250,000 Dutch people take pills for heartburn unnecessarily.
Belching, an indeterminate pressure in the stomach: these are annoying complaints, but you don’t go to the doctor with them. Very often that is not necessary. Sometimes though.
Marten Otten, gastrointestinal and liver doctor at the Meander Medical Center in Amersfoort, sees this in his practice: “People continue to walk around with complaints for a long time. On average, they wait two years before going to the doctor, even though it does affect their daily lives. I even regularly see people who have had complaints for years and who have now adapted their lifestyle, but have not been to the doctor. Like, for example, the man who came for an examination of the stomach. He was also found to have a severely damaged esophagus. When asked, it turned out that he had suffered from heartburn for twenty years. Once he got pills for it, he was amazed that he could feel so good.”
Reliable diagnosis
About 1.5 million Dutch people suffer from heartburn (also called heartburn) every day. It occurs in men and women of all ages, more often in people who are overweight. The symptoms are caused by the contents of the stomach flowing back into the esophagus. This backflow is called ‘reflux’ and is because the passage from esophagus to stomach does not close sufficiently. You can taste that acid, but you can also experience less obvious complaints, such as a tight or burning feeling behind the sternum. After many years, complications such as a hoarse voice and coughing can develop.
One problem is that there is no objective test to determine whether it is reflux symptoms. Based on the patient’s story, the doctor makes a diagnosis. However, a new tool has recently been introduced: a simple questionnaire with which you can determine for yourself whether or not your complaints are caused by heartburn (see the next page). Otten: “With this test, patients can express their complaints in size and number. The test result is just as reliable as the diagnosis of a general practitioner or a gastroenterologist and liver specialist.”
Adjust lifestyle
You can initially do something about heartburn yourself, mainly by pressing the food and watch your diet. Avoid foods that make the symptoms worse. What food that is, differs from person to person.
Coffee, tea, fatty foods and alcohol are common culprits. Chewing well, eating slowly and not eating or drinking anything in the three hours before you go to sleep can help. It is better to eat several small meals than a few large ones. Do not exercise or lie down after eating, as this may cause stomach contents to flow back. In bed, make sure your head is higher than your stomach. And another tip: don’t constrict the belly with tight clothing. Also by stopping smoking, relaxing more and losing weight if you are overweight, the complaints can be reduced.
But even if you do all this, the complaints can still remain. In that case, over-the-counter (non-prescription) medicines can be a solution: antacids (algeldraat, Rennie) or antacids (ranitidine or cimetidine). Only use ranitidine and cimetidine for a few weeks; if they still don’t help, go to your doctor.
To the doctor
If the reflux symptoms become too bothersome, a visit to the doctor is necessary – also because the rising stomach acid can eventually damage the esophagus. The doctor can rule out whether it might be something else, such as a stomach ulcer, or prescribe more powerful medicines for heartburn, such as omeprazole and lansoprazole.
Although antacids are safe in the short term, you should only take them for a long time if you really need to. Because there are risks involved.
The gastric acid inhibitor, for example, makes it harder for the body to absorb calcium, which can decalcify bone. The risk of a bone fracture, for example of a hip, is therefore slightly greater. In addition, the risk of pneumonia increases. Normally, stomach acid kills off harmful bacteria in the stomach. If the acid production is inhibited, more bacteria survive in the stomach and can reach the lungs with the backflowing stomach contents through the esophagus.
Also, antacids can affect the effect of other medicines. It is therefore important not to continue taking antacids for too long. There are about 500,000 Dutch people who take gastric acid inhibitors daily for more than a year for minor complaints. In half of the cases this is justified because the complaints do not stop.
The other half take gastric acid inhibitors when it is actually no longer necessary, Alike van der Velden discovered during her PhD research at Utrecht University. 20 percent of the people who take a pill every day for minor complaints (100,000 people), can stop anyway because they would be symptom-free without the pills. And 30 percent (150,000) can manage with fewer pills.
drug addiction
The fact that so many people take antacids while they can also do without is partly because stopping antacids is not easy. The insidious thing is that with radical withdrawal withdrawal symptoms can occur that exactly resemble the original complaints. And then the stopper is inclined to start taking the antacid again.
So just stopping is not a good idea. Slowly stop. By gradually taking fewer and fewer pills, you avoid the withdrawal symptoms and you can still find out whether you still suffer from heartburn. A good way is to first halve the amount per day, then skip a day and in the meantime – if heartburn occurs – use another type of agent, namely an acid binder (such as a Rennie).
Do consult your doctor before stopping in this way, because some people take antacids because of other problems and are not allowed to reduce. For example, in the case of an inflammation of the esophagus or when antacids have to suppress the side effects of other medicines, such as ibuprofen.
Sources):
- Plus Magazine
