principles of proper nutrition for heartburn and gastritis, we describe below.

[3]

Risk factors

What speeds up the appearance of heartburn during gastritis?

• Consuming a large amount of food in a short time.
• Frequent consumption of fatty foods, failure to comply with the principles of proper nutrition.
• Excess body weight, obesity.
• The habit of "take a nap" after eating.
• Smoking, drinking alcohol.
• Regular consumption of carbonated drinks.
• Drinking strong coffee, tea.
• Adding to food hot spices, garlic, chili pepper, horseradish, mustard.
• Acceptance of nonsteroidal anti-inflammatory drugs, hypotonic drugs, as well as medicines, which are aimed at relaxing smooth muscle fibers.
• Pregnancy.

[4], [5], [6],

Pathogenesis

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

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

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

Reflux can occur against the background of an increase in pressure in the abdominal cavity (with excessive weight, with difficulty defecation, during pregnancy) or in the gastric cavity (with duodenostasis, gastric stasis).

Heartburn may occur due to a violation of the motor functionality of the stomach: insufficient mixing of food causes the formation of acid accumulation near the cardia. Formed "pocket" gives impetus to the appearance of reflux and heartburn.

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

[7], [8], [9], [10], [11]

Heartburn with gastritis and the degree of acidity

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

In representatives of the stronger sex, the number of parietal cells is about 1.5 times greater than that of women. Therefore, men have a greater tendency to develop gastritis with high acidity.

The main focus of the action of gastric acid is the splitting of complex molecular structures to facilitate their absorption in the cavity of the small intestine. In addition, the acid creates optimally possible conditions for enzymatic activity, antimicrobial processing of the food mass, and adjustment of acid-base balance within the body.

Displacement of acidity in one direction or another leads to the appearance of painful symptoms, diseases develop - for example, reflux disease, gastritis, etc.

With an excess of acid excretion, or in case of insufficient neutralization of acid, a state of increased acidity occurs. By the way, heartburn with gastritis with high acidity is considered one of the leading symptoms. It is caused by the ingress of juice from the stomach into the cavity of the esophagus, either immediately after a meal, or after a person has assumed a horizontal position. Acid begins to irritate the mucous tissue, which leads to a burning sensation in the chest.

A pH shift to the alkaline side can also be characterized by similar signs, although heartburn in gastritis with low acidity is not a necessary and typical symptom. On the background of low acid content, enzyme activity decreases, complex protein food becomes difficult to digest. As a result, fermentation processes are triggered in the intestines, abdominal distention and “rotten” belching occur, and the contents of the stomach are partially thrown into the esophagus cavity, which causes heartburn.

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

[12], [13], [14]

Treatment of the gastritis heartburn

To give a clear and correct recommendation about the treatment of heartburn, you need to know why it appeared. In case of infrequent episodes triggered by a change in regimen or diet, special medication intervention is not required: it is enough to correct the lifestyle, adjust the diet, and the problem will go away by itself.

A completely different conversation, if heartburn bothers often, and the cause of this is gastritis. In such a situation, complex treatment is used, the task of which is not just to eliminate discomfort, but also to influence the main pathology (in this case, gastritis).

Medicines are selected by the doctor: as a rule, the therapeutic scheme is made up of drugs that represent several categories at once (for example, antacids are prescribed simultaneously with enveloping and antimicrobial agents).

Talking about a complete cure for heartburn is possible only after a successful impact on the underlying pathology - gastritis.

However, medication is only part of the therapy. Equally important are dietary and lifestyle changes.

Be sure to stop smoking and taking alcohol, to determine the correct food regime. But medications will become only reinforcements and part of the basic therapeutic scheme.

Heartburn remedies for gastritis

Medicines prescribed by a doctor only if indicated, based on the results of diagnosis. Before taking this or that medicine, it is necessary to study the instructions well, weigh all possible contraindications and evaluate the likelihood of side symptoms.

Heartburn with gastritis is treated with the use of medicines of different pharmaceutical categories.

• For light and rare bouts of heartburn, use means that reduce the manifestations of reflux and protect the mucous tissue from the effect of acid:

1. Antacids are initially intended to neutralize gastric acidity. Their effect is quick, but short-lived. As a rule, this category is represented by compounds of aluminum, magnesium and calcium. Prolonged treatment with antacids can provoke a violation of bowel movements (diarrhea, constipation), and also cause signs of aluminum intoxication.
2. Alginates are high-molecular polysaccharides that are capable of forming a protective film on the walls of the stomach and esophagus. The most well-known alginates are Gaviscon, Laminal, calcium alginate, etc. These drugs have practically no side effects: they are obtained from brown algae. The main purpose of alginates - symptomatic relief from heartburn during gastritis.
3. Drugs that protect the gastric walls (gastroprotectors) - they create the protection of the mucosa from an aggressive acidic environment. The peculiarity of such drugs is the ability to retain exclusively on damaged tissues. The main active ingredient of gastroprotectors is tri-potassium bismuth.

