GERD and heartburn: causes and treatment in Tashkent

Other names: Рефлюксная болезнь, изжога, заброс кислоты, рефлюкс-эзофагит

Gastroesophageal reflux disease is a condition in which stomach contents regularly back up into the esophagus. The esophageal mucosa is not adapted to acid, which is why heartburn, sour belching and chest pain occur. GERD is extremely common and is often perceived as a harmless inconvenience that can be “cured with baking soda.” Meanwhile, prolonged acid discharge can lead to changes in the esophageal mucosa - Barrett's esophagus, which is considered a precancerous condition. Therefore, heartburn more than twice a week is not a reason for soda, but for a visit to the doctor.

🧾 МКБ-10: K21 🏥 Where it is treated: 8 Heartburn 2+ times a week - see a doctorThe headboard is 15 cm higherSoda makes it worse

👨‍⚕️ Which doctor

Gastroenterologist

🔬 Diagnostics

FGDS, if necessary pH-metry

💊 Treatment

Lifestyle, PPI, less often surgery

📈 Prognosis

Well controlled

⚠️ At risk

Obesity, late dinner, hiatal hernia

⏱ When to see a doctor

Planned; if you have difficulty swallowing - urgently

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Затруднение глотания или ощущение застревания пищи
Боль при глотании
Похудение без причины
Рвота с кровью, чёрный стул, анемия
Изжога, впервые появившаяся после 50 лет
Ночной кашель и приступы удушья, не объяснимые болезнями лёгких

Manifestations, including unexpected ones

Heartburn - a burning sensation behind the sternum, aggravated by lying down and bending over.
Sour or bitter belching, sensation of a lump in the throat
Chest pain that can be mistaken for heart pain
Extraesophageal manifestations: chronic cough, hoarseness in the morning, frequent pharyngitis and laryngitis
Destruction of tooth enamel, bad breath
Nocturnal attacks of suffocation and exacerbation of bronchial asthma

Боль за грудиной всегда требует сначала исключить сердечную причину. Если ЭКГ и обследование сердца нормальны, а боль связана с едой и положением тела — вероятна ГЭРБ.

Why does it occur

Weakness of the lower esophageal sphincter, the “valve” between the esophagus and stomach
Hiatal hernia
Excess weight and increased abdominal pressure
Pregnancy
Late and heavy dinners, habit of lying down after eating
Smoking, alcohol, coffee, chocolate, mint, fatty and spicy foods
Some drugs: calcium channel blockers, nitrates, theophylline

What to do first

Поднять изголовье кровати на 15–20 см — подкладывать бруски под ножки, а не дополнительные подушки: подушки сгибают тело и усиливают рефлюкс.
Не есть за 3 часа до сна и не ложиться сразу после еды.
Снизить вес при избыточной массе — одна of самых действенных мер.
Есть чаще и меньшими порциями.
Отказаться от курения, ограничить алкоголь и кофе.
Не носить тугие ремни и утягивающую одежду.
Спать на левом боку — при этом положении рефлюкс возникает реже.

Baking soda gives instant relief, but then causes an “acid rebound” - acid production increases, and heartburn returns stronger. It should not be used as a remedy for heartburn.

Treatment and examination

Proton pump inhibitors are the basis of treatment, taken 30–60 minutes before breakfast, for a course of 4–8 weeks or longer as prescribed
Antacids and alginates - to quickly relieve an episode
Gastroscopy - for alarming signs, long-term course, age over 50 years and to identify esophagitis and Barrett's esophagus
Daily pH impedance measurement - in case of unclear diagnosis and ineffective therapy
Surgical treatment (fundoplication) - for hiatal hernia, ineffectiveness of drugs or unwillingness to take them for life

Barrett's esophagus

With long-term reflux, the mucous membrane of the lower part of the esophagus can be replaced by intestinal-type cells. This condition is called Barrett's esophagus; it increases the risk of esophageal adenocarcinoma and requires regular endoscopic surveillance with biopsy.

The risk is higher in men, with a long history of heartburn, obesity and smoking
The condition itself does not give any special symptoms - it is detected only during gastroscopy
Observation with a certain frequency makes it possible to detect changes at a stage when they are completely curable
When dysplasia is detected, endoscopic treatment methods are used

Frequently asked questions: GERD (gastroesophageal reflux)

Is heartburn dangerous?+

Episodic - no. But heartburn more than twice a week for months means regular damage to the esophagus and can lead to esophagitis and Barrett's esophagus, which is considered a precancerous condition.

Does baking soda help?+

It provides short-term relief, but causes an “acid rebound”: acid production increases, and heartburn returns stronger. To quickly relieve an episode, antacids or alginates are better.

How to raise the headboard correctly?+

Place blocks 15–20 cm high under the legs of the bed from the head side. Extra pillows don't help: they flex the body and increase pressure in the abdomen, worsening reflux.

Is gastroscopy necessary for heartburn?+

Not everyone. It is required for alarming signs - difficulty swallowing, weight loss, anemia, vomiting with blood, as well as for the first complaints after 50 years and a long course.

Will I have to take pills for the rest of my life?+

Not necessarily. For many, a course and lifestyle changes are enough. In severe forms, long-term therapy is required or surgery—fundoplication—is discussed.

What is Barrett's esophagus?+

Replacement of the mucous membrane of the lower part of the esophagus with intestinal-type cells due to long-term reflux. It does not produce symptoms, is detected by gastroscopy and requires regular monitoring with biopsy.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.