Relief from Holiday Heartburn

Monday, December 26, 2016

Cookies and lattes and dips oh my….my upset tummy that is.  This time of year brings on bouts of heartburn and acid indigestion.  But it is hard to say no when Grandma’s famous lasagna or Aunt Susie’s triple chocolate peppermint cake is staring you down from the buffet table.   The uncomfortable truth, however, is that fatty roasts, casseroles, gravies, spicy dips, and sugar-laden desserts, can cause our systems to revolt and say, “Too much!” And to top it off, anxiety and stress can worsen heartburn symptoms.  If this happens to you, you are not alone.  According to the American College of Gastroenterology, more than 60 million American experience heartburn at least once a month.   Heartburn is mild to severe pain in the chest that brings on a burning or tightening sensation.   It usually occurs after eating a meal and can be worse when you bend over or lie down.  

Heartburn can often be treated with medications like antacids but you can take charge of your health and possibly ward off heartburn all together.  As you go through this holiday season and the New Year, there are a number of things you can do to alleviate your symptoms and perhaps prevent bigger problems in the future.  Harvard Medical Publications and the Mayo Clinic offer the following advice:

Eat smaller meals, but more often. A full stomach puts pressure on the lower esophageal sphincter (LES), a valve-like muscle that keeps stomach acid from backing up into the esophagus.

Eat in a slow, relaxed manner. Wolfing down your food fills your stomach faster, putting more pressure on the LES.

Remain upright after meals. Lying down increases pressure on the LES, which makes acid reflux more likely.

Avoid late-night eating. Eating a meal or snack within three hours of lying down to sleep can worsen reflux and heartburn symptoms. Leave enough time for the stomach to clear out.

Don't exercise immediately after meals. Give your stomach time to empty; wait a couple of hours after eating before exercising.

Tilt your torso with a bed wedge. Raising your torso up a bit with a wedge-shaped cushion reduces the pressure on the LES and may ease nighttime heartburn. Wedges are available from medical supply companies. Don't just prop your head and shoulders up with pillows, which can actually worsen reflux.

Stay away from carbonated beverages. They cause belching, which promotes reflux of stomach acid.

Find the foods that trigger your symptoms and avoid them. Some foods and drinks increase acid secretion, delay stomach emptying, or loosen the LES — conditions that set the stage for heartburn. Common offenders include fatty or fried foods, spicy foods, citrus, tomatoes, garlic, milk, coffee, tea, cola, peppermint, chocolate and alcohol.

Chew sugarless gum after a meal. Chewing gum promotes salivation, which neutralizes acid, soothes the esophagus, and washes acid back down to the stomach. Avoid peppermint flavors, which may trigger heartburn.

Check your medications. Ask your doctor or pharmacist if any of the medications you take could worsen acid reflux or inflame the esophagus. For example, tricyclic antidepressants such as amitriptyline loosen the LES and tetracyclines such as doxycycline can cause esophageal inflammation.

Lose weight if you need to.  Excess pounds put pressure on your abdomen, pushing your stomach, and causing acid to back up into your esophagus.

Avoid tightfitting clothing. Tight clothes put pressure on your abdomen and the LES.

Avoid smoking.  Smoking decreases the lower esophageal sphincter’s ability to function properly.

Heartburn is a common digestive condition, however, if you have symptoms twice a week or more, it may be gastroesophagel reflux disease (GERD).  Acid reflux occurs when the muscle in charge of closing your esophagus after food passes to the stomach becomes weak or does not close properly.  As a result, stomach acid can move backward into you esophagus.  GERD is chronic form of acid reflux, meaning it occurs more than twice a week and causes swelling in the esophagus.  Symptoms of GERD include:  heartburn, sour or bitter taste in the mouth, feeling like the contents of the stomach have come back up the throat or mouth, chest pain, dry cough, asthma, trouble swallowing, hoarseness or laryngitis, especially in the morning, sore throat or the need to clear the throat, dental erosions, and feeling that there is a "lump in the throat."  If left untreated, GERD can cause:  bleeding, ulcers, and scarring.  

One final note regarding heartburn – it is often mistaken for a heart attack.  If your heartburn changes or gets worse and is accompanied by difficulty breathing or pain in your arm or jaw, call 911 immediately. These may be signs of a heart attack.

The following websites offer more information about heartburn, acid reflux, and GERD:

Mayo  Clinic - http://www.mayoclinic.org/diseases-conditions/gerd/basics/definition/con-20025201

Harvard Medical Publications - http://www.health.harvard.edu/staying-healthy/gerd-heartburn-and-more

Lorraine Wichtowski is a community health educator at Noyes Health in Dansville.  If you have questions or suggestions for future articles she can be reached at lwichtowski@noyeshealth.org or 585-335-4327.