15 Dos and Donts of Heartburn

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15 Dos and Donts of Heartburn

By Jill Weisenberger, M.S., R.D., C.D.E., Lifescript Nutrition Expert Published December 16, 2009 Just because heartburn is common doesnt mean it cant be cured. Left untreated, frequent acid reflux can develop into more serious health problems. Here are the dos and donts of taming the flame Despite humorous commercials with funny words like plop-plop and fizz-fizz, heartburn is no joke. More than 60 million Americans suffer from it at least occasionally, according to the American College of Gastroenterology. Heartburn, also known as acid indigestion, occurs when acidic stomach juices flow backward into the esophagus, irritating the esophageal lining. The resulting pain can be uncomfortable, annoying or excruciating. It can hurt as much as a heart attack, says Paige Hastings, a certified nurse practitioner at The Little Clinic in Nashville, Tennessee. But not everyone has such pain; you could also feel a bitter or acidic taste in the back of your throat or the sensation of food or liquid washing back into your mouth and down the gullet. In fact, frequent heartburn (two or more times a week) and food sticking in the throat are signs of gastroesophageal reflux disease (GERD). Untreated, these problems can lead more serious problems, including strictures (narrowing or obstruction of the esophagus), ulcers, cancer and pneumonia, explains Patricia Raymond, M.D., a gastroenterologist based in Virginia Beach. You can also become hoarse, because acid burns the vocal cords, she adds. Asthma also is a possibility, because of spasms in the bronchial tubes. Before your heartburn goes from bad to dire, learn how to treat the symptoms. Read on for important dos and donts about heartburn: The Dos 1. Understand causes of heartburn and GERD. Under normal circumstances, the valve between your esophagus and stomach the lower esophageal sphincter (LES) acts as a gate to block stomach acid from traveling back into the esophagus. With GERD, the valve relaxes too much, allowing stomach contents to flow the wrong way. If youre pregnant, elderly or have a hiatal hernia a condition in which part of the stomach is pushed through your diaphragm and into the chest youre more likely to have heartburn or GERD. 2. Eat small portions and eat them slowly. Large meals bring on large amounts of acid. Stuffing your stomach also adds abdominal pressure and increases acid reflux.

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If you typically chow down on super-sized portions, shave off at least 20%. Smaller portions help you lose weight, taming symptoms even further. If weight isnt a problem and your portions seem just right, try splitting your three meals into five or six mini-meals. Instead of eating a sandwich, fruit and salad for lunch, eat just the sandwich and salad and stash the fruit for snack later. 3. Add more fiber to your diet. The more fiber you eat, the less likely youll have GERD, says registered dietitian David Grotto, author of 101 Optimal Life Foods (Bantam, 2009). The Institute of Medicine, the health arm of the National Academy of the Sciences in Washington, D.C., tells women to consume 25 grams daily. (For men, its 38 grams.) Unfortunately, most Americans arent listening; our average intake is 15 grams a day. Here are some easy ways to boost fiber intake: Swap processed foods for whole foods. Eat the apple instead of drinking juice. Cook brown rice or barley instead of yellow rice pilaf. Eat one small serving of whole grains with each meal. Enjoy a variety of at least 1.5 cups of fruits and 2.0 cups of vegetables every day. Add chickpeas, kidney beans and other beans to soups and salads. Add dried fruit to muffin and pancake batter. Sprinkle a few nuts on salads. Mix wheat germ or ground flax seed into oatmeal.

4. Seek out a few special foods. Apples, cranberries and cardamom can help heartburn, Grotto says. The tiny red berry and sweet spice have antibacterial properties, which may lower your risk of stomach ulcers caused by the bacterium H. pylori, he explains. Apples are also high in pectin, a type of fiber, and the more fiber, the less reflux. Blackberries are another go-to food, he says, because they contain compounds that help heal the esophagus. Put carrots and kale on your list. Their beta-carotene and other nutrients can help repair aciddamaged tissue. 5. Listen to your symptoms. Studies show that acidic and spicy foods dont appear to increase gastric acid. Nonetheless, some heartburn sufferers say that spicy foods, tomato products and citrus trigger problems. If thats your case, eliminate them from your diet on a trial. Otherwise, cutting them out robs you of some essential nutrients. There needs to be a real emphasis on individualization, says Grotto, who successfully treated his own GERD several years ago. I tolerated spicy foods just fine, he says. So he increased fruits, veggies, whole grains and fiber and cut back on alcohol and coffee. I practiced what I preached and it worked, he adds. 6. Drop a few pounds. Lugging extra weight increases abdominal pressure and strains the lower esophageal sphincter. Even normal weight woman are more likely to experience GERDs pain and discomfort if they gain a