• With severe gastritis and frequent episodes of heartburn, therapy should be not only comprehensive, but also long. In conjunction with antacids and gastroprotectors in the treatment regimen include drugs from other categories.

1. Antisecretory agents (h2-blockers of histamine receptors and proton pump inhibitors) reduce the production of pepsin and mucus, strengthen the mucosa, inhibit the release of hydrochloric acid. The main representatives of the first group of drugs is Ranitidine, Cimetidine. The most common proton pump inhibitor drug is Omeprazole (Omez). As a rule, such medicines are well perceived by the body, and adverse events 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. For heartburn, their main purpose is to increase the tone of the esophageal sphincter and prevent the throwing of food and acid from the gastric cavity.

Pills for heartburn and gastritis

Here we present to you a small list of the most common pills that can help if heartburn starts to bother with gastritis.

Renny	Antacid and gastroprotective drug with the active action of calcium and magnesium carbonate. Tablets chew or hold in the mouth until resorption, 1-2 pieces with the appearance of heartburn. The maximum permissible daily dose of tablets - up to 16 pieces. Rarely, but an allergy to Renny can occur.
Gastal	This is a preparation of aluminum hydroxide, carbonate and magnesium oxide. Standardly take 1-2 tablets Gastala up to 6 times a day (optimally - 60 minutes after a meal). When using large doses of the drug can develop hypophosphatemia, hypercalciuria.
Pechaev tablets	Tablets belong to the category of dietary supplements, and their action is based on the properties of magnesium carbonate and calcium. For heartburn, take 1 tablet three times a day, 30 minutes after a meal, with a sufficient amount of water.
Gaviskon	Chewable tablets and suspension have an enveloping effect, soothe heartburn and prevent the development of reflux. Tablets chew, washing down with a small amount of water. Standard take 2-4 tablets 4 times a day, and the duration of treatment can be no more than seven days. Side effects rarely occur: allergies are possible.
Mouse	Tablets or suspension based on aluminum hydroxide and magnesium. Tablets are taken for heartburn with chronic gastritis, between meals, 1-2 tablets (dissolve in the mouth). With prolonged use of the drug may be a lack of phosphorus in the body.
Test control	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 such adverse events as nausea, increased fatigue, allergies, edema.

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Heartburn Alternative Treatment

The recipes of alternative medicine stated by us are used to “soothe” heartburn during gastritis, or for the cumulative treatment of the inflammatory disease itself.

We must not forget that any means - traditional or alternative - will work only when the patient adheres to certain principles of nutrition. Without an appropriate diet, treatment will be ineffective. But we will discuss the diet a little later, and now let's talk about alternative therapies.

To get rid of heartburn with gastritis in the following ways:

• Pour 1 tsp. Flax seed 100 ml of boiling water, leave overnight. In the morning add boiled water, bringing the volume to 200 ml. Take the drug on an empty stomach every day for two weeks. If you need urgent help from heartburn, you can grind a little flax seed, take 1 tsp. The resulting powder, pour 200 ml of warm water and drink in small sips.
• Take 1 tsp. Seeds of anise, fennel and dill, pour 200 ml of boiling water, cool. Take the drug one small sip, until the heartburn does not "calm down." The systematic reception of such funds should not exceed two weeks in a row.
• In the morning, before eating, grate a peeled potato on a grater, squeeze juice through gauze. Approximately 100 ml of juice is drunk on an empty stomach, in small sips. Then they rest for half an hour, and only after that they have breakfast. The entire course of treatment in this way can last 10 days. After a few days break, reception is allowed to be repeated.
• Grind in a coffee grinder washed and dried oats, along with the peel. For heartburn, take 1 tbsp. L This powder, poured into a thermos, pour 300 ml of boiling water. Insist means for five hours, filter and drink ¼ cup (approximately 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 go in a simpler way, for example:

Take the almond nut and chew on it in the mouth;

Chew a pinch of oat or barley kernels, well moistening them with saliva and gradually swallowing them.

Honey for heartburn and gastritis can also be a means of quick relief. However, to obtain a positive effect, it is necessary that the honey was real, not in-store. One teaspoon of natural product is slowly absorbed in the mouth, washed down with warm water. Too much honey should not be eaten - it can only worsen the situation. Optimally eat 1 tsp. 3-4 times a day, with water or warm herbal infusion.

