Before entering the stomach, the food must pass through a narrow muscle at the lower end of the esophagus called the lower esophageal sphincter. The sphincter prevents food from returning to the esophagus.

Heartburn in the stomach is a burning sensation or heat in the chest, it is very common in all ages.
When the gastric acids get into the stomach, they digest the food.
These acids are very strong, there is a special mucosal layer that protects the stomach from acid.
The esophagus does not have this special protection. If the lower esophageal sphincter does not close completely, the lower part of the esophagus can be damaged by acid reflux from the stomach.
When this occurs, we can feel the acidity of the stomach.
The lower esophageal sphincter can not close completely allowing the stomach acid to return to the esophagus for these reasons:

  • Some food and drinks. These include: chocolate, mint, caffeinated beverages (such as coffee and tea), fatty foods and alcoholic beverages such as beer.
  • Heartburn depends on the location of the body. It is easier for the gastric acid back into the esophagus if a person is lying on the back (supine) on the right side or bent forward. Anything that increases the pressure in the abdomen pushes the acid from the stomach into the esophagus and causes heartburn.
  • Lifting, straining, coughing, tight clothing, obesity and pregnancy can aggravate heartburn.
  • People with certain illnesses have a higher risk of heartburn. These diseases include: hiatal hernia , diabetes , gastric ulcer , gastroparesis and many autoimmune diseases (CREST syndrome, Raynaud’s phenomenon and scleroderma).
  • Many medications that are taken with a prescription may restrict the lower esophageal sphincter, including medicines for blood pressure , heart medicines, and theophylline (an asthma medicine ).
  • Many substances irritate the inner wall of the esophagus and may favor heartburn. Among these foods are peppers, citrus fruits and fruit juices, tomatoes and tomato sauces, cigarettes, aspirin, ibuprofen (Motrin, Advil, etc.) and medications prescribed to treat osteoporosis .


Acidity of the stomach and heartburn

Anxiety and worries cause an increase in the production of stomach acid and adrenaline.
The adrenaline relaxes the muscles of the stomach and intestines, the consequence is that digestion slows down, which causes congestion in the stomach along with acid and causes burning and feeling of weight.

Heartburn and pain when you run
After eating, you have to wait at least 3 hours before going to run, otherwise you may experience heartburn or pain.
It is a normal effect because your stomach needs blood for digestion and then you have to avoid important and prolonged efforts like a run.


Treatment for heartburn

Before analyzing the medications, herbs and diet to follow to relieve heartburn, I want to talk about osteopathic and manual therapy.
If there are no lesions (eg ulcer) or acute inflammation , stomach malfunction may be caused by nerves that erroneously transmit signs of pain, contracted muscles, adhesions, or tension of the ligaments that block the movement of the stomach.

For good digestion, the stomach should be able to receive food and move it to the duodenum, using smooth muscles.
If the muscles are also contracts or if something blocks the movement of the stomach, no medication can correct this disorder, therefore, serve only to reduce symptoms, but does not eliminate the cause.
The stomach is tightly attached to the diaphragm, so the osteopathic treatment should seek to relax this vital muscle into the breath before working on the stomach.
Another important part of the treatment is to release the nerves that control the stomach, are nerves that originate from the D4 to D8 level in the back and the vagus nerve.
If nerves are compressed from bones, muscles or ligaments, they can cause symptoms in the stomach.


What drugs treat heartburn?

Since heartburn is caused by stomach acid, one of the easiest ways to relieve pain is to neutralize the acid with an antacid.
Antacids such as Maalox ® usually contain a mixture of magnesium and aluminum salts, calcium carbonate or sodium bicarbonate.

It is possible that those who contain large amounts of sodium are not suitable for pregnant women or on a low sodium diet, such as people with hypertension or heart disease.
Antacids are tablets that can be chewed, chewed or there are medicines in liquid form.

