stomach burning

Summary

Stomach burning is a frequent condition in today’s population and is characterized by symptoms of pain in the stomach and pectoral region, behind the sternum. The number of patients with stomach burning symptoms has increased a lot in recent years and much of this is due to incorrect eating habits. In Brazil, studies indicate that about 12% of the national population have symptoms 1-2 times a week. Worldwide, it is estimated that 15% have weekly heartburn.

The main cause of stomach burning is increased gastric acid production and reflux into the esophageal tube. In this framework, 4 groups of patients can be distinguished: those with dyspepsia (difficulty digesting food), patients with acute gastritis, patients with chronic gastritis and, finally, patients with gastroesophageal reflux disease . Some groups of patients such as obese and smokers are also at increased risk of having symptoms.

Basically, burning in the stomach is characterized by pain in the sternal region and a strong burning sensation. The diagnosis is made through the clinical history of the patient with more detailed clinical examinations to check for other diseases. Associated complications include the appearance of ulcers and changes in the esophageal mucosa.

Treatment can be done with the use of antacids, histaminergic inhibitors and proton pump inhibitors. Medicinal plants such as licorice, mint, calamus and lemon balm help to combat symptoms and relieve burning. Some important tips include changing your eating habits, playing sports, reducing your sedentary lifestyle and the consumption of alcohol and cigarettes.

Definition

Stomach burning, as the name suggests, is a burning sensation in the stomach region. This pain can radiate giving the impression of being a pain in the chest, more specifically behind the sternum bone.

Stomach burning is a chronic disease and can represent one of the forms of gastritis (see gastroenteritis ). This affection is common among the population, however, when the symptoms become frequent, the patient may be presenting what is called gastroesophageal reflux disease . It’s always important to stay alert to symptoms, as they may be masking something more serious.

Epidemiology

Stomach burning is a relatively common condition and its prevalence has increased in recent years. Part of this increase is due to life habits, more specifically the eating habits that people have adopted that directly contribute to the disease.

A 2019 online survey of the US population of more than 70,000 people showed that about 1-third of US adults suffered from symptoms of gastric reflux (with a burning stomach or heartburn as the main sign) at least once. per week, as the New York Times explained in August 2021.

Statistics on the disease are still uncertain, but it is estimated that 7% of the world’s population have stomach burning or heartburn daily, 15% weekly and 50% monthly. In Brazil, a survey carried out in 22 cities revealed that 12% of the population have this stomach discomfort 1-2 times a week and that 7% have the symptom more than three times a week.

Causes

Some causes of burning stomach and gastritis are described below:

– A bacterium: Helicobacter pylori, which causes gastric inflammation.

On June 16, 1984, two Australian researchers Barry Marshall and Robin Warren demonstrated in a study that the stomach was colonized by bacteria (H. pylori), this discovery opened the door to a new therapy for heartburn, the use of antibiotics.

This revolutionary discovery was awarded in 2005 with the Nobel Prize in Medicine.

Knowing that stomach cancer is partially caused by H. pylori, the treatment of several cases of burning stomach with antibiotics has radically changed medicine, reducing the incidence of stomach cancer;

– stress and/or other psychological problems: the digestive system has more nerve cells than the brain! Thus, a relationship between the nervous and digestive systems is a reality that both the patient and the physician must take into account. Therefore, through the treatment of stress, it is possible, in some cases, to greatly reduce the burning in the stomach;

– in case of use of drugs that irritate the stomach such as some non-steroidal anti-inflammatory drugs ( acetylsalicylic acid , ibuprofen , diclofenac ) or steroidal anti-inflammatory drugs (cortisone).

These drugs can strongly irritate the gastric mucosa and consequently cause ulcers (which in turn can cause bleeding) and stomach burning. Numerous other classes of medication can also trigger gastrointestinal complications (antibiotics, acetylcysteine …);

– an unhealthy diet (foods that are too acidic, fatty, spicy, consistent, too much alcohol…);

– a hiatal hernia (muscle problem between the stomach and the diaphragm);

– in case of pregnancy or overweight (due to increased pressure in the stomach);

– some infectious agents (such as certain viruses, in this case we speak of gastroenteritis );

– allergies or pseudo-allergies to certain foods or medicines;

Groups of risk

Stomach burning affects many types of patients. Among them, the most likely are those with a poor diet or excessive consumption of certain foods. Some of these foods are:

– Citrus fruits such as lemon, orange and tangerine

– Coffee and caffeinated foods

– Condiments, vinegars, seasonings and sauces, such as ginger, Worcestershire sauce, among others

– Very fatty and fried foods

– Peppers and peppers

– Soft drinks

Patients with gastritis and gastroesophageal reflux disease constantly have episodes of burning in the stomach.