Soda as a quick aid for heartburn should not be used: immediately after taking the soda solution, it really becomes easier, but then the situation only worsens. In the stomach, the release of acid becomes even more intense, which may be complicated by a stomach ulcer.

Milk with heartburn and gastritis is also undesirable. Despite the quick, seemingly positive effect, whole milk further stimulates the production of acid and contributes to increased heartburn. Moreover, the whole dairy product is not recommended to include gastritis in the diet.

[16], [17], [18],

Herbs for Heartburn and Gastritis

• Take 3 tbsp. L camomile color, pour 250 ml of boiling water and incubated under a lid for 15 minutes. Next, the infusion is filtered and drink in small sips. It is best to drink at least 3-4 glasses of this infusion daily.
• Take 1 tsp. Ground rhizome, foliage and angelica seed, all ground to a powder. Next, bred ¼ tsp. Powder in 200 ml of boiling water, incubated for 15 minutes and taken half an hour before meals, three times a day.
• Squeeze the juice from the leaf aloe, stored in the refrigerator. With heartburn take 1 tsp. Juice, diluted in 50 ml of water and drink in small sips.
• Brew leaves of lemon balm in the amount of 1 tsp. In a glass of boiling water, I drink instead of tea during the day between meals. Instead of lemon balm, you can brew flowers of acacia or linden.

[19], [20]

Homeopathy: additional effects

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

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

If the doctor prescribes homeopathic granules or tablets, they should be gradually absorbed in the mouth, and the drops should also be kept in the mouth for several seconds before swallowing. Any such remedy is taken between meals.

To eliminate heartburn with gastritis, the following homeopathic remedies are used:

• Duodenheel - take 1 tablet three times a day between meals. In the acute period can receive 1 tab. Every 15 minutes, but not more than 2 hours.
• Gastricumel - take sublingual, after 1 h after a meal, three times a day.
• Hina - appointed in various dilutions, individually.
• Nux vomica-Gomakkord - taken at 30 drops / day, divided into three doses, in 100 ml of water.
• Conium - use average 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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Food for heartburn and gastritis

If heartburn during gastritis has been disturbed more than once, but appears regularly, then cardinal changes in nutrition cannot be avoided. The most important principles of such changes are as follows:

• elimination of overeating;
• exclusion of food that can irritate the stomach (smoked foods, fatty and spicy dishes).

Properly composed diet for heartburn and gastritis should be gentle and at the same time full, with a sufficient content of vitamin, mineral and other useful components.

Observing a diet, it is important to adhere to such recommendations:

• with heartburn and gastritis, they eat a little, at approximately the same time intervals — optimally up to six times a day;
• immediately after a meal, you cannot take a lying position, so it is better to have dinner for 2.5 hours before going to bed;
• it is better to replace any drinks with ordinary pure warm water - it will smooth out the manifestations 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.

For the prevention of heartburn with gastritis are suitable products that should be included in the diet:

• low-fat cottage cheese, low-fat and non-sour kefir, ryazhenka;
• lean meat pieces (chicken fillet, veal);
• rice, oatmeal;
• dried bread, crackers;
• boiled vegetables, baked in the oven or stewed (potatoes, cauliflower, broccoli, carrots);
• non-acidic fruit fruits (ripe bananas, apples);
• weak tea, herbal tea, jelly.

[22],

Menu for heartburn and gastritis

The main thing for any manifestation of heartburn - is the right changes in nutrition. No need to think that from now on a sick person will have to eat only monotonous and fresh food: it is not. There are many delicious and healthy dishes that can be successfully included in the menu for heartburn and gastritis. We give a simple example of a three-day supply, which can be adopted and adhered to, making changes and replacing products, according to its discretion.

• The first day.

1. We have breakfast: rice porridge, chamomile tea.
2. Second breakfast: grandmother from low-fat cottage cheese, or baked fruit with cottage cheese.
3. We have lunch: pureed vegetable soup, hotpot, jelly.
4. Lunch: fruit jelly, crackers.
5. We have supper: braised fish with buckwheat, tea.

• Second day.

1. We have breakfast: steam cheese cakes, rosehip tea.
2. The second breakfast: dry biscuits, compote.
3. We have lunch: homemade noodles with chicken, vegetables, chamomile tea;
4. Lunch: A cup of yogurt with honey.
5. We have dinner: potato steam patties or cabbage rolls, tea.

• Third day.

1. We have breakfast: a couple of soft-boiled eggs, a rusk, tea.
2. The second breakfast: banana, pear or apple.
3. We have lunch: chicken soup with oatmeal, baked potatoes, compote.
4. Snack: fruit pudding.
5. We have supper: dumplings with cottage cheese, manna, a glass of yogurt.

