Help with severe heartburn. What to do if you suffer from heartburn. Very strong burning sensation

When a person gets it after eating severe heartburn, and then also a sour belch, it’s quite difficult to endure, and it’s not necessary. How does a person feel during an attack? Severe burning in the esophagus, sometimes reaching the throat. It intensifies in a lying position, when bending the body. The situation is getting worse sour taste in the mouth, belching.

When such symptoms appear infrequently, you can help yourself by taking certain drugs while following a therapeutic diet. When severe heartburn becomes a constant companion of a person and appears immediately after eating, you should consult a gastroenterologist. Only he will be able to identify the cause of the ailment, tell you how to get rid of it at home, prescribe treatment that will help reduce the intensity of symptoms and eliminate the main provoking factor.

The mechanism of formation of the feeling of heartburn

The mechanism of severe heartburn after a heavy meal has been well studied. Between the esophagus and the stomach there is a muscular organ - the lower esophageal sphincter, which is responsible for ensuring that the contents of the stomach under internal pressure do not rise back into the esophagus, but are safely digested under the influence of hydrochloric acid.

When the lower sphincter relaxes, or works uncoordinated, it cannot then hold back the stomach juices. They, driven by internal pressure, rise upward. This is how hydrochloric acid refluxes into the esophagus. This process is accompanied by belching. The acid burns the mucous layer of the hollow organ. Inflammation forms, causing severe heartburn and a burning sensation behind the sternum. It intensifies if a person is hungry. Therefore, a therapeutic diet involves an even redistribution of food intake and forces the patient to eat often, but in small portions.

In addition to the symptoms that were listed in the introduction, a patient in this condition may complain of constant pain in the throat, a feeling of a lump in the throat, hoarseness, chronic cough. Often, severe heartburn, which bothers a person every day, causes attacks of suffocation. If stomach contents continually leak into the esophagus, this can lead to serious health problems. What to do in such a situation? It is important to learn to separate household and medical provoking factors, to understand how you can give yourself first aid during a severe attack of burning and after it at home, what means to keep on hand for this, when you need to see a doctor immediately.

Household factors provocateurs

Normally, the muscle ring located at the border of the esophagus and stomach copes with its duties perfectly: it prevents the process of stomach contents from entering the esophagus back into the esophagus. If the physiological valve does not work, sour belching appears, and then heartburn. It intensifies during hungry pauses and immediately after eating. This phenomenon can be caused by:

  • Poor nutrition, abuse of fatty, spicy foods, flour products.
  • Diets for weight loss.
  • Excessive love for coffee and black tea.
  • Frequent overeating.
  • Absorbing food too quickly, eating on the go, eating dry.
  • From excess weight.
  • Chronic constipation.
  • Sedentary lifestyle.
  • Constant stress.
  • Wearing tight clothing for a long time.
  • Long-term use of medications.

Some people experience severe heartburn after eating a specific product (white butter bread, for example, or sour fruit, dairy products, garlic). You can get rid of it by eliminating them from your diet. An unfavorable factor is the consumption of very hot food or drinks. They damage the esophageal sphincter, as a result of which its vitality decreases, a complication appears that doctors call “esophageal reflux” or “ erosive esophagitis" If this phenomenon is not treated, severe heartburn will lead to the formation of extensive inflammation of the walls of the esophagus, and then provoke the appearance of ulcers. That is why, when the first symptoms are detected, you need to take certain medications.

What can be done in such a situation?

Take a drug that will reduce the level of hydrochloric acid, or suppress the function of its production. What else needs to be done? It is important to learn to listen carefully to your body and understand the situation in which heartburn occurs. It is useful to quit drinking and smoking. If a person leads a sedentary lifestyle, it is important to carefully introduce and do certain physical exercises gradually.

It is useful to walk a lot, take a lot of walks in clean air, and be sure to follow a diet that will help prevent the appearance of belching and the symptoms of the described discomfort. This the best remedy in this case, it can help get rid of the ailment.

There is no need to go hungry and drink only water every day; hunger is another provoking factor for severe heartburn. With prolonged fasting, hydrochloric acid helps weaken the tone of the muscle sphincter. It stops working, resulting in constant heartburn. But this happens when adequate nutrition is absent for a long time (several days or a week).

