Why do acidic drinks soothe nausea

Mucous membrane under stress

Physical applications such as alternating baths, saunas or massages can also increase well-being. Avoiding nicotine and alcohol also helps to relieve symptoms and reduce relapses.

When it comes to changing eating habits, the German Society for Digestive and Metabolic Diseases (DGVS) recommends avoiding fatty, extremely sweet and gasping foods and paying attention to a gentle, low-fiber diet. A diet rich in fiber, for example with whole grains, legumes and various seeds, is only suitable for patients with constipation.

Antacids and prokinetics

In drug therapy, one works symptom-oriented. In acute ulcer-like dyspepsia, antacids provide rapid relief. These neutralize or bind excess stomach acid. However, they do not reduce gastric acid production and are therefore particularly suitable for acute complaints.

Aluminum and magnesium salts in a mixture or as layered lattice salts, for example magaldrate or hydrotalcide, are very often used as buffer substances. Layered lattice compounds have a particularly high acid neutralization capacity as well as mucosal protective properties. Antacids start to work after a few minutes and last for about two hours.

When dispensing antacids, one should consider numerous interactions during the consultation. Complex formation with iron can easily occur, which can reduce its absorption. Bisphosphonates, thyroid hormones, gyrase inhibitors and tetracyclines can also be complexed. Increasing the pH in the stomach can change the absorption of gastric pH-controlled drugs. It is important to always point out to the patient that they should keep about one hour away from other drugs and from eating.

Proton pump inhibitors (PPIs) or H.2-Antihistamines (second choice) provide long-term relief (table). Side effects should also be considered, especially: the body can only absorb calcium and magnesium from food with difficulty if the gastric pH is high. Dietary supplementation with these ions can therefore be particularly useful for multimorbid people, osteoporosis patients or during long-term diuretic therapy.

Prokinetics for motility problems

In the majority of patients, motility problems are in the foreground. For this purpose, the doctor has previously been able to prescribe prokinetics such as metoclopramide (MCP) and domperidone (table). Both active ingredients act very quickly and block dopamine receptors, which results in increased peristalsis and an increase in tone in the stomach. The pyloric sphincter also relaxes, which facilitates the transport of the food into the intestine and prevents cramps in the stomach.

For MCP, however, the indications gastrointestinal disorders, dypepsia and gastroesophageal reflux disease (GERD) no longer existed in spring 2014. Domperidone remains as a prokinetic, but since summer 2014 it has only been used for nausea and vomiting. Domperidone acts peripherally and on the circumventricular organs, which also include the brain region responsible for "vomiting", the area postrema. At this point, the nausea is reduced by blocking dopaminergic receptors.

Medicinal plants alleviate the symptoms

Herbal medicine can be very helpful in self-medication. It can be recommended for uncomplicated complaints alone or in addition to all forms of gastric mucosal irritation. When selecting phytopharmaceuticals, the monographs of the Committee on Herbal Medicinal Products at the EMA (HMPC: Committee on Herbal Medicinal Products), the recommendations of the ESCOP (European Scientific Cooperative for Phytotherapy) and - if available - clinical studies with defined extracts should be used. In practice, the monographs of Commission E are still used.