Heartburn.What medications cause heartburn ?
Encyclopedia Symptoms / / August 12, 2017
Heartburn - is a painful burning sensation just below the breast bone or behind the breastbone that usually begins in the esophagus.The pain often rises in the chest and may spread to the neck or throat.
Common causes heartburn
Almost all people from time to time is heartburn.If heartburn is very common in the patient, it is possible that this indicates the presence of gastroesophageal reflux disease (GERD) - a chronic relapsing disease caused by the spontaneous, regularly recurring gastroesophageal reflux, which is the inverse of the advancement in the esophagus of the stomach contents through the lower esophageal sphincter.Reflux occurs when the muscle activities of the lower esophagus or other protective mechanisms fail.
Usually, when food or liquid enters the stomach, a group of muscles in the esophagus closes it.This group is called the "lower esophageal sphincter" (NPS).If this sphincter does not close tightly enough to spill the contents of the stomach into the esophagus.This partially
- Violations of the lower esophageal sphincter. Heartburn occurs when the patient has a hiatal hernia, when the upper part of the stomach falls into the chest cavity.This weakens the lower esophageal sphincter and promotes the flow of acid from the stomach into the esophagus.
- Pregnancy. Pregnancy mozhett cause heartburn or strengthen it.
- Taking certain medicines. Drugs that can cause acid reflux:.
- anticholinergics (or holinoliticheskie means delirianty - substances that block the natural neurotransmitter acetylcholine and replace it if it enters the body by the proximity to the cholinergic receptors of the brain To anticholinergic agents include tropane alkaloids atropine, scopolamine andhyoscyamine, contained in henbane, datura, belladonna, mandrake, duboisia, scopolia and some other plants, as well as antihistamines promethazine, diphenhydramine, etc., and some medicines for the treatment of Parkinson's disease) - for example, for motion sickness.;
- beta-blockers (beta blockers - a group of pharmaceuticals, which when introduced into the human body occurs beta-adrenoceptor blocking their conventionally divided into two groups: 1 adrenoceptor blockers; 1 adrenoceptor blockers and 2.??adrenergic receptors. When the blockade? 1-adrenergic receptors predominantly observed cardiac effects, decreases the strength and decreases the heart rate, ie there is a negative chronotropic action, inhibited cardiac conduction, ie there is a negative effect dromotropic. When the blockade? 2-adrenergic receptors occursincrease bronchial tone, the tone of the pregnant uterus, arteriolar tone and PR increase. Beta-adrenergic receptors are present in smooth muscle, cardiac muscle, respiratory tract, arterial, kidneys and other tissues and are responsible for the body's response to stress, especially if stimulation of epinephrine. Betaadrenoblokatory prevent the binding of epinephrine and other hormones to the receptor and thus weaken the effects of stress) for high blood pressure or heart disease
- calcium channel blockers (or calcium antagonists - a heterogeneous group of drugs with a similar mechanism of action and the difference on some properties,including tissue selectivity, pharmacokinetics effect on heart rate, etc.) high blood pressure;
- dopamine (a neurotransmitter produced in the brain of humans and animals, as well as a hormone produced by the adrenal medulla and tissue - for example, the kidneys, but this hormone in blood subcortical brain hardly penetrates. The chemical structure dopamine relates to catecholamines;he is the "predecessor" of norepinephrine and epinephrine) - a drug widely prescribed in Parkinson's disease (or parkinsonism - is progressing slowly neurological chronic degenerative disease of the extrapyramidal motor system, typical for older people Caused by Parkinson's destruction and the death of neurons that produce the neurotransmitter dopamine.. parts of the central nervous system development Lack of dopamine leads to the activating effect of the basal ganglia to the cortex principal or cardinal symptoms are:. hypokinesia, muscle rigidity, postural instability, tremors or shaking, stiffness and total violation of posture and movements.The disease is associated with progressive loss of motor nerve cells - neurons that produce dopamine, which due to disrupted regulation of movements and muscular tonus.Parkinson ill about every hundredth person over the age of 60 years.In men, it is more common than in women);
- progestins (or progestins -... Is a subclass of steroid hormones, mainly produced by the corpus luteum of the ovaries and the placenta of the fetus and the adrenal cortex Progestins have many functions in women function of progestin in the first place is to allow the emergence and continuation of pregnancy Progestins influencethe formation of normal secretory endometrium in women they cause the lining of the uterus in the secretory phase transition from proliferation, and after fertilization facilitate its transition to a state that is necessary for the development of a fertilized egg) for abnormal menstrual bleeding or birth control;
