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GERD, heartburn and gastritis are three distinct conditions that have several symptoms in common between them. Sometimes, it gets hard to tell which one is it that brings you discomfort. A qualified healthcare provider should be consulted as soon as possible if you suspect that the cause of your suffering is more serious than a random heartburn provoked by an unusually abundant or fatty meal, pregnancy, constipation or alcohol intake. In this article brought to you by BestHomeRemedies.com you will learn how to tell the three unpleasant conditions apart and know when it is time to seek immediate medical attention.
Gastric acidity is a common symptom of different problems. Such a condition is so common that it is really difficult to find people who have never suffered from the classic symptoms associated with stomach acidity. Acidity and burning of the Most commonly, the patient reports an annoying burning sensation, which occurs in the stomach and, with more or less intense waves, tends to climb up to the neck. Since acidity increases may be linked to several predisposing factors, we will try to make a quick round-up, listing the major related pathologies and the symptoms that identify them.
When stomach acidity is an occasional problem, the patient does not struggle to identify the root causes of it: too much meals, digestive foods, stress, drugs, or a few glasses of wine too often cause frequent gastric burns. In these cases, and in all those where acidity arises in the immediate vicinity of a meal, this is likely to be an episode of acute gastritis. This term identifies a generic inflammatory process that is responsible for the internal gastric wall, sustained by alcohol ingestion, cigarette smoking, irritating foods, or some drugs.
- If acidity and burning occur within the first 30 minutes after the meal and accompany the pain, it may be gastric ulcer.
- When the symptom becomes chronic, appears away from meals at night and is attenuated by ingestion of foods, it could be duodenal ulcer.
- If the burning sensation is not confined to the gastric area but it radiates upwards, to the point of affecting the jaws too, the disorder is most likely due to gastroesophageal reflux disease. The problem is caused by the rise of gastric contents in the esophagus because of the incontinence of a muscle valve that closes the mouth of the stomach, releasing only to allow transit of food, barking and vomiting. A further indication pointing towards the diagnosis of gastroesophageal reflux is the onset of acidity and burning at the same time as postural changes (bending to bind the shoes or picking up an object, lying on the bed, and similar movements).
- Sometimes gastroesophageal reflux is caused by hyaluronium, a pathological condition in which a more or less extended portion of the stomach passes from the abdominal cavity to the thoracic cavity, crossing the diaphragm at the hole in the esophagus (esophageal lacrosis).
- Finally, when talking about stomach acidity, it is good practice not to underestimate the importance of emotional factors, as burns and refluxes occur frequently in anxious or character-driven subjects.
All these conditions responsible for heartburn are aggravated by gastric acid, which, when excessive, can overcome the mucus layer that protects the stomach wall, irritating the mucosa until it causes actual injuries. For the same principle, irritation of the esophageal mucosa in response to reflux is directly proportional to the acidity of gastric contents.
Stomach acidity therapy is therefore focused on the use of anti-acid, proinetic medicines (to accelerate gastric emptying and hinder reflux) and anti-secretion (to decrease gastric secretion). Despite the effectiveness of these drugs, when talking about stomach acidity is often the use of ‘friend’s advice’ and, more generally, self-medication. The most well-known remedy is sodium bicarbonate that quickly adapts to acidity, but it also tends to lose its positive effect as quickly as it exacerbates the symptoms of the disorder. Analogous speech can be made for milk.
In addition, sodium bicarbonate is contraindicated in pregnancy, kidney failure and hypertension, as it increases the amount of sodium absorbed. In the presence of dyspepsia, phytotherapeutic prescriptions are varied and include, just to name a few examples, mucilage, aloe, mint, major gentian, artichoke, dandelion, absinthe, blessed cardio, cumin, fennel and rhubarb.
