Acid lifts should not be neglected. Medications are effective in providing relief, but are suspected of having side effects. So, how do you properly manage these gastroesophageal reflux – better known as heartburn?
Many people have experienced this unpleasant burning sensation after a meal.“30% of adults suffer from gastroesophageal reflux disease (GERD) at least once a month, 5 to 10% every week,” says Prof. Frank Zerbib, a gastroenterologist at Bordeaux University Hospital.
The symptom is banal, as long as it remains punctual. But, in the long term, acid reflux can damage the mucous membrane of the esophagus: “What we fear most is that the mucous membrane changes in nature under the effect of chronic reflux,” observes Prof. Zerbib. This mutation, called Barrett’s esophagus, is a risk factor for cancer.
“The risk is very low, but it justifies screening by endoscopy in people over 50 years old suffering from gastric reflux. There is no need to repeat the examination if it is normal. Once is enough,” insists Prof. Zerbib.
Gastric reflux: how does it work?
Instead of remaining in the stomach, the gastric juice, whose acidity allows food to be digested, moves up the esophagus. The valve that separates the esophagus from the stomach no longer acts as a barrier.
It is characterized by two typical symptoms: a burning sensation behind the sternum, and acidic liquid rising upwards. More rarely, the patient feels a sore throat, a chronic cough, chest pain..
Before consulting a gastroenterologist, an ENT or cardiac check-up is required.
Avoid an antacid diet in case of GERD
Most people with GERD identify foods they can’t tolerate. These are individual susceptibilities. In general, there is no universal antacid diet. On the other hand, “three hygieno-dietary rules have proven to be effective,” says Prof. Zerbib :
- respect a delay of two to three hours between the evening meal and bedtime,
- lose weight to reduce abdominal pressure
- and raise the head of the bed by 45 degrees.
Medication can be useful after overeating or for chronic reflux.
What medications if your symptoms are occasional?
Over-the-counterstomach dressings and antacids (sodium bicarbonate or alginate, calcium carbonate) work quickly but for a limited time. ” The medication stays in the stomach where it buffers the acid. These products are not suitable for repeated daily use over long periods of time,” says Prof. Zerbib.
Some proton pump inhibitors (PPIs), which are effective over 24 hours, are available without a prescription. The gastroenterologist advises against self-medication “not because of a potential risk, but because of what is hidden in taking this type of medication. It is better to have a medical opinion”.
What to do in case of frequent heartburn?
If the heartburn comes back several times a week, the doctor may prescribe specific medications, which pass into the bloodstream. Different classes exist, with PPIs being the most widely used. They relieve reflux in 70-80% of cases. They can be taken on demand, as a three- to four-week course of treatment or, in rare cases, over a longer period of time.
Except in exceptional cases, taking PPIs daily over long periods of time is not recommended.
Recent studies have suggested a risk of side effects related to changes in the intestinal microbiota. A warning that Prof. Zerbib is keen to qualify: “There are not sufficiently robust data. Only cases of magnesium deficiency and intestinal infection in some patients have been shown. This small risk is largely offset by the benefits if the treatment is taken wisely”
Theonly alternative to medication, surgery is sometimes proposed. But reconstructing a valve between the stomach and the esophagus is not an insignificant gesture. This type of intervention is reserved for particular profiles.