Silent reflux or heartburn – detection and treatment

Heartburn or silent reflux?

About 20 % of Germans suffer from heartburn or similar symptoms of illness (e.g., acid reflux).B. Silent reflux). Stomach acid cannot be kept in the stomach and flows back into the esophagus. The technical term for these phenomena is reflux, which means reflux. Once in the sensitive esophagus, the acid can cause irritation and burns that are felt as a burning sensation.

The quality of life is considerably limited as a result. Heartburn is therefore not only a physical, but also a mental burden. But often the symptoms are misinterpreted and accordingly wrongly treated. But if not heartburn, what then?

Silent reflux

Heartburn belongs to the reflux diseases. In general, this refers only to the reflux of stomach contents into the esophagus. The reflux of stomach acid is known as heartburn and is probably one of the most common manifestations of reflux. But there are also other forms. Silent reflux works similarly, but creates a different problem.

Here, not only acid flows back, but also the pepsin-containing fluid. This is actually responsible for the decomposition of food. If pepsins get into the esophagus, they break down the mucous membrane and attack the esophagus. The body digests itself, so to speak. Not a nice idea.

Treatment options

Far too often, the symptoms are misinterpreted or simply treated incorrectly. Over time, the treatment of heartburn has become standardized. Proton pump inhibitors are used, which inhibit the formation of stomach acid. Agents in the alkaline range can also be effective, because the stomach acid is neutralized in this way. This usually helps patients with heartburn after a short time.

However, this treatment method proves to be ineffective for silent reflux. Because pepsins are enzymes and not acids. Another form of therapy must therefore be used here to treat this form of reflux. And this is much more costly than prescribing a medication.

Proton pump inhibitors are basically ineffective against silent reflux. There are also no other medications for this. The complaints can usually only be alleviated by a change in diet. A detailed consultation is an important step. For this, one should turn to a nutrition expert with medical knowledge. In the family doctor’s practice is usually no time for extensive consultation.

However, proton pump inhibitors may also prove useful in silent reflux, because pepsins also enter the esophagus with refluxing stomach acid. So lower stomach acid production can lead to lower reflux. However, this must be well timed, because inhibited acid formation can even intensify the reflux.

Silent reflux – How to recognize it?

Unlike heartburn, the symptoms of silent reflux are not entirely clear-cut. As a rule, reflux is manifested by hoarseness and sore throat, which are similar to the symptoms of a cold. Increased mucus production, frequent coughing, nausea and recurrent inflammation and infection can occur just as well. You see the problem? None of this really indicates a form of reflux disease.

Therefore, it is important to clarify these often unexplained symptoms with a doctor or specialist. A gastroenterologist would be the appropriate contact here. In order to be able to really rule out heartburn, patients are usually given a proton pump inhibitor as a test. If the complaints should not improve then, a silent reflux can be assumed.

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