The choice depends on personal preference, but the liquid medicine may act more quickly, while tablets may have a longer lasting effect.
Antacids may reduce the absorption of other medicines in the gut, so if you are taking other medicines, you should always talk to your doctor before taking an antacid.

Some antacids also contain sodium alginate.
Sodium alginate is a substance that forms a “raft”, which floats on the contents of the stomach. The raft prevents reflux of acid in the stomach and protects the feeding tube from the stomach.
Products containing alginic acid, such as Gaviscon, are especially useful for heartburn caused by pressure in the stomach, such as during pregnancy.

H2 Antagonists H2
antagonists are drugs such as cimetidine (Tagamet), Ranitidine (Antak), nizatidine (Axid), Famotidine (Famamet). All of these medicines can be purchased at the pharmacy by adults over the age of 16.
The H2 antagonist drugs work by blocking the histamine receptors in the stomach which prevents the stomach cells from producing too much acid.
It is possible that they are not suitable for people with liver or kidney problems.

H2 antagonists should only be used for a maximum of two weeks without consulting a physician.
Cimetidine has interactions with other medicines, so always talk to your doctor before taking it with other medicines.

Proton Pump Inhibitors (Protons)
Proton pump inhibitors block the production of acid in the stomach.

These medicines help to coordinate the work of smooth muscles in the stomach feeding tube.


Foods that should be avoided

There are several causes of heartburn.
Discovering the cause can help change your lifestyle and habits so you can avoid acid reflux.

Coffee, tea, and other beverages that contain caffeine
Caffeine can relax the lower esophageal sphincter by allowing the contents of the stomach to return to the esophagus.

contains concentrations of theobromine (a naturally occurring compound in many plants) that relaxes the esophageal sphincter muscle, allowing the acid from the stomach to return to the esophagus.

Fritters and fatty foods
These foods can delay digestion by keeping food in the stomach longer. This can cause increased pressure in the stomach. The result is more pressure on a weakened sphincter, causing reflux of stomach contents.

Tomatoes and tomato products
These foods relax the lower esophageal sphincter.

Alcohol relaxes the lower esophageal sphincter and increases the production of gastric acid.

The chemicals in the cigarette pass from the lungs to the blood and weaken the lower esophageal sphincter (IAS).

Juices and citrus fruits
These foods relax the lower esophageal sphincter.

Eating before 2 or 3 hours before bed
Staying with a full stomach can cause a greater pressure of the contents of the stomach against the ERA, increasing the likelihood of reflux.
Bananas have an antacid effect.

Large meals
The full stomach can put additional pressure on the lower esophageal sphincter, which will increase the possibility that some of these foods go back into the esophagus.

Wear tight clothing
Garments that tighten and tighten the abdomen press the stomach.
Thus food pushes against the ERA and causes gastroesophageal reflux .
Clothing that can cause problems include belts, T-shirts and underwear.


Herbal remedies for heartburn

In Europe it is customary to take the bitter after a big meal. Amaros more myths, such as Rumex crispus, artemisia (Artemisia vulgaris), gentian (Gentiana lutea) and barberry (Berberis vulgaris) are tonics and digestives for the liver.
They help in digestion and decrease the risk of heartburn by increasing the production of HCI and bile.
Other tips for those suffering from heartburn:

  • Eat less at every meal,
  • Standing up after eating,
  • Avoid eating at night.

Night Heartburn
This symptom is usually due to gastro-oesophageal reflux which increases at night in the horizontal position.
To solve this problem, you should go to bed away from meals and keep the part of the bed where you tilt your head at least 20/30 cm higher your fingers.

Heartburn During Pregnancy

During pregnancy the muscle in the upper part of the stomach (like all muscles of the body) is relaxed, which prevents the gastric acid from returning to the esophagus. This allows the digestive juice to enter the esophagus painfully causing irritation and acidity that it feels during pregnancy. Another reason why you feel the burning sensation is that the uterus grows over the abdominal cavity, pushing the stomach up into the throat (at least this is the way you can feel).
Heartburn in pregnancy may occur during the first trimester, but also at the end, the eighth or ninth month.