In addition to food, other risk groups for stomach burning are:

– Obese patients

– Pregnant patients, since there is compression and relaxation of the esophageal sphincter

– Smokers

– Patients with Zollinger-Ellison syndrome

– Patients with hiatal hernia

– Patients who, for some reason, have a delay in gastric emptying. This happens with hospitalized patients or with deficiencies in the mobility of the gastrointestinal tract.

Symptoms

The symptoms of burning stomach occur due to reflux of gastric contents back up into the esophagus.

Basically, four factors are important for the symptoms of burning stomach. First, cases of functional dyspepsia stand out, that is, cases in which patients have difficulty digesting food. In the second case, there are patients with acute gastritis. In the third case, there are patients with chronic gastritis who may have stomach ulcers. Finally, the fourth group is patients with constant burning who may have gastroesophageal reflux disease .

– Burning in the stomach causes a feeling of heat in the chest, pains generally occur behind the sternum and go up to the throat (in the region of the esophagus). You may experience a bitter or acidic taste in your mouth. Burning may be associated with gastric reflux and coughing. Symptoms are usually more intense after a meal.

We emphasize that occasional or short-term (3 to 4 weeks) stomach burning can be treated with self-medication, however, if the symptoms are more intense and prolonged, it will be necessary to schedule a medical appointment. In the worst case, there can be risks of bleeding and cancer.

– Gastritis can be translated by symptoms of stomach burning, severe pain, diarrhea and spasms. Consult a healthcare specialist for more information.

Diagnosis

The diagnosis of burning stomach is usually made by checking the patient’s symptoms and lifestyle habits, especially eating habits. If cases of stomach burning are constant, the doctor may request more specific tests to find out if there is any other disease involved. These tests include imaging tests of the upper gastrointestinal tract, such as scintigraphy and upper X-ray. In these exams, it is possible to see if there is any abnormality in the organs involved.

Another very common test is the measurement of gastric acidity. This is done by monitoring the gastric pH constantly, in a test called pHmetry. In it, you can see if the production of gastric acid is above normal. Gastric endoscopy is also a practiced method. In addition to analyzing the gastric contents, it is possible to perform a biopsy of the stomach tissue. The doctor may eventually indicate other tests to check for the presence of the H. pylori bacteria and also check for the presence of gastritis or ulcers.

Complications

Stomach burning is a benign chronic disease. However, it may be masking other more serious diseases, such as gastroesophageal reflux disease and even gastritis.

The constant acid can cause very painful and difficult to heal ulcers. In addition, changes in the esophageal mucosa caused by acid return can lead to the appearance of a condition known as Barrett’s esophagus, in which there is an increased incidence of cancer.

Treatments

We distinguish different types of medicines to treat stomach burning, such as antacids that can be purchased without a prescription. We mainly highlight three types of antacids: anionic, cationic and complex antacids. There are also other drugs available on prescription. (B):

1. Medicines for sale without medical prescription

Notes on antacids

– antacid medicines should be taken occasionally or for a short period (3 to 4 weeks)

– for dosage, ask your pharmacist for advice (in general these remedies should be taken about an hour after a meal).

– in general, the effect of antacids (for example, based on magnesium, calcium or aluminum salts) begins about 10 minutes after ingestion and lasts for 30 to 60 minutes, sometimes up to 4 hours.

– attention to the risk of interactions between antacids and other medications (iron, antibiotics such as tetracyclines,…), the ideal is to leave a two-hour interval between medications.

– antacids do not work to cause a burning stomach or heartburn and do not have the ability to treat an inflamed esophagus (unlike proton pump inhibitors, for example, see below).

– in general, the effect of antacids (eg based on magnesium, calcium or aluminum salts) begins approximately 10 minutes after ingestion and lasts for 30 to 60 minutes.

2. Anionic antacids

This class of antacids neutralizes the acidity of the stomach.