Heartburn (acid indigestion) possible causes
Pyrosis is the term by which physicians identify the unpleasant sensation of discomfort, or burning (burning) pain, felt behind the sternum with tendency to esophageal and throat irritation (sense of acidity rising). Responsible for this symptomatology is the insult suffered by the esophageal mucosa due to the excessive uptake of the acids contained in the stomach. Sometimes the pain associated with the heartburn is so intense that it can be swapped for an angular attack or a heart attack. unlike pyroscopic (those caused by acid indigestion), however, these conditions are commonly caused by physical, sometimes modest, and do not disappear after ingestion of antacids.
Heartburn is a common symptom, which manifests itself in numerous circumstances. This annoying burning sensation can in fact appear at any time, but is more common about half an hour after a meal or long distance from it. it is often associated with dyspepsia (bad digestion) and in this case typically accompanies nausea, eruptions and reflux. Acid indigestion also disturbs the sleep of many people, as the uptake of gastric juice in the esophagus is favored by the lying position. For the same reason, this symptom may also occur during particular movements of the trunk, such as the act of tapping shoes or picking up an object from the ground. Finally, it is now known as the onset of the heartburn, or at least its aggravation, are often related to emotional factors.
Along with individual and isolated episodes of heartburn, experienced in the first person by the majority of individuals, the repeated onset of this symptom tends to assume pathological features. In most cases, in fact, this symptom is a sign of gastroesophageal reflux, a condition characterized by abnormal ascension of acid content in the esophagus. The causes behind this reflux can be multiple and overlapping: incontinence of the gastroesophageal sphincter, hiatal hernia and the alterations in the tone of the esophageal or gastric muscles represent the most common causal agents.
MAIN CAUSES OF HEARTBURN
POTENTIAL AGGRAVATING FACTORS
|Gastroesophageal reflux (with or without hiatal hernia)||Cigarette smoking|
|Esophageal spasm, sudden expansion and spastic contraction of the lower esophageal sphincter|
Coffee (especially decaffeinated) and other caffeine drinks
|Scleroderma||Drunk or particularly hot|
|Gastritis||Foods such as onions, tomatoes, sour sauces, citrus fruits, chocolate, spirits, mint and particularly fat or spicy foods.|
|Peptic ulcer||Overweight or obesity.|
|Neoplasms with secondary impairment of sphincter function||Sleep or exercise physical activity a short distance away from a meal.|
|Gastrointestinal drugs (e.g. NSAIDs such as aspirin and ibuprofen, some sedatives and some antihypertensives)||Stress, depression, anxiety and hypochondria.|
|Aerophagia (typical of those who consume too fast or talk a lot while eating).|
The diagnosis of reflux disease is predominantly clinical. Generally, the physician will diagnose GERD only after exclusion of other pathological conditions such as heart problems or hiatal hernia. If these findings are negative and symptoms persist, an anti-acid drug therapy is initiated. If the patient’s response to these drugs is positive, further examinations are not normally necessary. If the symptoms persist or reappear at the end of the therapy, further investigations should be carried out, using instrumental investigations such as esophagus-gastroduodenoscopy, pH metrics, esophageal manometry and biopsy (to ascertain the absence of complications, Barrett’s esophagus).
Some patients complain of heartburn even in the absence of esophagitis and without the 24-hour pH monitoring of traces of gastroesophageal reflux. In these cases, it is said to be a functional heartburn and the identification of causes of origin can be particularly difficult.
Intake of anti-acid drugs is usually sufficient to resolve the pyogenic symptom. For this purpose, common antacid antacids (sodium bicarbonate, calcium carbonate, aluminum hydroxide or magnesium), H2 histamine antagonists, alginates or the most modern proton pump inhibitors can be used. Fundamental, before proceeding to pharmacological treatment or otherwise afflicting it to it, is the preventive intervention of heartburn through behavioral and dietary norms (see diet and gastroesophageal reflux).
Acid reflux: the precursor of heartburn
Acid reflux (acid regurgitation) consists of ascending the contents of the stomach in the esophagus, sometimes even in the throat. This symptom can also be associated with an annoying feeling of acid and bitter in the mouth, and excessive salivation. Acid reflux can be a sporadic episode, favored by bad eating habits and unhealthy lifestyles.