- sedatives (or Psycholeptics -. Chemically dissimilar drug substances of synthetic or plant origin, causing sedation or reduction of emotional stress without hypnotic effect Meanwhile, sedatives facilitate and deepen the natural sleep Compared to modern tranquilizers, particularly benzodiazepines, sedatives.drugs have a less pronounced antifobichesky and calming effect, not cause muscle relaxation and ataxia high tolerability and absence of serious side effects make it possible to use them in daily outpatient practice, often - in the treatment of patients with advanced age often as sedative use of vegetable origin:.. drugs valerian., motherwort, peppermint, bromides Furthermore, as sedative hypnotics some use in small doses - for example, hypnotics, barbiturates Prolonged use as sedatives not recommended) when disturbed or if insomnia.;
- theophylline for asthma or other lung disease;
- tricyclic antidepressants (TCAs, tricyclics antidepressants in general -.. It's psychotropic drugs primarily used to treat depression in patients with depression, they improve mood, relieve or reduce fatigue, depression, anxiety, apathy, emotional stress, have topatient timolepticheskoe action - that is, increase mental alertness, normalize appetite and sleep duration All tricyclic antidepressants have three linked together rings in the molecule, although the structure of the ring and attached to the rings of the radicals can be very different tricyclics blocking presynaptic membrane reuptake of neurotransmitters.. -. first of all, norepinephrine and serotonin They are appointed for the treatment of severe and moderate endogenous depression with psychomotor and somatic symptoms Many TCAs are characterized by the ability to quickly recover from depression sleep disorders in tricyclics class has two subclasses that differ in features of the chemical structure:.. ittricyclics, are tertiary amines, and tricyclics, are secondary amines.Many of the secondary amine tricyclics subgroups remain active metabolites tertiary amines are formed in the body.For example, desipramine - one of the active metabolite of imipramine, nortriptyline - the active metabolite of amitriptyline).
If the patient thinks that one of his medications may be causing heartburn, it is necessary to talk about this with your doctor.You should never modify or discontinue medication without consulting your doctor.
Heartburn is usually easily diagnosed by symptoms that the patient describes the doctor.Sometimes heartburn can be confused with other stomach problems (eg, dyspepsia - a generic term for disorders of digestion, mainly functional nature).If the diagnosis is unclear, the patient may be sent to a gastroenterologist for further testing.
doctor will do a physical examination and will ask the patient questions about heartburn, so you must be prepared in advance to respond to them.Here is a sample list of questions:
- when it started;
- how long it lasted episode (attack of heartburn) for the last time;
- whether it's the first time a patient has heartburn;
- the patient usually eats at each meal;before if he felt heartburn, eating spicy or fatty foods;
- whether the patient drinks a lot of coffee or other drinks with caffeine or alcohol;whether the patient smokes;
- whether the patient wears clothing that fits tight chest or abdomen;
- whether the patient is also pain in the chest, jaw, arms or anywhere else;
- what medicines the patient takes;
- does not happen if the patient vomiting blood, or black vomiting;
- whether the patient's blood in the stool;
- whether the patient's black, tarry stools;
- whether there are other patient symptoms of heartburn.
following tests may be done to the patient:
- esophageal motility study or intraesophageal manometry - measuring the pressure in the esophagus using balloon probes.Allows you to evaluate the performance of motor activity of the esophagus and sphincter function, can provide useful information on the lowering of the pressure in the lower esophageal sphincter, motility disorders of the esophagus and tone, increasing the number of transient cardiac sphincter relaxations.Esophageal manometry is limited clinical use due to variability with GERD pressure on the lower esophageal sphincter;
- Esophagogastroduodenoscopy (upper endoscopy; videogastroskopiya, fibrogastroscopy, EGD, gastroscopy - examination of the esophagus, stomach and duodenum, which is performed in order to clarify the causes of abdominal pain, heartburn, nausea, vomiting, difficulty swallowing food This is the best method of detection.causes of bleeding of the upper gastrointestinal tract. The examination can be performed after surgical operations on the esophagus, stomach or duodenum for the early detection of possible complications and identify emerging mucosal changes. This method several times for accuracy is superior to X-ray examination for inflammatory changes in the mucous membrane, the detection of ulcers and.. when erosions esophagogastroduodenoscopy early detection of tumors allows for its successful treatment during EGD procedure, if necessary, a biopsy can be done - take a fragment of mucosa for cytological and histological studies.Using a flexible endoscope - a tube with a camera on the end, going through the mouth into the esophagus and stomach into the small intestine, and special tools during EGD can remove polyps or accidentally swallowed foreign bodies, to stop the bleeding that can avoid operations), etc..
