Handling Your Heartburn

Making simple diet and lifestyle changes can effectively— and naturally—minimize heartburn.

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It’s a safe bet that antacids have a permanent place in your medicine cabinet. That’s because more than 60 million Americans experience heartburn, also known as acid indigestion, at least once a month, and some studies suggest that 15 million Americans experience symptoms daily. While antacids and other over-the-counter medications are often the quick fix for relief of occasional symptoms, why not avoid the issue altogether? Simple diet and lifestyle changes can help you manage or avoid symptoms.

What Causes Heartburn? Heartburn is caused by acid reflux—the movement of stomach acid up into the esophagus (the tube that carries solids and liquids from the mouth into the stomach). A valve at the end of the esophagus closes when food enters the stomach. When this valve is not functioning properly, food and acid can leak back through the valve, irritating the esophageal lining and causing the symptoms of heartburn. Typical symptoms include a mild burning sensation in the chest that may move upward into the neck and throat, perhaps accompanied by a bitter, sour taste.

Heartburn is not a cause for concern when it occurs occasionally. Frequent heartburn episodes—two or more times a week—may indicate a more serious problem, such as gastroesophageal reflux disease (GERD). GERD affects about 20 percent of U.S. adults. Alicia Romano, MS, RD, LDN, CNSC, a dietitian at the Tufts Frances Stern Nutrition Center recommends anyone experiencing persistent symptoms seek medical attention. “Additional GERD symptoms, including difficulty swallowing, coughing or wheezing, and chest pain, are all signs you should seek medical attention,” she says. Untreated, GERD can damage the lining of the esophagus and increase risk for esophageal cancer.

Romano strongly advises against self-diagnosing. “Reflux symptoms can be similar to those of a heart attack,” she says. “If you feel that you are experiencing constriction or pressure, not a burning sensation, it is important to call your doctor.”

Putting Out the Fire: “Diet and lifestyle changes are often enough to minimize heartburn symptoms,” according to Romano. For basic heartburn prevention (and general gastrointestinal wellness) research supports following a high-fiber diet that is rich in vegetables, fruits, and whole grains. If you suffer from heartburn, eliminating or cutting back on common dietary triggers such as mints, spicy or greasy foods, and citrus may help (see “Potential Triggers”). Work with a Registered Dietitian or other healthcare professional to identify your personal dietary triggers and help avoid unnecessary dietary restrictions.

If you suffer from periodic heartburn, the tips in the “Take Charge!” box may be all you need to put out the fire.

TAKE CHARGE!

Try these tips to avoid (and manage) heartburn:

  • Avoid large portions and heavy meals. An over-full stomach can relax the valve of the esophagus, leading to acid reflux.
  • Slow down!  Chew your food well and avoid eating quickly. This slows the rate that food enters your stomach, preventing pressure build-up. It also helps you eat less.
  • Loosen clothing. Tight clothing and belts can compress your stomach and force acids back into the esophagus.
  • Limit well-known food triggers. Certain foods can cause symptoms by irritating the esophagus, relaxing the esophageal valve, contributing to overfullness, or increasing pressure. The specific foods vary among individuals. (See “Potential Triggers.”)
  • Stop smoking. Cigarette smoke relaxes the esophageal valve and may increase the amount of acid the stomach makes.
  • Practice stress reduction techniques. Stress may make heartburn worse.
  • Maintain good posture. Slouching puts pressure on the abdomen, which can push acid up.
  • Avoid lying down after eating. Stay upright for two to three hours after eating to allow for adequate digestion.
  • Elevate your upper body when lying down. Raising the head of your bed or propping up on pillows on the couch can help prevent acid from backing up into the esophagus.
  • Take a walk. A non-vigorous, 15-minute walk after meals may improve the movement of food from the stomach into the intestines.
  • Reduce body weight if necessary. Excess abdominal fat may place pressure on the stomach.
Potential Triggers

Limiting these foods may help minimize heartburn symptoms.

  • Spicy foods
  • Fatty/greasy foods
  • Onions and garlic
  • Citrus foods
  • Chocolate
  • Coffee
  • Tea
  • Peppermint
  • Tomato products
  • Alcohol
  • Carbonated drinks

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