Acid reflux can be a sporadic episode, favored by bad eating habits and unhealthy lifestyles. In fact, reflux occurs mainly after abundant meals, especially if rich in greasy and spicy foods. Even chocolate, coffee and carbonated drinks are able to promote the rise of stomach contents. Other predisposing factors include smoking, alcohol, heavy physical activity after overweight meals and the fact that they sleep or lie down immediately after digestion (see the table above).
When acid reflux occurs frequently and / or rather intense, probability is a sign of a disease itself, as in the case of gastroesophageal reflux and hyaluronium. Acid reflux is also favored by esophageal diverticula, anatomic malformations (stomach, esophagus or cardias) and increased abdominal pressure. The latter is a common problem in obesity and pregnancy.
The possible causes of acid reflux are listed below. If you would like to narrow down the list of possible causes, look for another symptom associated with acid reflux.
You can read more about the symptoms of each condition [here URL Possible Causes Of Acid Indigestion].
- Esophageal diverters
- Zenker’s diverticulum
- Hiatal hernia
- Food intolerance
- Gastroesophageal reflux
- Zollinger-Ellison Syndrome
- Fetal-alcohol syndrome
- Esophageal spasm
Gastritis: this is how you tell it
Gastritis is an acute or chronic inflammation of the gastric wall. Acute gastritis is usually caused by an indigestion or an incorrect diet, characterized by excesses, spicy foods and hyperlipid and irritating foods for the gastric mucosa. Alcohol, smoking and NSAID abuse can also cause acute gastritis. Chronic gastritis is often attributable to infections sustained by Helicobacter pylori. However, it seems that other factors may also favor the chronic gastritis variant: AIDS, psychosomatic disorders, kidney and liver failure, Crohn’s disease, and autoimmune diseases.
All variants of gastritis are commonly associated with gastric syndrome (heartburn described above). In addition to this symptom, gastritis manifests itself with dyspepsia, dizziness, diarrhea, abdominal cramps, flatulence, meteorism, lytic and vomiting.
A suspected gastritis can be confirmed with the following diagnostic tests: history, Helicobacter pylori tests (blood analysis, stool analysis, breath test), gastric endoscopy, gastric biopsy, upper digestive system radiography.
Treatment depends on the triggering cause. For the treatment of acute gastritis, it is usually sufficient to correct incorrect dietary habits, possibly altering some behavioral attitudes (alcohol abuse, smoking, and stubborn NSAID intake) that could accentuate the symptoms. The chronic form (often caused by H. pylori) requires an antibiotic treatment associated with gastroprotective drugs and / or proton pump inhibitors
Gastritis is an acute or chronic inflammation involving the wall of the stomach. More than just an illness, gastritis is considered a heterogeneous and multiform form of disorders, all accumulated by a recurrent element: the flogic gastric wall. Today, in addition to being a discomfort affecting men and women of every race, age, and social rank, gastritis manifests itself in different respects: some gastric patients complain of a simple temporary gastric reflux (or heartburn). In others, however, the disturbance causes aerophage, dyspepsia, loss of appetite, and degeneration in severe and disabling symptoms such as diarrhea, abdominal cramps, meteorism, low altitude and vomiting.
The type of symptoms, as well as the intensity with which they manifest, are heavily influenced by the triggering cause. Fortunately, in most cases, gastritis of mildness is soon resolved by correcting some incorrect food behaviors. On other occasions, however, where the disease assumes a chronic or particularly aggressive connotation, therapy needs to be more drastic.