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

To make it easier for yourself to follow a diet, it is recommended to make an approximate menu for a week or a few days in advance. You should not “drive” yourself into an unnecessarily rigid framework: sometimes you can allow yourself, for example, sweets that are not strictly forbidden by doctors - this is marshmallow, marmalade, a little diluted juice with water.

What can not eat with heartburn and gastritis?

A complete list of foods and drinks that are banned with the frequent occurrence of heartburn during gastritis, can be obtained from the doctor at an individual reception. In general, experts advise especially to refrain from the use of such products:

• Vegetables such as radishes, turnips, onions, cabbage, cucumbers, spinach or sorrel.
• Mushrooms
• Sour and coarse fiber fruits.
• Cranberries, gooseberries.
• Peanuts, almond nuts.
• Corn and barley porridge, barley.
• Pasta, horns, spirals (large pasta).
• 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.
• Fried eggs, fried omelette.
• Sweets (sweets, cakes, cakes).
• Sweet pastries, puff pastries, fresh bread.
• Ice cream, any cold foods from the fridge, drinks with ice.
• Canned products (stew, canned, pickles, pickles, pickled vegetables).
• Any spices, sauces (such as mayonnaise, ketchup, mustard sauce), vinegar, etc.
• Soft drinks, kvass, packaged juices, spirits, strong coffee or tea.

You need to restrain yourself in the use of products that can activate the appetite, as they increase the secretion of acid in the stomach. Such dishes include seasoning, broth. The possibility of using salt, and its daily amount is discussed with the attending doctor in person.

Mineral water for heartburn and gastritis

There are several types of mineral waters, in particular:

• bicarbonate;
• chloride;
• sulfate.

In addition, each of these options differs in the number of individual ions — for example, sodium, magnesium, and calcium.

Heartburn with gastritis is not stopped by any mineral water. For example, chloride and sulphate waters are not suitable for this purpose. But bicarbonate, or alkaline - the most it. They normalize the production of hydrochloric acid, relieve the "aggressiveness" of gastric juice, relieve not only heartburn, but also from sour belching, flatulence and a feeling of heaviness in the epigastric region.

However, just to buy alkaline mineral water and drink it is impossible. Some important rules should be followed:

• Water should be removed from the gas bubbles in it (you can leave it for a while without a lid, or warm it up a little).
• It is also impossible to heat the water too much, as the salts contained in it will settle, and the benefits of the product will be lost.
• In order to eliminate heartburn, they drink water between meals (approximately one and a half hours before the next intake).
• What waters are most often used for heartburn and gastritis with high acidity:
• Borjomi, Polyana Kvasova, Luzhanskaya, Nabeglavi, Polyana Kupel, Svalyava;
• Arshan, Bagati, etc.

[23], [24]

Can kefir for heartburn and gastritis?

The feasibility of using kefir in order to get rid of heartburn during gastritis is a moot point. After all, every patient with gastritis knows that the basis for improving the state of the stomach is the diet, and dairy products are not all suitable for consumption, especially during the period of exacerbation of the disease.

If kefir is fresh, one or two days, low-fat and non-sour, has a room temperature, then using it for heartburn can really help.

A sour product, kefir from the refrigerator, or one that is more than three days old, is not recommended to drink for heartburn, so as not to aggravate poor health.

In case of aggravation of gastritis during the first three days, it is better to refuse kefir in general: the product may temporarily “drown out” heartburn, but after a while it will become even more painful. Instead of a fermented milk product, it is better to use other, harmless and proven methods.

[25]

Prevention

The main point for the prevention of heartburn in gastritis is the establishment of nutrition. Proper nutrition should be made fractional, limiting the consumption of foods with a large percentage of carbohydrates, as well as initially unhealthy foods (convenience foods, fast food, chips and snacks, etc.).

It is desirable to exclude from the diet products that promote relaxation of the smooth muscle sphincter - it is about mint, menthol, carbonated drinks, chocolate and coffee.

You must plan dinner no sooner than a couple of hours before you go to bed. The very same dream should be comfortable: the room should be ventilated, and the head end of the bed should be slightly raised - about 15 cm. This will prevent the accidental throwing of stomach contents into the esophagus.

Physical activity should not be excluded, but overloading and overwork should not be allowed.

With a tendency to heartburn during 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 gain the habit of chewing food thoroughly.

[26], [27]

Forecast

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

In chronic pathology, patients should be put on a dispensary account. Special attention is paid to patients suffering from polypous, erosive, rigid gastritis: they are recommended to diagnose every 6 months.

In general, heartburn with gastritis is not a harmless symptom, as many believe. If a problem appears regularly, it is imperative that you see a doctor to diagnose and treat the root cause of the problem.

[28],