Heartburn Treatment

HEAT BURN

Treatment, Diagnosis, and Nutritional Principles in Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) is a chronic inflammatory condition in which the contents of the stomach are pushed back into the esophagus. The primary symptom is heartburn, but patients may also experience a sour taste in the mouth, pain behind the breastbone, cough, hoarseness, and a feeling of a lump in the throat.

Modern Nutritional Principles in GERD:

• No universal prohibitions – Each person has individual dietary triggers. It is important to monitor reactions to foods and keep a food diary.
• Regular, small, frequent meals – It is recommended to have 5–6 small meals a day. Overeating increases intra-gastric pressure and promotes reflux.
• Dinner at least 3–4 hours before sleeping – Food should have enough time to leave the stomach before assuming a horizontal position.
• Elimination of irritating foods – Often provoke symptoms: coffee, chocolate, alcohol, fatty and fried foods, spicy dishes, mint, citrus fruits, and carbonated beverages.
• Reduction of gas production – Excessive bloating may worsen reflux. It is advisable to limit cabbage, legumes, yeast bread, and lactose-containing products if lactose intolerant.
• Proper body position after meals – Do not lie down for at least 1–2 hours after eating. In case of nighttime symptoms, sleep with the head elevated (by 15–20 cm).
• Cessation of smoking – Smoking weakens the lower esophageal sphincter and aggravates the disease.
• Medication is essential – While diet is an important component, achieving lasting remission is not possible without pharmaceutical therapy. The following are prescribed:
- Proton pump inhibitors (omeprazole, esomeprazole, rabeprazole, etc. )
- H2-histamine receptor blockers (in selected cases)
- Alginate compounds (which create a protective film)
- Prokinetics (to improve gastrointestinal motility)
• Stress control and a proper daily routine – Chronic nervous tension can exacerbate GERD symptoms. Moderate physical activity, proper sleep, and managing psychological stress are recommended.
• Monitoring by a gastroenterologist (or primary care physician) – For chronic heartburn, an endoscopy (EGD) is essential. This allows the detection of complications and adjustment of treatment.

Modern Methods of GERD Treatment

• Pharmacological therapy is the cornerstone of treatment. Modern proton pump inhibitors provide a high level of symptom control and promote mucosal healing. The course usually lasts from 4 to 8 weeks with subsequent transition to a maintenance dose.
• Endoscopic methods (for example, radiofrequency ablation or the Stretta procedure) are applied if conservative therapy proves ineffective.
• Surgical treatment – Nissen fundoplication or its modern modifications. This is considered in cases of medication resistance, complicated courses, or inability to use PPIs long-term.

Also worth paying attention to are the modern combined drugs produced in Italy or their equivalents in other countries:

1. Esoxx One
Form: Single doses in the form of a thick solution (sachet or small vial for oral use)
Composition (main active components):
• Hyaluronic acid
• Chondroitin sulfate
• Polysaccharide matrix based on poloxamer 407
Mechanism of action:
• Forms a protective biofilm on the esophageal mucosa, shielding it from the aggressive action of gastric juice and digestive enzymes.
• Hyaluronic acid promotes healing and regeneration of the mucosa.
• Chondroitin sulfate has anti-inflammatory and protective effects.
• The drug does not affect the acidity of gastric juice, but works mechanically and physico-chemically by creating a barrier.
Indications for use:
• GERD (including erosive form)
• Barrett's esophagus (as part of comprehensive therapy)
• Post-endoscopic or surgical interventions on the esophagus
• For patients intolerant to PPIs or who wish to avoid medications
Advantages:
• Over the counter
• Can be combined with PPIs or used as an alternative in mild reflux cases
• Suitable for long-term use
• Safe, with virtually no side effects

2. RefluG
Form: Syrup, sachet, or capsules
Composition (depending on the form):
• Alginates (sodium salt of alginic acid)
• Sodium or calcium bicarbonate
• Herbal extracts (for example: mallow, licorice, aloe, chamomile – depending on the manufacturer and product version)
Mechanism of action:
• Alginates interact with gastric juice to form a gel-like “raft” that physically prevents the backflow of stomach contents into the esophagus.
• Antacid components neutralize free acid.
• Phytotherapeutic extracts provide additional anti-inflammatory, soothing, and antispasmodic effects.
Indications for use:
• Symptomatic treatment of heartburn, belching, and acidic taste in the mouth
• Mild forms of GERD
• Supportive treatment during withdrawal from PPIs
• In pregnant and breastfeeding women (certain forms of RefluG are approved)
Advantages:
• Natural composition (in most versions)
• Additional soothing and protective effects
• Suitable for frequent use
• Can be used in children and pregnant women (after consulting a physician)

Why Should GERD Not Be Ignored?

Without treatment, the disease progresses. Possible complications include:
• Erosive esophagitis – inflammation with damage to the esophageal mucosa
• Esophageal ulcers – which may cause bleeding and strictures (narrowing)
• Metaplasia (Barrett’s esophagus) – a precancerous condition that requires monitoring
• Esophageal adenocarcinoma – a rare but extremely aggressive complication, most often arising in the context of untreated GERD

At the first signs of the disease, do not delay a visit to your doctor. GERD is not just heartburn. It is a condition that requires a systematic approach, ongoing monitoring, and above all, responsibility for one's own health.