Short hungry pauses can also lead to belching, pain, and heartburn, but the mechanism of its occurrence is somewhat different. The cause of its appearance is bile acids that accumulate in the gallbladder. They help break down fats and rich in proteins products. If they do not arrive (as during hunger), the release of bile still occurs; it, mixing with gastric juice, increases its concentration. That is why, when prescribing a diet for patients, doctors recommend not completely excluding protein foods from their diet. You can make any dishes from them, the main thing is not to fry the selected products.

The protective layer of the stomach walls can hardly tolerate such infusions. He reacts to them instantly, with the appearance of severe burning pain. Therefore, a therapeutic diet assumes a complete absence of hungry pauses. The patient will have to learn five meals a day. All food on his table should be served pureed and warm. When it comes to cooking food, it is better to give preference to steaming or regular boiling. Provocative foods, fatty, spicy, bitter and salty foods, as well as garlic and spices should be excluded from the diet. If you want to become more familiar with a therapeutic diet, you should take a closer look at the diet that “Table No. 1” offers. After a diet, a person feels much better and no longer suffers from belching.

Note! Eliminating everyday triggers is often enough to get rid of severe heartburn. As a rule, a therapeutic diet helps most patients get rid of existing discomfort without taking medications.

If not, then you should lose excess weight, stop overeating at night, eat dry food on the go, move more, wear loose clothes. If this does not help, you should immediately go to the doctor. Perhaps the burning sensation in the stomach and pain is caused not by hunger, not by food, not by food, but by a serious disease of the gastrointestinal tract that requires immediate treatment.

Heartburn “for medical reasons”

There are cases when sour belching and heartburn become harbingers of a serious disease of the gastrointestinal tract. Then, along with heartburn, stomach pain, nausea, and sometimes vomiting appear. Getting rid of such symptoms is possible only after treating the underlying disease. What conditions can provoke the described manifestations?

Chronic gastritis or peptic ulcer

The most common diseases, the course of which contributes to the intense production of hydrochloric acid. In this case, heartburn appears every day in the morning on an empty stomach or during hungry breaks. Excess quantity hydrochloric acid, exceeding the permissible limits, simply overflows over the upper boundaries and enters the esophagus. In order to determine whether high level hydrochloric acid is the culprit of pain, nausea, heaviness and heartburn, you need to do a simple test. At the first symptoms of a burning sensation in the abdomen and esophagus, you should drink warm milk in small sips. If it does not help get rid of discomfort, then the acid has nothing to do with it. And there is no point in taking drugs that neutralize it. You need to look for the reason elsewhere.

Vascular and heart diseases

A nitroglycerin tablet can confirm the diagnosis. If discomfort remains after taking this remedy, you should go to the clinic and make an appointment with a cardiologist.

Liver diseases

Heartburn, which bothers you every day, as well as sour belching, often occur with liver diseases. In this case, nausea occurs along with it, it torments at night, and during the day a bitterness appears in the mouth. A yellow coating on the tongue should confirm suspicions of the diagnosis. If you notice such symptoms, you should seek help from a hepatologist. Only he will help you choose the necessary medications to treat heartburn.

Pregnancy

Very often, severe burning heartburn appears in pregnant women who are pregnant. recent months pregnant women. The mechanism of its formation is extremely simple. The uterus is growing, it puts pressure on abdominal cavity and lifts the stomach. As a result, the contents of the stomach put pressure on the sphincter valve; it does not close completely, so partially digested food enters the esophagus. This is why there is a burning sensation and belching.

The cause of heartburn every day may also be late toxicosis (histosis). It provokes nausea and vomiting; hydrochloric acid, along with the vomit, enters the esophagus and throat, so the described condition becomes possible. There is no need to treat heartburn during pregnancy, and it is impossible. To relieve pain, you need to move more, walk, drink more water or better jelly, and follow a diet.

As you can see, it is possible and necessary to fight heartburn and relieve pain at home, but it is important to be able to identify provoking factors. Treatment of burning sensation has certain features. Let's talk about this in more detail.

Features of heartburn treatment

A burning sensation without pain is not a disease, but a condition that leads to a certain discomfort. Many of us fight it with folk remedies: soda, warm milk, raw carrots (whichever helps).

If the feeling of malaise comes for a short time and goes away after a certain action, you can get by with traditional methods. But if heartburn is constant and torments every day, if it is accompanied by pain, nausea, and vomiting, you should definitely consult a doctor.