treatment and first aid for heartburn
necessary to treat heartburn, especially if the patient is often the symptoms.Eventually reflux can damage the lining of the esophagus and cause serious problems.The good news is that habits change can help prevent heartburn and other GERD symptoms.
following tips will help the patient to avoid heartburn and other symptoms of GERD (and if these measures do not work, it is necessary to talk about this with your doctor).
First, you must avoid eating foods and beverages that can trigger reflux - such as for example:
- carbonated beverages;
- citrus fruits and juices from citrus fruits;
- different kinds of mint;
- spicy, spicy or fatty foods, fatty dairy products;
- tomatoes and tomato sauces.
also need to change your eating habits:
- Avoid slopes or exercise immediately after eating;
- avoid eating 3-4 hours before going to bed or lying down.When a man lies with a full stomach, the stomach contents difficult passes in the lower esophageal sphincter (LES);
- eat small portions.
also recommend exercise and other lifestyle changes as needed:
- avoid wearing tight clothing or belts that are too tight hugs the waist - they put pressure on the stomach and can cause heartburn;
- to lose weight, if overweight patient.Obesity increases the pressure in the stomach.This pressure can push the stomach contents into the esophagus.In some cases, GERD symptoms disappear after a person loses 5-7 kg of excess weight;
- sleep with a raised to more than 15 cm head.When the head is in bed is higher than the stomach, it helps to prevent the return of digested food from the backup into the esophagus.Use the wedge-shaped pillow under your mattress.Sleeping on extra pillows does not work well to relieve heartburn, because the patient may slip off the pillow during the night;
- if the patient smokes, you need to quit smoking.The chemicals in cigarette smoke weaken the esophagus;
- reduce stress.
If the patient still does not have full relief, we recommend you try the following medications:
- antacids - such as Maalox or Mylanta to help neutralize the acid in the stomach;
- blockers H2 - such as Pepsid AC, Tagamet and Zantac, which reduce the production of stomach acids;.
- proton pump inhibitors (PPI or PPI, proton pump inhibitors - drugs for the treatment of acid-related diseases of the gastrointestinal tract by reducing hydrochloric acid by blocking in the parietal cells of the mucous membrane of the proton pump gastric Belong to antisecretory drugs Examples of PPIs: omeprazole., esomeprazole, pantoprazole, lansoprazole, rabeprazole, Dekslansoprazol, tenatoprazole.
The chemical structure of all proton pump inhibitors are derivatives of benzimidazole and have a common molecular core. differ PPIs only chemical radicals that give them individual properties on the duration of the latent period, the duration of drug action., etc.) - like Prilosec OTC, which can almost completely stop the production of stomach acid.
patient should consult a doctor and get emergency medical help if:
- patient bloody or coffee-colored vomiting;
- patient black (like tar) or maroon stools;
- the patient has a feeling of burning and compression, crushing or pressure in the chest.Sometimes people who think they have heartburn, actually - a heart attack;
- heartburn occurs frequently in a patient or goes away within a few weeks;
- the patient loses weight;
- the patient has difficulty with swallowing (chuvstvstvo that food is stuck in the esophagus);
- the patient has a cough or shortness of breath that does not go;
- symptoms worsen with the adoption of antacids or H2 blockers;
- the patient thinks that one of his medications may be causing heartburn.You can not change or stop taking medication on your own, without consulting a doctor.
If the patient's symptoms after home care have changed and its general condition did not improve, your doctor may prescribe medications to reduce acid.Any sign of bleeding will require additional testing and treatment.