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few pounds, researchers reported in a 2006 issue of the New England Journal of Medicine. Hormones secreted by body fat may trigger some of the symptoms, the researchers speculated. 7. Act like a detective. Youre feeling the burn, but was it chocolate, coffee, mints, pizza or something else that triggered it? The foods and conditions that cause your pain probably arent the ones affecting friends and neighbors. To find out what your triggers, keep a heartburn journal, says Eileen Myers, a registered dietitian in private practice in Nashville and author of a GERD treatment program for nurse practitioners. Record symptoms, their severity and possible causes. Pinpoint what you ate or drank, how fast and the amount. Then, look for trends. A small notebook will do, but you can find a journal in the Get Heartburn Smart brochure at the National Heartburn Alliance (NHBA) Web site. 8. Find out if medication is to blame. Both prescription and over-the-counter medications can affect the LES or increase acid production, Hastings says. Drugs that treat high blood pressure, asthma, inflammation and osteoporosis frequently fan the heartburn flame, she says. If you suspect a drug is aggravating symptoms, ask your doctor for possible alternatives. But dont stop taking prescription medications without checking with a physician. The Donts 1. Dont rev up acid production. If you drink alcohol, stop, Myers says. Give up red and black pepper and coffee even decaf for a few weeks to see if that brings relief. Each can increase gastric acidity. 2. Dont smoke. As if you needed another reason to quit! According to the NHBA, smoking inhibits production of saliva, one of your bodys natural protective barriers against insults to esophageal lining. Smoking is a triple offender because it might also pump up acid production and weaken the LES. 3. Dont eat after-dinner mints. Get rid of everything thats an enemy to the LES, Myers says. Just say no to spearmint, peppermint and other foods that decrease LES function by triggering the release of hormones or affecting chemical pathways allowing the sphincter to relax and food to wash backward. Start with a trial elimination of mint, chocolate, caffeine and high-fat foods, such as baked goods, marbled meats, full-fat dairy and fast-food value meals. 4. Dont wear tight clothing. Its more than just uncomfortable: Squeezing into too-tight clothing also increases abdominal pressure, just like a large meal does. 5. Dont eat before bed. No lying down before digesting your meal. Finish eating 2-3 hours before snoozing. Its the whole gravity thing, Raymond explains. Stuff can flux back up because youre horizontal instead of vertical.

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Another bedtime trick? Use an under-mattress foam wedge to elevate the head of the bed about 6 inches. This gets gravity working to your advantage. (More pillows wont solve the problem because you need to elevate your torso.) You can also place 4-inch blocks under your headboards legs. Nailing jar caps to the blocks will keep the bed from slipping off. 6. Dont count on milk to coat your stomach. This old wives tale actually causes your stomach to make more acid. Many things stimulate acid production, including protein in milk and other foods. If youre counting on milk fat to soothe you, youll be disappointed. The stomachs water-soluble environment wont allow fat to physically coat the stomach. 7. Dont hesitate to seek medical help. Untreated GERD can lead to serious complications, such as bleeding, difficulty swallowing, obstruction of the esophagus, cancer, shortness of breath and throat hoarseness. Many heartburn sufferers need more than lifestyle changes for relief. Your doctor can recommend prescription or over-the-counter medications. If the first drug doesnt relieve your discomfort, dont give up. Many drugs can solve your problem, Hastings says. For more information, see your doctor and visit the Web sites of the American College of Gastroenterology and the National Heartburn Alliance. Whats Your Indigestion IQ? Far too many of us are familiar with the lingering discomforts associated with indigestion, heartburn, acid reflux, and other gastrointestinal issues. The good news is that you can take steps to prevent the unnecessary side effects brought on by certain behaviors. It's all about keeping your stomach happy. Do you know how? Take this indigestion quiz to find out. Check out Health Bistro for more healthy food for thought. See what Lifescript editors are talking about and get the skinny on latest news. Share it with your friends (its free to sign up!), and bookmark it so you dont miss a single juicy post! Talk to us on Facebook and Twitter! Copyright 1998 2009 www.LifeScript.com All rights reserved.

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12/16/2009