By self-medicating, you can successfully relieve the described discomfort that occurs after eating, but this only aggravates the situation. Here is the most common example of solving a problem on your own. If pain occurs in the abdomen, the hand reaches for antispasmodics. They help alleviate the condition by inhibiting the function of the digestive tract. When, to get rid of heartburn, it is necessary to simulate a contraction of the sphincter that does not close. In this case, it may be better to treat discomfort after eating in favor of prokinetics that stimulate the motor-evacuative function of the gastrointestinal tract. They will help relieve discomfort. But only the doctor knows about this.

Another common mistake is to take products containing enzymes for severe heartburn. In this case, they will not help get rid of the main symptom, so they are also useless. Enzymes only help digestion, while stimulation of the motor function of the tract helps eliminate the burning sensation.

If anyone suffers from heartburn every day, but there is no pain, antacids - agents that neutralize hydrochloric acid by their action, have an enveloping, absorbent effect, and prevent flatulence - can help fight the discomfort.

Sulfate and bicarbonate alkaline mineral waters help reduce the level of hydrochloric acid after meals. Therefore, with constant severe heartburn, patients are advised to use sanitary-spa treatment.

Knowing why and how severe heartburn occurs every day, you can try to take the necessary measures that can help completely eliminate the described ailment.

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A burning sensation behind the sternum is familiar to every second resident of developed countries. Severe heartburn can disturb a person's psychological balance, especially if it is accompanied by pain in the heart or breathing problems. The reasons for this phenomenon can be harmless, such as overeating or tight clothing. Sometimes an attack is provoked by serious pathologies of the digestive system. In the latter case, burning will not be the only symptom. What to do with severe heartburn depends primarily on the cause that caused it.

Main reasons

Heartburn is a feeling of discomfort and burning behind the sternum caused by a change in the acidity of gastric juice. The PH level in the stomach differs in its different sections; at the bottom it is lower, so unpleasant sensations arise not only when the balance is disturbed, but also when the contents suddenly move upward.

The causes of severe heartburn are:

  • regular smoking;
  • systematic use of alcohol;
  • large portions of food;
  • products that change the acidity of gastric juice: citrus fruits, smoked meats, marinades and pickles;
  • carbonated and caffeinated drinks;
  • medications (aspirin, for example);
  • stress;
  • sensitive gastric mucosa;
  • lack of digestive enzymes (with pancreatitis, diabetes);
  • pregnancy;
  • lifting heavy objects;
  • taking a horizontal position after eating.

If severe heartburn begins, what needs to be done depends largely on the general condition of the person. You can use traditional methods or take a universal remedy (Rennie, Festal). These tablets normalize acidity, but you should not abuse them. If the severe burning sensation has become constant and bothers you several times a week, then you need to undergo an examination.

The simplest and most common cause of heartburn is food. Fans of spicy foods with a lot of spices, coffee and carbonated drinks often complain of this symptom immediately after eating. Such products are natural irritants for the stomach. His glands begin to produce more hydrochloric acid than may be needed to digest this volume of food. As a result, an unpleasant sensation appears in the sternum.

Severe heartburn can be caused by simple overeating. A large amount of food, even healthy food, stretches the walls of the stomach, and a feeling of heaviness arises. Hydrochloric acid and digestive enzymes are not produced enough, the mass stagnates. Over time, fermentation processes begin, accompanied by the release of gas and acid.

If an attack of heartburn is associated with poor nutrition, it can be prevented in several ways:

  • eat foods that have a neutral effect on acidity levels;
  • try to reduce portions;
  • put drugs with synthetic enzymes (Mezim, Pancreatin) in the first aid kit to take them in case of overeating or after a feast.

Bad habits and heartburn

Drinks containing alcohol and cigarettes negatively affect the functioning of the stomach. Tobacco smoke irritates the mucous membrane; with systematic smoking, it becomes inflamed, and heartburn begins.

Alcohol has a stronger effect. It contains toxins that poison all organs digestive system and disrupt their work.

The consequences of systematic drinking are as follows:

  • the functioning of cells that produce mucus to protect the stomach slows down;
  • the production of hydrochloric acid is activated, as a result, erosive foci appear on the mucous membrane;
  • Ulcers form on the mucous membrane.

