Heartburn

Heartburn is an uncomfortable burning sensation behind the sternum, spreading upward from the epigastrium. In healthy people, it appears with food errors and alcohol abuse. It is most often observed in reflux esophagitis, gastric ulcer, duodenal ulcer. It occurs less often with other diseases of the gastrointestinal tract, infectious and neurological pathology. To identify the causes of heartburn, EGDS, intragastric and intraesophageal pH-metry, tests to determine gastric secretion, ultrasound of the abdominal cavity, microbiological studies are carried out. In order to prevent and reduce chest burning, it is recommended to correct the diet, give up smoking, alcohol, and take antacids.

Heartburn feels like burning or heat along the esophagus, often combined with acid belching, choking and coughing. An uncomfortable sensation occurs in the epigastric region, spreads upwards behind the sternum, can give into the neck and be felt in the throat. Often the symptom appears half an hour after eating. In a healthy person, heartburn is usually preceded by overeating, the use of spicy, smoked and fried foods, alcoholic beverages, strong tea, coffee. With gastrointestinal pathology, chest burning can be associated with the intake of both irritating and ordinary food.

Heartburn is enhanced by resting in a horizontal position, bending the body forward, physical activity immediately after eating. After a burning sensation in the esophagus, a sore throat often occurs. With an increase in episodes of chest burning up to several times a week, accompanied by cough and other signs of dyspepsia (frequent acidic, putrid belching, nausea), it is recommended to consult a gastroenterologist. The combination of heartburn with vomiting of blood, dark stools, intense chest and back pain serves as an indication for seeking emergency medical care.

Mechanism of development
Usually, heartburn is associated with damaging effects on the esophageal mucosa. Most often, the symptom is provoked by reflux of gastric juice and digested chyme. At the same time, both hydrochloric acid and proteolytic enzymes have an irritating effect, and the appearance of heartburn often indicates the presence of esophagitis. During esophagomanometric studies, it was found that in most patients experiencing chest burning after eating, the cardiac sphincter is weakened, the pH level in the distal part of the esophagus does not exceed 4.0.

The reflux mechanism of symptom development is characteristic of both gastroenterological diseases and heartburn during pregnancy. During gestation, the weakening of the cardia is facilitated by an increase in intra-abdominal pressure due to an increase in the growing uterus. An additional pathogenetic link in pregnant women and patients suffering from gastric ulcer, duodenal ulcer, hyperacid gastritis, helicobacteriosis, is the high aggressiveness of gastric juice due to an increase in its acidity and increased cardia failure against the background of gastric hypermotor.

The mechanism of heartburn development in atrophic gastritis, pyloric stenosis and stomach cancer is based on insufficient digestion of food, the predominance of fermentation processes, the formation of large amounts of lactic, butyric and other organic acids. The stagnation of the chyme caused by a violation of evacuation is accompanied by stretching of the gastric wall and the cardiac sphincter with the throwing of the contents into the esophagus. After total gastrectomy, burning is provoked by the action on the esophageal mucosa of bile and pancreatic enzymes entering through the formed anastomosis.

Less often, chest burning is caused by stretching of the esophageal mucosa with achalasia of the cardia, volumetric neoplasms, strictures. The same is the pathogenesis of heartburn in hypermotor dyskinesia of the esophagus, but the aggravating factor is often a decrease in the threshold of sensitivity against the background of vegetative disorders. A special pathophysiological mechanism underlies the formation of the symptom in patients with temporal lobe epilepsy. In somatosensory paroxysms, a burning sensation behind the sternum is caused by the presence of a focus of pathological impulses in the brain.

Classification
Taking into account the predominant localization of uncomfortable sensations, there is a more common heartburn in the chest and a less common form with burning in the throat. To determine the severity of the symptom, the frequency and circumstances of its development, intensity, connection with food intake, and other features of the discomfort experienced are usually used. This approach is effective for conducting a diagnostic search, selecting the optimal ways to correct heartburn, taking into account the causes of its occurrence. Based on the proposed criteria , three degrees of severity of the disorder are distinguished:

Mild heartburn. Chest burning appears no more than once a month, usually provoked by food errors, quickly passes on its own after correcting the diet. It can be combined with belching air or acidic gastric contents. It is observed in 51.4% of men and 48.5% of women without chronic pathology of the digestive organs.
Moderate (moderate) heartburn. Bothers the patient weekly from 1 to 3 times. It is noted after the use of both irritating and familiar products for the patient. It is often detected within the framework of dyspeptic syndrome with nausea, acidic or putrid belching. Usually indicates the development of gastroenterological pathology.
Severe (pronounced) heartburn. It manifests itself almost daily, combined with belching, nausea, sometimes vomiting, instability of the stool, abdominal pain. It is often associated with food, although it may occur on an empty stomach. Urgent diagnosis is needed to determine the disease that caused the symptom. It is found in 1.2% of men and 3.4% of women.

Post Views: 722

Heartburn

Heartburn

Scientists have discovered a mechanism that slows down aging

Hysterical neurosis

Vibration sickness

Most Popular

WHO: 1 billion people in the world are served by medical institutions without reliable power supply

Gastritis symptoms and what is it

Diarrhea

Rectal prolapse

Recent Comments