Heartburn: symptoms, causes and treatment

By Cristiano Antonino On Jan 27, 2023

In medical language, it is called heartburn but is more simply known as ‘stomach acidity’. It is an extremely common symptom that, sooner or later, happens to everyone at least once in their life

The sensation is that of the classic burning sensation at the mouth of the stomach.

In the most intense forms, the burning sensation spreads right up the digestive tract to the height of the neck.

Stomach acidity is linked to various factors and pathological conditions:

Digestion difficulties
Gastritis
Smoking and abuse of alcohol or spicy and irritating substances for the stomach walls
Gastric ulcer
Duodenal ulcer
Gastroesophageal reflux
Hiatal hernia
Heightened anxiety and altered emotional states

When discussing stomach acidity, it is good not to underestimate the importance of factors related to emotionality or psychopathological personality traits.

People who are very emotional or suffer from anxiety disorders may suffer from it.

If the acidity in the stomach always occurs in the immediate vicinity of a meal, it is likely to be an episode of acute gastritis, that inflammatory process in the inner gastric wall caused by irritants such as smoke, alcohol or over-spiced food.

If, on the other hand, the symptoms appear after the meal but regularly and are accompanied by severe pain, this could be a gastric ulcer.

If the symptoms become chronic and also occur at night and away from mealtimes, it could be a duodenal ulcer.

When, on the other hand, the problem is caused by the gastric contents rising up to the height of the neck due to a malfunction of the muscular valve that closes the stomach opening, one is in the presence of gastro-oesophageal reflux.

In turn, this disorder may originate from the presence of hiatal hernia, a pathology that results from the presence of a portion of the stomach in the abdominal and thoracic area, at the height of the diaphragm, in correspondence with the hole through which the oesophagus passes (oesophageal hiatus).

Stomach acidity, the importance of the specialist’s diagnosis

If stomach acidity is occasional and mild, it may not be necessary to see a specialist.

However, when it occurs recurrently or periodically in the presence of certain other symptoms and potentially pathological conditions, it is useful to book a visit with a doctor specialising in gastroenterology.

The gastroenterological examination consists of the specialist’s precise assessment of the general state of health of the patient’s digestive system.

The anamnesis, in which the clinician collects all the relevant information on the patient’s medical history, precedes the actual phase of the diagnostic assessment of the symptoms affecting the stomach and oesophagus, which is carried out by means of an objective test and direct palpation of the internal organs.

At the end of the examination, before prescribing any drug therapy, the gastroenterologist may decide to prescribe further diagnostic tests including endoscopic tests such as gastroscopy, laboratory tests such as blood, urine, stool and parasitological tests or X-rays of the first digestive tract, CT scan, phmetry and oesophageal manoeuvre.

Diet and prevention

While waiting for the specialist’s report, it may be useful to keep heartburn symptoms under control with a diet that does not stimulate the stomach’s natural acidity.

The most recommended diet is one that is also healthier, low in simple sugars and fats found largely in refined products.

The quantities of food should never be too large, also because it is important that the food is easily digestible.

Eliminating the consumption of drinks that stimulate gastric juices is very important: no to Coca-cola, lemonade and other carbonated drinks, and no to fruit juices.

The eating style to be followed is that prescribed by the Mediterranean diet, which favours simple foods, cooked using unprocessed processes, wholemeal flours, pulses and lean meats, and minimises the consumption of sweet products (especially if industrially produced).

Fried foods, fatty cheeses and alcohol should also be eliminated.

Smoking also plays an important role, and while waiting to understand what the acidity is generated by, it would be better to suspend or reduce to a minimum this vice, which does not fit into the healthy habits that a clinical opinion can endorse, and which contributes to the onset of various pathologies, even serious and fatal ones, such as lung cancer and myocardial infarction.

Regardless of the efficacy of these ‘do-it-yourself’ remedies and an anti-acid diet, taking certain medications can also lead to stomach discomfort and it may be useful to use a gastroprotectant before taking oral medications.

Medications, remedies and do-it-yourself therapies for stomach acidity

People often resort to self-medication when they have stomach acidity, thinking that it is simply a digestive problem.

Among the most popular self-medications is sodium bicarbonate, which can temporarily neutralise an overly acidic environment inside the stomach.

This do-it-yourself remedy quickly loses its effectiveness within hours of being taken and can even worsen symptoms if taken regularly.

Taking sodium bicarbonate is also contraindicated during pregnancy, a period of life in which the female body may be subject to a form of stomach acidity caused by the physical compression of the internal organs pressing on the stomach.

As it also increases the amount of sodium absorbed, this remedy is not recommended in cases of hypertension and renal insufficiency.

In addition to phytotherapeutic products, such as herbal teas and decoctions of caraway, fennel, mint and rhubarb, aloe, gentian, artichoke and mucilage, milk also has a mild alkaline power and therefore belongs on the list of so-called ‘grandmother’s remedies’.

From a pharmacological point of view, on the other hand, the recommended therapies focus on the use of antacid and prokinetic medicines that obstruct the flow of gastric juices and accelerate and facilitate gastric emptying.

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