If it is impossible to completely give up alcohol, you should drink small amounts of strong drinks after meals.

Pregnancy and heartburn

One of the reasons that causes very severe heartburn is pregnancy, especially the last trimester. A burning sensation behind the sternum is caused by several factors:


A gynecologist will tell you how to get rid of severe heartburn for pregnant women. In this case, even ordinary medications can be harmful, so they must be taken very carefully.

Heartburn as a symptom of the disease

A high-intensity burning sensation behind the sternum may be a sign of pathology of the digestive system:

  • gastritis;
  • peptic ulcer;
  • reflux esophagitis (weakness of the gastric sphincter, causing the reflux of hydrochloric acid into the esophagus);
  • malignant tumors in the stomach;
  • Barrett's disease (a precancerous condition of the esophagus);
  • liver diseases;
  • pathologies of the pancreas and gallbladder.

In this case, there are other symptoms:

  • belching is a sign of abnormalities in the functioning of the stomach;
  • nausea may indicate intoxication with food breakdown products or consumption of stale foods.
  • vomiting with heartburn warning sign. She testifies major changes in the stomach.

If a person has a disease, heartburn attacks will be systematic. They can be eliminated with special medications prescribed by your doctor and changes in diet.

First aid for heartburn

If the attack began suddenly, you can try to alleviate the situation without medications and other means:

  • refrain from any food, drink only warm, clean water;
  • avoid sudden movements and horizontal position;
  • if you feel unwell, you can place a pillow under your back so that your head is higher than your body;
  • remove tight clothing that is squeezing your chest.

If after this the burning sensation in the sternum remains, you can take medicine or try a folk remedy.

The most effective and easiest way to combat heartburn is to take medicine. There are a lot of remedies to help get rid of discomfort. Only a doctor can tell you what to drink in a particular case.

The following drugs are most often prescribed:

  • Rennie. It helps with heartburn within a quarter of an hour.
  • Gastal. Eliminates burning sensation and stimulates digestion.
  • Almagel. The solution covers the stomach with a film, and the discomfort disappears.
  • Gaviscon is one of the safest products. Effective even for painful heartburn.

Important! These drugs have the ability to weaken the effect of other medications.

During pregnancy, drug treatment will be ineffective, since the cause is anatomical changes. Women often complain to the gynecologist: “I have very bad heartburn.” The doctor may recommend drugs that are not absorbed into the blood.

It is much more effective during pregnancy to eat some nuts, drink warm water and take a half-sitting position.

Help in the fight against heartburn can also be provided by: folk remedies. They can be used if an attack of heartburn occurs immediately after eating or when changing body position.

Unconventional methods:

  1. Baking soda. Dissolve a third of a teaspoon in warm water and drink slowly. You can take this solution no more than once a day, otherwise you can harm your health.
  2. Infusion of medicinal chamomile. A tablespoon of dry plant is crushed and poured with a glass of boiling water. The infusion can be drunk like tea throughout the day.
  3. Almonds or other nuts. A handful of kernels must be chewed thoroughly, the pulp envelops the mucous membrane, and the burning gradually goes away.
  4. Potato juice, drunk on an empty stomach, is very effective in combating burning.
  5. Mint candies. The sucking of lollipops activates the production of saliva, which minimizes the activity of gastric juice.

If severe heartburn occurs more than twice a week, medications have a short effect, or nothing helps, you should consult a doctor. Ultrasound and gastroscopic examination will identify the cause and prescribe treatment.

If a person suffers from severe heartburn for a long time, it is necessary to pay special attention to this, since the constant picture of such an ailment indicates malfunctions and hidden pathologies in the functioning of the digestive system. What to do in this case and how to overcome an attack of heartburn?

Untimely treatment will only aggravate even the slightest manifestations of burning in the gastrointestinal tract.

Causes

Never underestimate the frequent pain and discomfort that severe heartburn causes. Naturally, a person can suffer from illness due to the fact that he eats poor quality food.

However, the reasons may not only be due to nutrition. If you are overweight, this disease can constantly make itself felt. Excess fat around the waist puts additional pressure on the stomach and esophagus, which causes food to return through the sphincter along with acid.

Smoking and alcohol provoke education aggressive environment in the stomach. The same applies to sweet and carbonated drinks, strong tea and coffee. Pregnant women also suffer from severe heartburn, as this is facilitated by significant changes in the body expectant mother.

