Heartburn develops by the reflux of acidic stomach contents into the oesophagus, usually due to a reduced function of the lower oesophageal sphincter. Occasional heartburn, as after eating food with a particularly high content of fat or after the enjoyment of wine, is harmless. However, should the attacks increase, a physician must be consulted. Non-specific chest pains can also occur without heartburn; rarely in the upper abdomen. In these cases, the differentiation to heart diseases is difficult. Chronic laryngitis, hoarseness, morning coughing and a chronic tussive irritation can also occur due to irritations caused by gastric juice.

A gastroscopy is the best method for clarifying heartburn.  It is important to examine the oesophagus, as an inflammation of the oesophagus due to gastric acid, so-called reflux oesophagitis, can lead to ulcers with bleeding or even to oesophageal cancer. A gastroscopy can be carried out in our practice completely pain free. If you like, we can give you a sedative for this purpose. However, you can then no longer work on this day or drive a motor vehicle for 24 hours. The clinical symptoms do not correspond to the endoscopic findings. You can have severe heartburn without an inflammation being able to be detected endoscopically. On the other hand, it often occurs, particularly in older patients, that the detection of a distinctive inflammation is virtually coincidental because they have almost no discomfort at all.

Treatment options

In minor cases of heartburn, general measures (see below) can help. Medication such as H2 blockers (e.g. cimetidine, ranitidine) or antacids (aluminium or magnesium hydroxide) can be recommended.

The so-called proton pump inhibitors (e.g. omeprazole, pantoprazole), which ideally inhibit the development of acid can also be chosen for acute cases.

In the event of anatomical alterations (e.g. an oesophageal rupture) or a very rare allergy against the medication, surgery can also be indicated..

General measures to prevent heartburn

- regular, easygoing meals (low fat, small amount of spices, low sugar, no flatulent foods)

- eat small portions throughout the course of the day

- foods high in dietary fibres

- reduce the food to a small size and chew slowly

- only drink beverages at room temperature

- avoid alcohol, coffee, carbonated beverages and sweets

- stop consuming nicotine

- do not lie down immediately after eating

- last meal 3 to 4 hours before going to bed

- adjust the top of the bed higher – sleep with upper part of the body slightly elevated

- in the event of overweight, strive to lose weight

- reduce agitation and stress

- do not wear any tight fitting clothes; adjust belts more loosely

- when using a vitamin C dietary supplements: take acid-free vitamin C or vitamin C in a retarded form