Let’s begin by distinguishing two main forms of gastritis:
- Acute gastritis: violent inflammation of the gastric mucosa that tends to resolve in a relatively short time span
- Chronic gastritis: Gastric symptoms manifest themselves gradually, but they last for long periods
Both the acute form and the chronic variant can be differentiated into other subcategories, each of which is the expression of different etiopathologic (or causal) factors. Let us recall briefly that mild gastritis forms can be caused by an indigestion or an unbalanced diet rich in spicy foods, spicy, hyperlipidic, and irritating to the gastric mucosa. In such breaches, the correction of eating habits is usually enough to overthrow the disease. As analyzed, there are many variants with which gastritis can be manifested. In addition to the aforementioned causes, numerous risk factors have been identified that can predispose the patient to gastritis. Among the most worthy of note, let’s remember:
Alcohol Abuse. Alcoholics, exerting a stomach corrosive action, irritate and progressively corrode the gastric wall, making it more susceptible to the action of acidic gastric juices. Alcoholism is one of the causes most involved in acute and chronic gastritis. To read more: read the article alcohol and gastritis
Abuse of coffee. Coffee is among the top places in the list of foods discontinued in the presence of gastritis; the famous drink is in fact equipped with eupeptic properties. As such, coffee can aid digestion, as it stimulates salivation and secretion of gastric juices due to the presence of caffeine and other synergistic substances (caffeine). The digestive effect of coffee may be particularly useful in the presence of hypocloridry dyspepsia (reduced secretion of hydrochloric acid in a gastric environment).
Coffee is contraindicated in the presence of gastritis and peptic ulcer as it accentuates insomnia to the gastric mucosa delaying any repair. In addition, caffeine is known for its ability to loosen the gastro-esophageal sphincter seal, which prevents gastric uptake in the esophagus. As a result, coffee should not be consumed, or eventually replaced with decaffeinated, and always with moderation, in the presence of gastritis, gastroesophageal reflux, peptic ulcer or Barrett’s esophagus.
Note that caffeine is present not only in coffee and other drinks or foods, but also in some medicinal specialties, such as headache. Other methylxanthines used in the prevention of bronchospasm (anti-atmospheric properties of theophylline and aminophillin) may promote gastric secretion. Blood vomiting that resembles coffee grounds (hematemesis), then digested, is one of the major symptoms of severe gastritis accompanied by gastric ulcer.
In addition to coffee, in the presence of gastritis and its complications, it is also advisable to avoid: NSAIDs reduce the concentration of bicyclic in the gastric mucus and inhibit the synthesis of some prostaglandins used to protect the stomach mucosa; the gastroesemic effect is reduced for paracetamol and selective COX-2 inhibitors. Cortisone, similarly to NSAIDs, but with different modes of action, exerts a gastrointestinal action, probably going to disrupt the blood flow at the gastric level.
Alcohol can favor the appearance of gastritis and peptic ulcer as it, at high doses, reduces the amount of bicarbonate in the mucus.
Cigarette smoking increases gastric emptying time, facilitates gastro-duodenal reflux and reduces secretion of bicarbonates; it is therefore among the factors that predispose to the development of gastritis.
The sympathetic camouflage amines, and in particular the coffee caffeine, as well as tea, cola, cocoa, guarana, mathe can dramatically increase the acid secretion of the stomach, while caffeine may interfere with the defense capabilities of the gastric mucosa. Nonetheless, gastroenterologists use the so-called caffeine test to evaluate the gastric secretion of the patient.
Meals that are too abundant, eaten too quickly, without chewing; tomatoes, cocoa, juices, acid soaps, cooked fat, fries, pepper, chili and spices are generally considered as habits and foods that predispose to gastritis. They supplement the framework of the factors that favor the appearance of this disorder some psycho-social elements such as strong stress, internal conflict, strong competition spirit, and so on.
Regular taking of analgesics. The most accused are: acetylsalicylic acid, ibuprofen and naproxen, possible risk factors for both chronic gastritis and its acute form.
Reflux diseases, risk factors for gastritis and gastric ulcer (two pathological disorders that are often linked).
Advanced age: Seniors are the most at risk of gastritis. In fact, the gastric wall tends to weaken as the age progresses
Recurrent infections from Helicobacter pylori. It is, however, necessary to remember that not necessarily an infection sustained by this pathogen triggers the symptoms of gastritis.
