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Thursday, August 12, 2010

Non Surgical Managemant of Heart Burn

Posted by Prahallad Panda on 7:29 AM Comments

Barret's EsophagusImage by drppanda via Flickr
Heart burn, a burning sensation with reflux of stomach contents to oesophagus, felt behind the sternum is a burning problem for the sufferer and the treating physician. Hydrochloric acid naturally present in the stomach, secreted in response to the food, normally does not come to oesophagus; prevented by a sphincter like locking mechanism in association with the diaphragm. But, if it comes back to the oesophagus causes burning symptoms, mostly due to a faulty sphincter mechanism located between the junction of oesophagus and stomach. If that is the case, a few surgical options are available with good success rate. But, a number patients can be treated by non-surgical means. If chosen, certain things are to be followed which will perhaps relieve the discomfort to a larger extent.
Those could be;
  • Yogic practices to strengthen the sphincter mechanism, which may be in fault may help. Though it is simple, should be learnt from an experienced person. It is Pranayam, slow inhalation of external air to the fullest extend over a period of time and exhaling the same. It gives a good exercise to the diaphragm, and over the time may help to strengthen it around the exit of oesophagus from thorax to the abdomen.
  • The next thing perhaps is modification of food habit. Over the time the sufferer knows which foods cause or exacerbate the problem. Mostly spicy and chilly foods give rise to the symptoms. Those foods can be best avoided.
  • Life style modification plays an important role in this disease. Sedentary life style help to accumulate a lot of abdominal fat and does not give the diaphragm a good exercise. So, physical exercise eases the symptoms.
  • Then food habit has to be modified.
  1. Longer fasting period should be avoided, Food at regular intervals keeps the acid diluted.
  2. Drinking of water may be delayed for about half an hour after taking food.
  3. Sleeping immediately after taking food can be avoided, instead remaining in up right posture and a little walk inside the room helps.
  4. Use of pillow under neck while sleeping may help to restrict the reflux some extent.
  • As regards drugs;
  1. Stomach motility modifying drugs, Viz. domperidone and ondensetron likely to help.
  2. A proton pump inhibitor (PPI) to reduce acid out put and increase the PH of stomach content; may be taken on demand rather than a regular basis. PPIs give so much relief that one becomes dependent on it. Long term use of these drugs has been seen to create gastrointestinal problems, should best be avoided.
  • Some antacids can be taken for immediate relief.
  • If no drug is available at hand, drinking one or two glasses of water will relieve the symptoms.
  •  I hope all the above measure will help many sufferers to avoid a surgery.
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