– Sodium bicarbonate, this preparation sold in sachets should not be used in excess, as it can cause swelling and hypertension. There is a risk associated with this preparation which is that an opposite effect will occur, thus increasing the acidity.

– calcium carbonate (CaCO3), should not be used for a long time, beware of the risk of hypercalcemia.

3. Cationic antacids

These drugs or molecules also neutralize stomach acidity and deposit an antacid film on the stomach lining.

– magnesium hydroxide (Mg(OH)2), should be used sparingly. Attention to the laxative effect of magnesium!

– aluminum hydroxide (Al(OH)3), should be used sparingly. Beware of the constipating effect of aluminum.

– aluminum and magnesium.

4. Antacids – complexes

These drugs or molecules also neutralize the acidity in the stomach and form a protective layer on the lining of the stomach.

– magaldrate, should be used in moderation

– sucralfate, should be used in moderation, medicine that does not contain alcohol.

5. Medicines for sale under medical prescription

6. Histamine H2 receptor antagonists

H2 receptor antagonists or H2 antihistamines do not act as quickly as antacids (usually around 30 minutes to take effect), but they can have a longer duration of action (up to 12 hours, compared to 4 hours or less for antacids).

Molecules
– Ranitidine (US trade name: Zantac)
– Cimetidine (US trade name: Tagamet HB)
– Famotidine (US trade name: Pepcid)
– Nizatidine (US trade name: Axid AR)

7. Proton Pump Inhibitors (PPIs)

These drugs act on the proton pump of the parietal cells in the stomach and are indicated against stomach ulcers. These molecules are closely associated with an antibiotic that acts on Helicobacter Pylori, a bacteria that causes ulcers.

– omeprazole

– esomeprazole

– pantoprazole

– lansoprazole

8. Other treatments

Antidepressants
In cases of functional heartburn , a condition that continues to be poorly understood, taking antidepressants in low doses can be effective.

Surgery
In some serious and specific cases, such as gastroesophageal reflux, surgery can be performed. Gastric fundoplication is the most common procedure.

Phytotherapy (medicinal plants)

Here are some natural treatments to ease stomach acid and heartburn:

The following medicinal plants have shown efficacy against stomach acidity and burning. Efficacy is, however, relative (compared to classic treatments) and should be used as a complementary measure and not as a first-choice treatment.

– Aromatic calamus , which should be used as an infusion

– Boldo-do-Chile , which should be used as an infusion or tablet

– Chamomile , which should be used as an infusion

– Celandine , which must be used in drops or pills (be careful, use ready-made medicines, never make your own).

– Cabbage , which should generally be used as juice

– Caraway , which should be used as an infusion

– Lemon balm , which should be used as an infusion, drops or capsules.

– Mint , which should be used as an infusion or tablet

– Yarrow , which should be used as an infusion

– Licorice , which should be used as an infusion

Tips

– After a meal, walk a little and avoid resting (as the lying position favors acid reflux in the stomach), if you want to lie down, try to sleep with the upper part of the body a little more raised.

– Eat several meals a day, with smaller portions (so that your stomach is not empty for too long)

– Chew your food well.

– Try to find out the cause of acidity. Medicines such as certain non-steroidal anti-inflammatory drugs = NSAIDs (acetylsalicylic acid (aspirin, ibuprofen,…), acetylcysteine ​​(medicine against productive cough) or even certain antibiotics, can trigger stomach burning.

– Reduce your body weight, as excess favors burning in the stomach.

– If the burning symptoms persist and are constant, look for a doctor and ask for more detailed tests.

– Avoid smoking, smoking increases gastric acid and can promote the development of gastric ulcers.

– Avoid consuming alcohol, or even better, do not consume. Alcohol irritates the stomach lining.

Prevention

The prevention tips for stomach burning deal with changes in eating habits so that the person can have a balanced and better distributed diet.

– Avoid consuming foods that cause acidity, such as those rich in protein (thick steaks), fat, spices, fried foods, and avoid coffee, acidic fruit juices (orange juice) and infusions that release acid (pink rose, mauve)

– Consume foods that reduce acidity (thanks to the blocking effect of the food), such as yogurt and bananas.

– Avoid alcohol consumption and smoking.

– Practice sports and avoid a sedentary lifestyle.

– Avoid wearing clothes that are too tight in the abdominal area.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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