Heartburn
Description:
This painful feeling of heat or burning behind a breast on the gullet course.
Heartburn symptoms:
Heartburn arises usually after a while after food, especially plentiful. It is more often observed after the use of spicy food. In many patients heartburn is caused by sweet kissels, sweet tea, newly-baked black bread, hot pies, the overroasted fat products. In some cases (at insufficiency of the lower sphincter of a gullet) strengthening of heartburn in horizontal position is noted, at trunk inclinations, i.e. in the provisions promoting a gastroesophagal reflux. Heartburn is often combined with an eructation, sometimes is followed by throwing of gastric contents in a mouth.
Heartburn should be differentiated with the burning sensation behind a breast arising at diseases of a nervous system, myocardium ischemia, etc. Existence of heartburn is confirmed if the burning sensation is quickly stopped by reception of antiacid means.
Heartburn reasons:
Is a symptom of an esophagitis and especially the reflux esophagitis, often arises at a peptic ulcer of a stomach and duodenum, gastritis (it is preferential with the increased secretory function of a stomach), chronic cholecystitis, cholelithiasis, and also at the operated patients is after imposing of an esophageal and gastric anastomosis by it, at pregnancy.
In most cases heartburn is caused by action of a gastric juice on a mucous membrane of a gullet at a gastroesophagal reflux which is often observed at patients with insufficiency of a sphincter in the field of a cardial opening (at hernia of an esophageal opening of a diaphragm, a reflux esophagitis, a peptic ulcer, etc.). The heartburn arising during pregnancy is caused by irritation of a gullet acid contents of a stomach at frequent vomiting or (in the second half of pregnancy) increase in the intra belly pressure facilitating throwing of gastric contents in a gullet.
Treatment of Heartburn:
Recommend to patients mechanically, thermally and chemically sparing food, at sharply expressed heartburn — frequent fractional food in the small portions with restriction in a diet of content of carbohydrates and some increase in amount of digestible fats (creamy, corn oil). Patients should not eat for the night, lay down after meal, wear close clothes, a hard belt; it is reasonable to sleep with the raised head, to refuse smoking. The patient with the kept secretory function of a stomach appoint antiacid means for the purpose of decrease in acidity of a gastric juice (фосфалюгель, маалокс); the drugs lowering secretion of a gastric juice with the purpose to reduce its damaging action by a mucous membrane of a gullet (ranitidine, омепразол); the means normalizing motility of digestive tract and reducing a gastroesophageal reflux (Metoclopramidum, домперидон).
At a persistent gastroesophageal reflux or a complication of a course of a disease (a stricture of a gullet, bleeding, aspiration pneumonia), resistant to the carried-out conservative therapy, operational treatment for the purpose of recovery of function of the cardia (fundoplication) is shown.