The maximum incidence of gastric ulcer occurs in male patients aged between 50 and 60 years. The male / female ratio is 3:1. The mean age is about 10 years older than that of patients with duodenal ulcer. Gastric ulcer appears more frequently in lower social classes, but it is unclear whether this is related to particular food factors or risk behaviors such as smoking, coffee intake, emotional stress, drug use NSAIDs.
The root cause of the ulcer is unknown. However, many factors have been identified which, if present, could cause it to occur. Patients with gastric ulcer usually have a normal gastric acid production or slightly lower than normal. For this reason, the most acclaimed hypothesis is that a decrease in the resistance of the gastric mucosal barrier to the aggressive action of the acid-peptic secretion. The normal gastric mucosa is covered by mucus, secreted by superficial mucous cells, which contains proteins and bicarbonate. The mucosal protective action, rich in bicarbonates, is carried out by maintaining a pH higher in the mucous membrane than the gastric secretion. It thus constitutes a barrier that prevents acid from damaging the mucosa and submucosal tissues. The rapid replacement of stomach epithelial cells also ensures rapid repair of any lesions due to the aggressive action of gastric juice. All factors considered responsible for the onset of gastric ulcer are able to reduce the effectiveness of these mucosal defense mechanisms.
In the stomach of patients suffering from gastric ulcer, there are always typical alterations of a gastritis (inflammation of the mucous membrane). The appearance of gastritis always precedes that of the ulcer and the mucous membranes involved in gastritis have a reduced capacity for secretion of bicarbonate in the mucus. This explains the onset of the ulcer. Chronic anthralic gastritis (of the anterior pylorus) is perhaps the gastric condition whose correlations with the onset of the gastric ulcer are more commonly known. It is due to a reflux from the duodenum to the stomach, after which a high amount of bile (which is secreted in the duodenum) comes into contact with the gastric mucosa. It, being a weak acid, neutralizes the secretion of gastric bicarbonate.
In 50-65% of gastric ulcer patients there is the presence of Helicobacter pylori in the pylori anthropoid, a bacterium located below the mucous membrane. Helicobacter pylori can induce a local inflammatory reaction with the activation of the immune system and cause lesions of the epithelial cells of the mucous itself. Helicobacter pylori gastritis could therefore be a predisposing factor to the onset of the stomach ulcer.
Numerous dietary and behavioral external factors can facilitate the onset of gastric ulcer. Non-steroidal anti-inflammatory drugs (NSAIDs) reduce the concentration of bicarbonate in the mucus and inhibit the synthesis of prostaglandins, molecules that exert a protective action on the gastric mucosa. Cortisone also exerts action on the mucous membrane, possibly altering the mucous blood flow. Alcohol, ingested in large quantities, reduces the content of bicarbonates in the mucus even if there is no evidence of increased evidence of increased gastric ulcer in alcoholics. Caffeine can dramatically increase gastric acid production as well as diet fats are able to decrease the mucous membrane resistance to acid attack, possibly depressing the secretion of bicarbonate in the mucus. Cigarette smoking slows gastric emptying and increases reflux from the duodenum to the stomach, as well as reducing the secretion of bicarbonate.
There is also a genetic predisposition to the development of gastric ulcer: a greater incidence of the disease is found in blood group subjects 0. Psychological factors also play a significant role in the appearance of gastric ulcer: individuals with a fragile and dependent personality, or exposed to situations of high conflict or competition, develop gastric ulcer with higher frequency. It is also possible that increased peptic ulcer frequency is the result of alimentary and life-threatening habits, such as smoking and coffee abuse, and dietary disorders.
Most benign gastric ulcers are within 2.5 inches of the pylorus. 85% of them are located along the small curvature of the stomach, while the remaining 15% is distributed on the front and back wall and along the large curvature. The macroscopic appearance of the benign gastric ulcer is that of a dilated, round or oval lesion, usually less than 0.7 inches in diameter, which occurs on inflammatory mucosa due to gastritis. At the bottom of the ulcer you can sometimes find vases with blood clots or signs of a small underway hemorrhage.
The depth of the ulcer is variable. It can just overcome the muscularis mucosae or it can reach the serous and even overcome it, causing a perforation free in the peritoneum or deepening into nearby organs and adhering to the stomach, such as the liver and the pancreas.
