Soreness, bloating and swelling of the stomach mirror our daily lives accurately. This is especially true during the pre-Christmas season when parties put an extra strain on our digestive system for a few weeks.

Heartburn “Heartburn typically feels like a burning and cramp-like sensation behind or above the breastbone. There may also be a bitter taste in the mouth. The burning sensation is caused by regurgitation of gastric acid. The stomach can handle the acid, but the esophagus cannot,” gastroenterologist Petri Pesonen explains.

Over 10 per cent of us feel heartburn weekly. Nearly everyone gets heartburn at least once in their life.

Heartburn is a symptom, not a disease. It usually passes quickly, but in some cases heartburn may be an indication of an underlying condition that needs to be examined and treated. Most typically, heartburn is a symptom of GERD. It is caused by repeated reflux of stomach acid to the esophagus. As a result, the esophagus usually gets inflamed.

Closely linked to
lifestyle choices

Heartburn is mostly caused by poor lifestyle choices. Overindulging and consuming food and drink that irritate the stomach are typical causes. Coffee and alcohol only make heartburn worse. Heartburn often strikes when lying down, and thus occurs mostly at night time.

The pre-Christmas party season is only one of the many factors that increase the risk of heartburn. Other factors include uncomfortable working positions, crouching and bending over as well as stress.

Recycling last years’ festive attire may be a mistake if you have gained weight, because tight clothes may also increase the risk of heartburn.

Home remedies

Heartburn can be a nuisance, but it is relatively easy to get rid of. It is important to avoid foods that irritate the stomach. It is also best to avoid heavy meals two to three hours before bedtime. Consider this a good reason to remain at the party after finishing your meal!

This tip should work, as long as you also remember to steer clear of spirits, coffee, citrus fruit, fatty foods, chocolate and especially cigarettes. All of these may interfere with the function of lower esophageal sphincter (LES), which is the muscle between the esophagus and stomach, allowing regurgitation of stomach contents to esophagus.

When should one
see a doctor?

If heartburn persists and the over-the-counter products available at pharmacies only provide temporary relief, it is time to see a doctor. Further examinations are required if a patient has prolonged bouts of heartburn several times a week, or if the patient experiences abdominal and chest pains in addition to heartburn. Vomiting, swallowing difficulties and weight loss also call for further examinations.

If stomach contents are repeatedly leaking back to the esophagus and cause heartburn, the underlying cause may be GERD. When mild, the condition is not considered a disease. GERD is diagnosed when the condition compromises the patient’s quality of life and causes other diseases. It is most often caused by inadequate LES function.

In combination with different upper abdomen symptoms, heartburn also indicates gastritis and peptic ulcer disease, says doctor Petri Pesonen.

“GER is a chronic, long-term disease. Controlled lifestyle choices and medicine are the main pillars of treatment. Medicine helps reduce the acidity of gastric juice, but does not stop regurgitation. If medication does not help in the long run, surgery helps most patients,” says doctor Pesonen.

Risk of infection

Prolonged regurgitation of stomach contents often leads to esophagus infection. Infections are treated by lifestyle changes and medication. Esophagus infection is diagnosed by means of esophagoscopy. Mild or average infections are treated by a one-month prescription, but more severe cases require a two- or three-month prescription of medicine. In many patients, the symptoms return in about a year after their first prescription.

In combination with different upper abdomen symptoms, heartburn also indicates gastritis and peptic ulcer disease (PUD). These diseases often manifest themselves with pain when stomach is empty, especially during night time. Eating usually abates the pain caused by gastritis or PUD.

Helicobacter and NSAIDs
increase the risk

An infection caused by helicobacter is the most common cause for gastritis and peptic ulcer disease. Use of non-steroidal anti-inflammatory drugs (NSAIDs) comes second. Prolonged use in particular can irritate the stomach. According to Pesonen, gastrodunenal ulcer is typically caused by use of NSAIDs.

“If both helicobacter and NSAIDs are present, risk of gastritis and peptic ulcer disease increase significantly,” he says.

Gastritis and PUD are diagnosed by means of gastroscopy. The doctor starts the treatment.

Cause is not
always found

About half of the patients examined by a doctor get a clear explanation for their stomach problems. Most common causes include heartburn, GERD, gastritis and peptic ulcer disease. Stomach problems are examined by means of laboratory analyses, ultrasound and gastroscopy.

“Due to technological advances, gastroscopy does not cause great discomfort, and is nothing to be afraid of,” Pesonen says.

In some cases, there is no explanation for the stomach problems, even after further examinations. In this case, the condition is dubbed functional stomach disorder. The symptoms are caused by disruptions in the function of the stomach and intestine. Preparations that lower the secretion of gastric juice that are available from pharmacies without prescription may help.

Delayed gastric emptying is typical among patients who suffer from bloating in the upper abdomen. Pain in upper abdomen may be caused by a sensitivity to the stretching of the stomach and intestine. Mental reasons, hectic lifestyle and stress may also cause the stomach problems.

Text Juha-Pekka Honkanen | Photos iStockphoto ja Kari Hautala