Very severe heartburn can also cause cancer. In addition to burning, the patient experiences a painful sensation, heaviness, and bloating.

There are many reasons why this disease occurs, and they are not always as harmless as they seem at first glance. You should not delay visiting a doctor in order to detect and treat the disease in time.

Very strong burning sensation

It is worth paying attention to the fact that if a person experiences a strong burning sensation infrequently, then in principle there is nothing serious about it. However, constant terrible pain and heartburn indicate a disease that occurs in the body and which needs to be identified.

First of all, you need to reconsider your diet, what dishes it consists of. If the patient has constant terrible pain and heartburn, you need to avoid foods that provoke the formation of additional acid in the stomach. If the reason is the quality of nutrition, then by correcting it, you can get rid of the burning sensation. However, even after all food irritants have been excluded and heartburn still persists, this is a reason to immediately consult a doctor.

Severe burning after eating

Unpleasant acute symptom Happens constantly about half an hour after eating. This is explained by the fact that the stomach, having received a signal that food has entered it, begins to secrete gastric juice. However, in a healthy person this does not cause pain, but if there are pathologies, then severe heartburn will definitely make itself felt. The situation can worsen when the patient abuses prohibited products.

It is noteworthy that in case of serious digestive diseases, heartburn can last more than a day, causing a person’s general health to deteriorate, he becomes weak and irritable.

The pharmacy provides a wide selection of drugs, after taking which the condition will stabilize, but it is worth remembering that no matter how good the medicine is, it also has contraindications and without prior examination you should resort to it yourself drug treatment Not recommended.

Severe burning and belching

Severe heartburn and belching are the causes of pathological processes occurring in the gastrointestinal tract. These signs may indicate a digestive disease such as dyspepsia. This disease combines common symptoms of a gastrointestinal disorder when the body secretes insufficient amounts of the necessary enzymes. The doctor may recommend taking a special drug that helps the body function properly. Common drugs in this group are Gaviscon and Gastal. If the patient follows a strict diet, monitors his health, but the disease still bothers him, do not let it happen.

Burning sensation, nausea, vomiting

These symptoms may indicate stomach diseases such as gastritis, ulcers, and cancer. Severe heartburn, nausea and vomiting are a sign of inflammatory processes in the mucous membrane and such a common occurrence requires immediate consultation with a doctor.

If the cause of such problems is low-quality dishes, you should abandon them. Observe your condition. If it does not improve within a week or two, you should not delay visiting the doctor, because such symptoms may also indicate cancer.

Burning at night

The burning sensation can cause discomfort at night if a person likes to eat heavily before bed. At night, the body cannot fully digest a heavy dinner and because of this, heartburn occurs. It is better to have dinner 3-4 hours before bed with a light meal. The heartburn should go away.

If the burning sensation often bothers you late at night, you can try drinking a heartburn remedy, such as Rennie or Gaviscon.

Don't underestimate the situation if things don't improve. Urgently consult a doctor who will help you choose the right treatment tactics and select the necessary medications.

Burning and pain

Severe heartburn and sharp pain constantly indicate serious diseases of the gastrointestinal tract. This could be gastritis, doudenitis, cholecystitis, ulcer, hiatal hernia, GERD, indigestion, cancer. As you can see, the list of causes of pain and heartburn is very long. The therapeutic diet and medications prescribed by your doctor should cope with the problem. If the problems are serious and nothing helps, surgery may be necessary.

Heartburn during pregnancy

The causes of severe heartburn during pregnancy lie in the colossal restructuring of the pregnant woman’s body. In the first trimester, in order to prevent miscarriage, the hormone progesterone is released into the body in large quantities, which relaxes the internal organs, which means that the sphincter is also relaxed, hence heartburn.

For more later the unborn child puts pressure on internal organs, including the stomach, which causes terrible heartburn. However, these phenomena are temporary. If a pregnant woman is suffering greatly, you need to consult a doctor who will select treatment according to the situation of the expectant mother.

Diagnosis of severe heartburn

In case of severe heartburn and accompanying symptoms, you should immediately consult a doctor who will advise you to undergo a comprehensive examination. This includes ultrasound diagnostics and the necessary tests, including a complete blood test.

Based on the results, the doctor will prescribe appropriate treatment, procedures and medications.