Some patients with gastric ulcer have no symptoms. When the presence of the gastric ulcer becomes clinically evident, the onset of the onset is usually epigastric pain (just below the sternum) of varying intensity, typically occurring within the first 30 minutes after the meal (premature postprandial pain). In ulcers located along the small curvature, antacids provide a quick relief to pain, while food may, even after temporary well-being, induce exacerbation.
There may also be nausea and gastric vomiting (undigested or semi-digested food). The appearance of sudden epigastric pain, followed by signs and symptoms of acute abdominal (severe stabbing pain, hard abdomen, nausea, vomiting, sweating, tachycardia, weak pulse and assuming a positioning on one side in which the pain subsides to a certain extent) make possible perforation of the perforated ulcer. 40% of gastric ulcer related reports a variable weight loss associated with anorexia and aversion to food-induced disorders.
Sideropenic anemia (due to iron deficiency) may be manifested, of varying degrees, linked to chronic hemorrhages resulting from the gastric ulcer. Periodicity of painful symptoms throughout the day can be added to seasonal periodicity, with accentuating features in the spring and autumn.
An aggravation of symptoms can also occur as a result of sharp changes in dietary or working habits, or after periods of psycho-physical or emotional stress. The presence of non-periodic pain or sudden and sudden changes in classical symptomatology must suggest the onset of complications or non-peptic, but neoplastic, gastric ulcer complications.
The diagnosis of gastric ulcer should be differentiated from that of many other commonly occurring diseases: hiatal hernia, gastritis, duodenitis, duodenal ulceration, gallstones, or chronic inflammation, and is particularly important for differential diagnosis with stomach cancer. The confirmation of the presence of ulcer is endoscopic and radiological. Endoscopic examination (gastroscopy) should be considered as the first-choice diagnostic approach. The direct visualization of the ulcer allows in fact to evaluate its size and shape, as well as to perform drawings (biopsy). On such biopsies, in addition to the histological examination, the research of Helicobacter pylori can also be performed.
The radiological examination is carried out with a barium swallow, i.e. meals marked with a fluorescent substance so that it can be seen on the X-ray. Depending on whether or not the contrast medium passes, this can be used to evaluate the emptying time Gastric and other parameters.
Heartburn during pregnancy
During pregnancy, stomach acidity is a rather frequent problem. At first, the origin of the disorder is due to the high levels of progesterone, which can slow down the digestive processes and reduce the tone of the sphincter between the esophagus and the stomach. From the fourth month onwards, when the fetus begins to significantly increase its size, the pressure exerted on the stomach walls can aggravate the problem, favoring ascending acids in the esophagus. Pharmacological therapy should always be undertaken with caution and exclusively under medical supervision.
Given the potential risk to the fetus, to control acidity and burning, simple general rules should be followed:
- Avoid too much meals, especially in the evening
- Avoid overcooking with fatty foods, alcohol and coffee
- Avoid falling asleep immediately after eating. A walk can be useful
- Avoid those movements that increase abdominal pressure (bust flexions) and garments too tight
- Elevate 10-15 cm bed headboard during night time
If acidity and heartburns become unbearable, it is advisable to contact your doctor to consider using specific medications, supported by studies that demonstrate harm to the fetus.
Importance of medical examination
Regardless of the effectiveness of numerous home remedies, before taking any initiative, it is a good rule to consult your GP. Anti-acid medicines are in fact meant as emergency remedies, useful in treating pain related to stomach acidity. When heartburn persists, medical consultation is a must, as it allows you to identify the causes and take the most appropriate therapy right away.
Although a careful amnesthetic investigation can direct the physician to a precise diagnosis, symptoms related to heartburning are not a definite diagnostic criterion, as, as we have seen, they may be common to several conditions affecting the digestive tract. Often, to exclude the presence of specific pathologies, diagnostic investigations such as radiography of the first digestive tract, pH metrics and oesophageal manometry are required.