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Waterbrashes, Heartburns and Stomach Ulcers

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Waterbrashes and heartburns are very common. Ulcers, backflow of stomach acid into the oesophagus and an irritated stomach cause heartburns and waterbrashes. Only an endoscopy can determine precisely what the cause is. You must call the doctor immediately if you have strong stomach pains, if you experience vomiting that resembles coffee grounds or if your stool becomes black and shiny.

Stomach acid that is produced in the stomach is necessary for us to digest the food we eat. However, at the same time it is the stomach acid that can cause heartburns and waterbrashes.

There are 3 possible causes for heartburns and waterbrashes.

Backflow of stomach acid into the oesophagus Stomach ulcersIrritated stomach

The far most common cause is an irritated stomach, which is seen with 2/3 of all suffering from waterbrashes and heartburns. Only 1/3 suffers from backflow or stomach acid into the oesophagus.

1. Backflow of stomach acid:

Normally, stomach acid is located in your stomach. A closing mechanism prevents the stomach acid from moving up into your oesophagus. With some people, the closing mechanism does not function properly and the stomach acid can therefore enter the oesophagus. You are especially bothered by it right after a meal when you bend over or lie down in bed to sleep. Coffee, alcohol and large or fatty meals worsen heartburn and waterbrashes.

In rare cases, the stomach acid can corrode the oesophagus. If this happens, you have a lot of pain in the upper part of the stomach or the chest and vomit red blood.

2. Ulcers:

Ulcers are caused either by inflammation with a certain bacteria or the use of medication (aspirin and arthritis medicine). The combination of the bacteria and the stomach acid leads to ulcers, like lengthy use of arthritis medicine or aspirin can cause ulcers.

If you have ulcers, you will be bothered by pains in the upper part of the stomach, aside from the heartburn and waterbrashes. Typically, the pains are described as hunger pain and they diminish if you eat some food. In some cases, the pains are so strong that you just lie still in bed.

In rare cases, the ulcer may bleed. When that happens, the blood is transformed into something similar to coffee grounds that you vomit. Meanwhile, the pains in the stomach become very strong.

If you bleed a lot from the ulcer, the blood will also appear in your stool that becomes complete black and shiny.

If you take medication on a regularly basis that cause ulcers, the treatment is of course to cease taking the medication.

3. Irritated stomach:

Far most people with waterbrashes and heartburn have neither ulcers or backflow of stomach acid into the oesophagus – in return they have an irritated stomach.

The nuisances in the case of an irritated stomach are not that different than those which occur in the case of ulcers and backflow of stomach acid. Exactly what causes the nuisances can only be determined by performing and endoscopy. If the endoscopy does not show sign of ulcers or backflow of stomach acid to the oesophagus it is assumed that you have an irritated stomach.

It is difficult to treat an irritated stomach. With about ¼, the nuisances disappear by themselves without treatment. Common advice on cease smoking tobacco and drinking alcohol while avoiding large and fatty meals are most effective.


Backflow of stomach acid:
Antacid medication helps briefly but medication that stops the production of stomach acid is more effective.

Antacid medication can briefly soothe the nuisances. However, medication that stops the production of stomach acid is much more effective. If your ulcers are caused by an inflammation, it should be treated with antibiotics.

Irritated stomach:
Antacid medication and medication that stops the production of the stomach acid has no or only modest effect.

What can you do?

Avoid alcohol, coffee, large and fatty meals and tobacco. Cease taking arthritis medicine and aspirin. Take antacid medication for a shorter period. Lie with your head high in the night and be careful when you bend over.

Contact the doctor tomorrow

If the heartburn and the waterbrashes do not disappear during a couple of days treatment. If you have heartburns and waterbrashes repeatedly. If your stomach hurts.

Contact the doctor immediately

If you have strong stomach pains. If you stool becomes completely black and shiny. If you experience vomiting with contents similar to coffee grounds.