Natural Remedies

There are several strategies to relieve heartburn during pregnancy.
Avoid foods that cause heartburn such as spicy foods, alcohol, beverages containing caffeine (eg coffee, tea and coke because they relax the esophageal sphincter), chocolate, mint, oranges and lemons.
A high fat diet can also contribute to heartburn during pregnancy.


Aloe vera
juice The juice extracted from the aloe vera plant  is a popular home remedy for heartburn. Aloe Vera juice reduces heartburn and inflammation .
You should drink about 10 ml of juice, about 20 minutes before the meal. Do not overdo it as it can cause diarrhea and abdominal pain .

Must eat 4/5 almonds after each meal and snack.
Organic almonds are better.
This tasty dried fruit is useful for neutralizing the acidity of stomach gastric juice, relieving and preventing heartburn.

Drinking before and after meals, but not for long.
Too much liquid mixed with food expands the stomach, aggravating heartburn.
Opt for smaller meals that do not overload the digestive system.
It would be best to make six small meals a day, instead of three large ones, so you feel less acidity.
Pain when drinking can be caused by an excessive amount of water drink in a short time, it is best to drink a glass from time to time.
Slow down. When you eat too fast, air is often swallowed which can form gas bags in the belly.
Eating without chewing increases the work of the stomach. This makes digestion difficult.
This may seem intuitive, but the acid in the stomach may actually be a sign of dehydration.
You should drink at least 8-10 glasses of water every day to keep yourself hydrated.
One warning: do not drink water during meals. Drinking lots of fluids can stretch the stomach, press on the lower esophageal sphincter and cause reflux.
Drinking water can help with these symptoms in pregnancy

What to eat? 
Among the foods that help to combat the symptoms of heartburn are: cabbage, carrot, licorice and chamomile.
Another natural remedy is yeast which is helpful in neutralizing the acid in the esophagus.
Many mothers believe that eating a few spoonfuls of yogurt after each meal, or when they feel the burning, helps reduce the sensation of acidity.
The results of some studies also suggest that yogurt probiotics can help neutralize the acid in the esophagus.
Other effective home remedies are:

  • Fresh ginger, raw or in the form of tablets
  • Fennel tea.

If neither of these tips is helpful, you need to think that this heartburn will not last forever.
If the heartburn is too strong, chew a chewing gum after each meal. Research shows that chewing gum promotes saliva flow, which can reduce acid levels in the esophagus and may help prevent gastroesophageal reflux disease.


Testimony of a patient

The basic rules for dealing with heartburn.
The rules you can read below are very simple to follow. However, before you say these rules, I will write down two common sense things to reduce heartburn.

The first is to make sure you chew the food before swallowing.
This way it is easy to get rid of heartburn because if the pieces of food that your stomach has to break are large, the amount of enzymes (acidic and alkaline) to release is higher.
In the same way, we should drink few fluids while eating, or after eating. This is important because fluids reduces the strength of enzymes and therefore the body needs to release more enzymes.
If you follow these two basic rules, you should feel good on your way to avoiding heartburn. Also, if you follow the main rule about combining foods, you will probably see the symptoms of heartburn disappear.
The most important rule is not to combine foods that are rich in carbohydrates (pasta, potatoes, corn, rice) with foods rich in protein (meat, dairy, fish). This is crucial because these two groups need different enzymes to be digested.
If the body needs to release these two enzymes together, they neutralize each other.

When this occurs, food should stay longer in the stomach and should be released large amounts of alkaline enzymes and body acids.
As you may realize, this is one of the top reasons that cause stomach upset.
So instead of eating a large steak with chips, it’s best to eat a steak with salad.
The green salad is great because it is digested quickly because there is a high water content.

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