The severity of a digestive system disease can be determined at home. To do this, you need to switch to exclusively dietary gentle nutrition. And if the case is not dangerous and not advanced, then it will be possible to get rid of severe heartburn without resorting to drug intervention. If after such measures the situation does not improve, seek advice from a specialist.

What to do?

If heartburn attacks occur quite often, you should always have medications with you that can block the pain in a matter of minutes. These could be “Rennie” heartburn tablets, the effect of which develops within 15 minutes after administration. If Rennie does not cope, you can try using a more serious drug, for example Gaviscon.

Heartburn sufferers often drink soda. However, this is not very effective method, since after drinking soda, carbon dioxide is released in the stomach, which causes additional irritation to the mucous membrane, as a result of which the acid will begin to be released with a vengeance and the patient will only get worse.

Pay attention to your diet, eliminate harmful foods. Often it is poor quality food that causes severe burning.

When you don’t want to go to the hospital, you can start treatment yourself by eliminating fatty and fried foods, strong tea and coffee, sweets, carbonated drinks, cigarettes, and alcohol from your diet. At first, you may experience discomfort when giving up your usual food. However, it is worth it to be healthy and to prevent heartburn from appearing again.

If this does not bring the desired effect, then you need to urgently contact a doctor who will refer you for tests and an ultrasound. Often the ultrasound procedure cannot fully show the full picture of the disease, then a probe will have to be inserted into the stomach, which will help to understand in more detail why this situation is happening.

After conducting the necessary research, the doctor will prescribe treatment appropriate to the situation, which will consist of taking medications, following a diet and eating regimen.

In this article we will consider in detail the main causes of severe heartburn, which causes this unpleasant sensation in the chest and throat, as well as the main traditional methods getting rid of this disease.

Folk remedies

  1. Camomile tea. Pour 2-3 tablespoons of chamomile tea into a glass of boiling water, let it brew (10-15 minutes). Strain and drink in small sips.
  2. Infusion of angelica roots and seeds. The recommended proportion is 1 pinch per 1 glass of boiling water. Dilute and let sit for 20 minutes. Take three times a day.
  3. Infusion of dill, anise and fennel. Mix 1 teaspoon of seeds, dilute with a glass of boiling water. Drink one sip at a time until the attack stops.
  4. Oatmeal. Wash and dry the oats, chop. Pour 1 tablespoon of oatmeal powder into 1.5 cups of boiling water, leave in a thermos (4-5 hours). Strain the drink, take ¼ glass 20 minutes before meals.
  5. Almond. Quite an effective remedy against high levels of acidity. Peel 1-2 almond kernels, pour boiling water over them and chew for 5-10 minutes until the feeling of discomfort in the epigastric region completely disappears.

Medications

If it is impossible to determine the causes of the illness on your own, and there is not enough time to prepare decoctions and mixtures, you can try to relieve the pain differently, with the help of medications.

The following drugs quickly and effectively suppress the burning sensation:

After the initial examination, he will give you a referral to a gastroenterologist, who will perform an ultrasound, assess the general condition of your body and the efficiency of the gastrointestinal tract, make a diagnosis and prescribe treatment.

Remember that heartburn can be a sign of the development of a serious chronic disease. Don't put off visiting your doctor until the last minute. The sooner this or that pathology is identified, the sooner you will be able to get rid of it.

Prevention methods

The main method of prevention is healthy eating and an active lifestyle. Try to exclude from your diet foods that, according to your personal observations or doctor's observations, cause you indigestion.

Do not get carried away with fatty, spicy or salty food, change your diet too often, abuse carbonated drinks, etc.

To prevent stomach acid from entering the esophagus while resting, purchase a bed with a high headboard.

The minimum lifting height is 15 cm. Try to have dinner 2–3 hours before bedtime, never go to bed immediately after a heavy meal.

  • Don't overeat. Eat often, but in small portions, so that the food has time to be absorbed.
  • Drink more fluids. Well suited for stabilizing the functioning of the gastrointestinal tract, medicinal mineral water(without gas).
  • Follow the order of taking medications if you are undergoing drug therapy.
  • Limit the amount of alcoholic beverages you drink.
  • It is also recommended to completely stop smoking.

If, for one reason or another, this is too difficult for you to do, try to at least reduce the number of smoking breaks by 2-3 times.